Background of Work in Maternal Health
Overall, most of my work has centered around reproductive health. I have worked on initiatives related to reproductive health, family planning, nutrition, education programs, scholarship programs, and anemia-related interventions. Allah Wale Foundation has undertaken many welfare initiatives, and I will discuss some of those here.
I joined the development sector in 2005 and began working on a USAID-funded initiative called PAIMAN (Pakistan Initiative for Mothers and Newborns) in South Punjab. At that time, the maternal mortality ratio (MMR) was approximately 375 per 100,000 live births.
I helped design a project to identify pregnant women who had never visited a doctor or health care provider for treatment or antenatal checkups. Six urban union councils were selected, and female staff were recruited to conduct household visits. At the same time, maternal clinics run by private doctors in those areas were upgraded according to need assessments. This included providing stethoscopes, weighing scales, theatre lights, whitewashing walls, replacing broken furniture, and other clinic improvements along with capacity-building trainings.
The doctors were also trained by professors from Nishtar Medical College in safe maternal care practices, including emergency obstetric care, comprehensive care, and child healthcare. Pregnant women identified through the project were provided with vouchers for medical checkups, free medicines, and PKR 50/- for travel expenses. The full cost of delivery was sponsored. This project became known as the Voucher Scheme.
As a result of the intervention, 2,000 deliveries were sponsored in one year, and there was not a single maternal death. The long-term benefits included capacity-building of healthcare providers, increased confidence among families in visiting clinics, and improved maternal healthcare practices in the community. This was considered one of the most successful USAID interventions in our region because it combined provider training, financial subsidies, and transport allowances for patients.
Based on this success, we received similar projects in Jhang and DG Khan in the year 2008, which were critically underserved areas where there was little data on maternal and child deaths due to lack of services and awareness.
After PAIMAN, I joined another USAID-funded project called FALAH (Family Advancement for Life and Health) in the year 2009. In this project, we identified rural areas without healthcare services. We specifically targeted women who had completed nursing or Lady Health Visitor (LHV) qualifications but remained unemployed. These women were placed in large hospitals for 3-6 months to work under doctors and receive practical experience. We also trained them in business skills. Once they completed their training and received certification from supervising doctors, we established clinics for them in rural areas of Bahawalpur and Rajanpur.
In total, we opened sixty clinics. For women who were not permitted by their families to travel far, we established clinics near or inside their homes. We even included contractual agreements with parents stating that after marriage, the clinic would be relocated to the woman’s in-laws’ residence.
Eighteen years later, I met one of those LHVs in Multan. She told me that she had since opened her own hospital with a resident gynecologist. This project significantly strengthened healthcare services in rural areas, and many of the clinics remain sustainable today because they were designed as small business models. Learning that these initiatives still continue gives me great satisfaction.
From Maternal Health to Family Planning
After leaving Greenstar/Population Services International, I became involved with FPAP/IPPF (International Planned Parenthood Federation) in the year 2011. Keeping in view the gap in capacity-building training on sexual and reproductive health and family planning among institutional and private healthcare providers, and recognizing that these topics were not adequately taught in educational curricula, there was a need for a dedicated training institute. Prior to this, organizations usually depended on PWD and Greenstar for training. As a result, I established the Rahnuma Training Institute in Lahore. At the time, we were implementing a project in South Punjab with Care International. Their work plan included funds of PKR 20 Lakhs to upgrade a training facility. I had an office in Johar Town with several unused rooms that stored old hospital equipment, and I realized those funds could be utilized more effectively.
When the country director visited, she asked if I had any innovative ideas. I suggested creating a reproductive health training institute using the allocated funds. An engineer later prepared a bill of quantities after visiting institutions such as LUMS and Fatima Memorial Hospital, estimating the project cost at around PKR 2 Crores. I told the country director this amount was unrealistic, but she encouraged us to continue exploring the idea.
