Sindh health minister advocates sustainable expansion of EPHS

KARACHI: Sindh Health Minister, Dr. Azra Fazal Pechuho, has called for scaling up the Essential Package of Health Services (EPHS) model beyond Tando Allahyar. She said that sustainability should be built into the programme from the outset. She expressed these views while addressing a province-wide symposium convened by the Aga Khan University (AKU) in partnership with the Sindh Department of Health and the People’s Primary Healthcare Initiative (PPHI). The symposium, which took place at the AKU on Tuesday, was supported by the Gates Foundation to mark two years of implementing of the EPHS in Tando Allahyar district. “I hope this implementation is not limited to Tando Allahyar alone. Obviously, we want a scalable and sustainable model because too often, once an intervention ends and the people driving it move out of a district, things fall through the cracks. That is exactly what we want to avoid. Sustainability has to be built in from the start, ” she said. The event brought together government officials, development partners and frontline health workers to review progress and discuss scaling the model across rural districts of Sindh. Representatives from 13 districts of Sindh attended the event. Tando Allahyar, home to nearly one million people, with 78 percent of its population living in rural areas, has served as the pilot district for EPHS, a 62-intervention package of care delivered across community, primary and first-level hospital settings. Since the programme’s launch, the district became the first in Sindh to roll out daily digital health reporting through DHIS2 and EMR, opened a Specialized Care Nursery at the District Headquarters (DHQ) Hospital, trained nearly 500 Lady Health Workers on clinical guidelines, and introduced general anesthesia services at the DHQ Tando Allahyar for the first time in the hospital’s history. More than 55 health facility staff have been trained on digital reporting, with progressively more of the district’s 55 facilities now actively reporting in real time. At the DHQ Hospital, the new Specialized Care Nursery, staffed by nine specially trained doctors, nurses and technicians, has added newborn intensive care capability that did not previously exist in the district. Surgical services have also expanded, with almost 30 percent of procedures now carried out under general anesthesia. These services were not previously available in the district. The symposium’s technical sessions covered the development of clinical guidelines across all 62 EPHS interventions, translated into Urdu, English and Sindhi, as well as costing analysis and provider behaviour-change initiatives. Speakers noted that the district’s Public Financial Management training and Service Coverage Index surveys have laid the groundwork for accountable, evidence-based scale-up to other districts in Sindh. According to Prof. Dr. Sameen Siddiqi of the Department of Community Health Sciences, AKU, “Over the past two years we had multiple learnings with regards to training and capacity enhancement, information system digitization, community engagement, and costing of services that can guide how EPHS can be implemented elsewhere in Sindh and in Pakistan. This serves as a model of how stakeholders can work together to close persistent gaps in essential care and lay down the path for Universal Health Coverage. ” The symposium also featured remarks from Dr. David Wilson from the Gates Foundation and Javed Jagirani, CEO of PPHI Sindh, alongside representatives from UNICEF, WHO, the World Bank, US State Department and Sindh’s Department of Health. Copyright Business Recorder, 2026

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