Karachi: In the bustling yet often neglected urban slums of Karachi, a quiet revolution in child health is underway. Children once vulnerable to vaccine-preventable diseases and malnutrition are now receiving critical care through the Engaging Private Providers for Immunization-Integrated Services project. Funded by the Gates Foundation, this groundbreaking initiative integrates routine immunization with nutrition services through a unique public-private collaboration involving the Expanded Program on Immunization (EPI) Pakistan, the Government of Sindh Health Department, Aga Khan University (AKU), and local communities.
Launched in 2022, the project emerged as a response to a growing crisis. Karachi’s rapid population growth—driven by internal migration and increasing numbers of mobile communities—has created densely populated slum areas with little to no access to preventive healthcare, especially for children.
Focusing on 15 Union Councils—10 high-risk and 5 super high-risk as identified by the Pakistan Polio Program—across three districts, the project has filled a critical gap. These include four UCs in District East, one in Malir, and ten in District West. In areas where trust in health systems was fragile and access scarce, families struggled to safeguard their children. But by December 2024, the data told a powerful new story:
- 144,563 children under the age of two were vaccinated
- 68,861 children were screened for malnutrition
- 76% reduction in zero-dose children
Behind these numbers are countless human stories: a mother no longer fearing measles, a child gaining strength after nutrition treatment, and communities beginning to trust the health system again.
The project’s strength lies in its dual strategy. On one side, 33 service centers were established closer to communities, offering extended hours and staffed by trained private healthcare providers to ensure quality service. On the other side, local women were engaged as community champions—trusted voices spreading awareness about immunization, addressing misinformation, and fostering acceptance. Digital campaigns and WhatsApp broadcasts played a pivotal role in reaching caregivers with timely EPI information.
Nutrition services were integral to the approach.
Among those screened:
- 4,629 children were found moderately malnourished
- 1,593 were severely malnourished
- 568 children recovered to a healthy weight
- 177 improved from severe to moderate malnutrition
Dr. Azra Pechuho, Sindh’s Health Minister, expressed optimism about the project’s future:
"We hope to expand these efforts beyond Karachi to the rest of Sindh. Karachi was meant to serve as a pilot to generate data that could inform scale-up across other districts.”
Dr. Zahid Memon, Associate Professor at AKU’s Community Health Sciences Department and the project lead, highlighted the value of cross-sector collaboration:
“This initiative proves that when the public and private sectors unite with communities, we can dismantle barriers to health care. By integrating immunization and nutrition services, we’re building a resilient health ecosystem.”
At the Primary Health Care Symposium held at AKU, Dr. Mukhtar Bharat, Minister of State for National Health Services, praised the initiative and the Gates Foundation:
“The health sector alone cannot resolve the challenges it faces. We need multi-sectoral collaboration to address the broader determinants of health. For this, multi-sectoral policies must be implemented.”
As a testament to its success, the project’s framework and lessons have been incorporated into the Provincial and National Immunization Strategies (2025–2030), providing a roadmap for broader implementation. For families in Karachi’s underserved neighborhoods, this is more than a pilot project—it’s a promise that their children's health and future matter.
Districts and Union Councils Covered by the Project:
District Union Councils
East:
Gulzar-e-Hijri, Safoora, Pehlwan Goth, Gujro 04
Malir Malir Cantt
West:
Qasba Colony, Frontier Colony, Baloch Goth, Maymarabad, Yousuf Goth, Chishti Nagar 07, Islamia Colony 09, Mangophir 08, Songal 05, Mominaba