At the same time, a friend working with Merlin International, which later merged with Save the Children, called from Swat and asked whether we could conduct family planning training in Lahore for LHVs from Swat. I immediately agreed, even though at that moment we had no proper facility. I believed that once you commit to an objective, you find ways to achieve it.
Within three days, we arranged accommodation for the trainees, assembled a pool of trainers, coordinated with doctors, and organized the entire training setup. Around 120 to 130 women attended these trainings, many of whom were Pathan women.
During the second training batch, two researchers from Care International in the United States visited unexpectedly. They inspected the training rooms and the practical insertion technique labs. After observing the sessions, they told us that the training met international standards according to their global checklists. A few days later, they submitted their reports recommending the establishment of a formal training institute.
Alhamdulillah, the Rahnuma Training Institute was eventually established in the year 2012, and through it we have conducted trainings for many organizations. Although the primary focus is family planning, the institute also provides awareness or training for HIV/AIDs, Disaster management, Life Skills-Based Education (LSBE), data management, project management and broader sexual and reproductive health education.
The institute still exists today, and it gives me great satisfaction to know that it continues functioning. We also made the decision that organizational meetings and conferences should be held there instead of at expensive hotels. The facility was built to the standard of a three or four-star hotel and can accommodate twenty-five people at a time.
Joining Allah Wale Foundation
In the year 2020, I became close friends with the founder of Allah Wale Foundation (Mr Shahid Lone). At that time, he ran a simple Dastarkhawan (free food service) in Johar Town, Lahore, where around forty to fifty people would come daily to eat. In 2021, we met again at a seminar organized by the Punjab University, where all three of us were presenting. During our conversation, he told me that they mainly focused on malnutrition and feeding people.
Later, he approached me with concerns about Pakistan’s nutritional crisis and the high rates of child stunting. He asked whether I had read the most recent health and nutrition survey report. After reading it, I decided we needed to act.
We approached Lady Willingdon Hospital and discussed the idea with Dr Iqbal Hussain Sahib. He agreed to support the project if we provided food for 200 patients. We accepted, and that food support continues today at both Lady Willingdon Hospital and Lady Aitchison Hospital.
We designed a project using hospital records from the previous 3-4 years to identify women who had previously delivered stunted babies and were now pregnant again. After extensive record reviews, we identified 57 women. Two female nutritionists were then placed in the gynecology outpatient department to assess these women, provide supplements such as calcium and iron, and conduct regular telephonic counseling.
Out of the 57 women, 46 delivered healthy babies weighing above 3 kilograms, despite previously having low birth-weight children. This success motivated us to expand the initiative to additional hospitals including Jinnah, Lady Willingdon Hospital, Lady Aitchison Hospital, and Services Hospital.
At the time, I was still working voluntarily with Allah Wale Foundation while serving as Director of Family Planning elsewhere. Eventually, after retiring from the United Nations Population Fund in 2025, I joined Allah Wale Foundation full-time.
Today, the MAAMTA project- which stands for Maternal Anemia, Acute Malnutrition Treatment and Awareness, operates in 25 government hospitals across Pakistan, including the cities of Gilgit, Islamabad, Rawalpindi, Lahore, Faisalabad, Multan, Bahawalpur, Rahim Yar Khan, and DG Khan. Thirty-two female nutritionists are currently employed through the project. One of the things that gives me the greatest happiness is interviewing young women for these positions and seeing their passion and updated knowledge.
Child Feeding and Nutrition Programs
Over time, we identified that only around 30% of people use government healthcare facilities, while the majority rely on private clinics. Many of these smaller clinics are in very poor condition. Using the same model, we had previously applied in DG Khan, we upgraded six clinics in Green Town and assigned nutritionists to rotate among them. We also provided free medicines to reduce stunted births.
This intervention later became the subject of research conducted by the University of Veterinary and Animal Sciences due to its success. Another major initiative that we worked for was the Child Feeding Program, which began after Professor Tipu Sultan from Children’s Hospital requested charity support.
