KARACHI: A public-private child health initiative launched in the city’s urban slums over two years ago has seen significant improvements in the nutrition and immunisation status of children, presenting a roadmap for scaling up the model in other parts of the province, officials associated with the project shared on 27th May.
Funded by the Gates Foundation, the project is made possible through a collaboration between the Expanded Programme on Immunisation (EPI), the provincial health department, Aga Khan University (AKU) and local communities.
According to officials, children who once faced the dual threats of vaccine-preventable diseases and malnutrition are now being reached by the Engaging Private Providers for Immunisation-Integrated Services project — an innovative initiative that blends routine immunisation and nutrition services.
In 2022, the project was born out of necessity. A rapid increase in the mobile and migrant population in Karachi led to the expansion of densely populated, underserved slum areas with limited access to healthcare — especially preventive services such as routine childhood vaccination.
In 10 “high-risk” and five “super high-risk” union councils designated by the Pakistan Polio Programme across three Karachi districts — where healthcare access was scarce and trust in the system low — families struggled to protect their children. These included four union councils in District East, one in Malir and 10 in District West.
However, by December 2024, the numbers told a new story: 144,563 children under two had been vaccinated, 68,861 screened for malnutrition and there was a 76 per cent drop in zero-dose children.
Dr Zahid Memon, associate professor in the Community Health Sciences Department at AKU and Project Lead, believes that, “This initiative proves that when the public and private sectors unite with communities, we can dismantle barriers to healthcare. By integrating immunisation and nutrition services, we’re building a resilient health ecosystem.”
According to AKU officials, the project’s success hinged on its dual approach. On one front, 33 service centres brought care closer to home, with extended hours and trained private providers ensuring quality. On the other, local women — trusted voices in their neighbourhoods — became champions for sharing information about immunisation and dispelling myths. Digital campaigns and WhatsApp broadcasts amplified the message, delivering EPI information to caregivers.
Nutrition services were also part of this effort, casting a lifeline for families. Screenings identified 4,629 moderately malnourished and 1,593 severely malnourished children. Through timely interventions, 568 children reached a healthy weight and 177 improved from severe to moderate malnutrition.
Commenting on the project’s success, Sindh Health Minister Dr Azra Pechuho said, “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.”
At the recent primary healthcare symposium at AKU, Dr Mukhtar Bharat, Minister of State for National Health Services Regulations and Coordination, referred to the project and praised partners such as the Gates Foundation for their technical assistance and innovations in strengthening health systems.
“The health sector cannot [alone] resolve the challenges it is facing. There is a need for multi-sectoral collaboration to address the determinants of health, for which multi-sectoral policies must be implemented,” he said.
The project’s lessons are now part of Sindh’s Provincial and National Immunisation Strategies (2025–2030), offering a roadmap to scale the model. For Karachi’s families living in urban slums, it is more than policy — it is a promise that their children’s health matters.
Published in Dawn, May 28th, 2025
