Health System in Azad Jammu and Kashmir
One of the defining aspects of the twenty-first century state is not merely sustaining infrastructure or borders but ensuring the well-being of its citizens. Healthcare is more than treatment; it is...
One of the defining aspects of the twenty-first century state is not merely sustaining infrastructure or borders but ensuring the well-being of its citizens. Healthcare is more than treatment; it is trust, legitimacy, and resilience. With a population of 2.45 million, Azad Jammu and Kashmir (AJK) has established a system that stands as a model in South Asia. In sharp contrast, Indian Illegally Occupied Jammu and Kashmir (IIOJK), with over 12.5 million people and greater resources, demonstrates chronic underinvestment and inequity. This is not only a medical comparison but also a political one: AJK shows how governance can translate into credibility and social power.
AJK’s healthcare network reflects deliberate planning. For its 2.45 million citizens, it has 8 large hospitals, 275 Basic Health Units (BHUs), 17 District and Tehsil Headquarters hospitals (DHQs + THQs), and 318 auxiliary centers. This stratified system ensures access to primary, secondary, and tertiary care in both urban and rural areas. By comparison, IIOJK, with a population five times larger, operates only 11 major hospitals and 41 DHQs + THQs. This reveals a vital truth: healthcare strength lies not in size, but in vision. AJK makes care accessible to all, while patients in IIOJK often travel miles for even the simplest treatment.
Human resources are the backbone of any system. AJK employs 12,542 medical personnel, including 1,058 doctors, 187 newly graduated and 230 in postgraduate training, ensuring both present capacity and future skills. The doctor-patient ratio in AJK is 1:4205, with even distribution across urban and rural regions. In IIOJK, the reported 1:2660 ratio looks stronger on paper but is misleading; most doctors remain clustered in cities, leaving rural areas underserved. AJK’s equity-based distribution highlights fairness as state policy, which makes the system stronger.
Another feature that makes AJK stand out is the incorporation of special medical centers into its public system. State-assisted institutions treat around 1.18 million patients annually, an extraordinary figure for a population of only 2.45 million. This collaboration reduces pressure on civilian hospitals, ensures universal access, and strengthens resilience during disasters, epidemics, or emergencies. IIOJK lacks such integration; its healthcare remains fragmented and politicized, weakening both efficiency and readiness.
The difference is also highlighted by the availability of hospital beds. AJK has 0.8 beds per 1000 people (above Punjab 0.46 beds), Sindh (0.38 beds) and Balochistan and Khyber Pakhtunkhwa (0.57 beds each). World health organization (WHO) suggests 1 bed per 1000 population, and AJK is closer to this international standard. IIOJK, though having a greater number of population base, has only 0.62 beds per 1,000. The increase in the ratio of AJK indicates its efficiency in its integrated network whereby its resources are centralized and operated to ensure maximum coverage.
Another area AJK has been doing well is in preventive care. Having 275 BHUs and 318 auxiliary facilities, even remote valleys can get the necessary services like immunizations, care of maternity, and early disease diagnosis. This decentralization allows bigger hospitals to be not overwhelmed with unnecessary cases. IIOJK however, depends on a centralized and urban-centric model, which exposes people of the rural areas. The case of AJK illustrates that resilience is developed on a ground level, and that prophylaxis is the real challenge of the modern rule of governance.
Even within Pakistan, AJK holds a strong position. Its per capita medical staff is higher than Punjab and Sindh, and its hospital bed capacity ranks among the best in the federation. Where larger provinces struggle with urban bias and patient overload, AJK provides a balanced solution. Against IIOJK, the difference is starker: fewer hospitals, weaker outreach, and politicized governance have left the occupied territory permanently disadvantaged.
AJK proves that state legitimacy is rooted in vision, not scale. Its infrastructure, skilled workforce, and institutional collaboration have produced an inclusive, efficient, and sustainable system. With indicators closer to international standards than many larger regions, AJK not only outperforms IIOJK but also sets an example for Pakistan’s provinces.
In a world where disparities in healthcare continue to grow, AJK stands out. Modest in geography and population, yet strong in commitment, it demonstrates how governance rooted in equity and planning can secure dignity and well-being for all. This is not only a local success but also a political statement: a state that prioritizes healthcare earns the trust of its citizens and the respect of the world.
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