We established outpatient treatment rooms and placed trained staff there to treat children suffering from Severe Acute Malnutrition and Moderate Acute Malnutrition. The children are provided Ready-to-Use Therapeutic Food (RUTF), and many recover fully within 45 days. Some children arrive in near-fatal conditions and later recover completely.
We carefully document every child’s progress, and multiple universities are currently researching this program. The initiative now operates in hospitals in Lahore and Multan, including General and Services Hospitals. We also expanded into South Punjab through partnerships with private pediatricians in Rajanpur, Layyah, DG Khan, and Muzaffargarh.
We purchase RUTF from Ismail Industries Limited, which costs approximately PKR 82/- per sachet, and distribute around PKR 1 Crore worth of nutrition through this means annually. We are now establishing our own RUTF production facility in Lahore, which will reduce production costs significantly and allow us to expand services and provision further.
Anemia Free Pakistan
Our third major initiative is ‘Anemia Free Pakistan’. This project involves partnerships with 9 universities. We conduct blood screening using portable hemoglobin testing devices and provide nutrition counseling and free supplements where needed.
Participants are given three options- 1. purchase medicine independently; 2. receive free medicines from us; or 3. follow dietary interventions without medication.
We also work with media organizations such as City 42, where initially we found that 27 out of 88 female employees were anemic. Similarly, we partnered with government nursing and family welfare training institutes in Faisalabad, Multan, Sahiwal, and Lahore. After several months of intervention, all participating students became anemia-free.
These institutes later installed plaques declaring themselves “Anemia Free Institutes” and began independently screening future students using equipment we provided.
We also implemented a school-based intervention in Islamabad. In two schools of G-9 and G-5 sectors, we screened approximately 2,300 girls and identified 576 cases of anemia.
Because these were adolescent girls, we focused on nutritional interventions rather than medication. We provided Iranian black dates, lunches, and deworming treatments, while teachers ensured regular consumption of dates. Within four months, the girls showed major improvements in health and energy levels. In this way, we are committed to doable, cost-effective, and healthy interventions for women’s health.
School Meal Program and Educational Welfare
The flagship initiative of Allah Wale Foundation is the ‘School Meal Program’.
Every day, approximately 170,000 students receive meals through this program across eight cities in Pakistan. Government primary schools in Islamabad, Gilgit, Chilas, and Skardu are fully covered. The program also operates in Lahore, Faisalabad, Pishin in Balochistan, Karachi, and Peshawar.
We intentionally focus on primary schools because many children there come from highly marginalized backgrounds. Alongside meals, we introduced WASH (Water, Sanitation, and Hygiene) awareness, teaching children the importance of handwashing and healthy eating habits. The Foundation also renovated fifty schools run by the Punjab Education Foundation, improving infrastructure, washrooms, and furniture.
In 10 schools of Kasur, we have introduced kitchen gardening, so that children learn how to grow vegetables while also learning about their nutritional value.
Challenges and Limitations
One major challenge has been changing attitudes toward nutrition and addressing the lack of public awareness about nutrition. Most people only focus on filling their stomachs and do not understand nutritional value in Pakistan. Additionally, dietary preferences differ greatly across regions. Food accepted in one province may not be accepted elsewhere.
Then came aid programs that promoted biscuits as adequate nutrition. However, we argued that processed snacks could never replace nutritious meals. We worked with nutritionists and food technologists to develop meal plans providing 400-500 calories per serving.
Government bureaucracy has also created major delays. For example, there is delayed response from the government when NGOs want to support welfare work. Projects that should have been completed years earlier often remain stuck because of institutional inefficiency and corruption. At the same time, I have also encountered dedicated government officials who sincerely want to help.
For example, one federal secretary personally supported the expansion of our programs into Islamabad and ensured that agreements were finalized despite his transfer to another ministry. Similarly, in Gilgit, senior officials helped us establish the MAAMTA program and even assisted in recruiting local female nutritionists. So while corruption remains a major obstacle, there are also many committed individuals within the system.
Efforts for Inclusivity and Interfaith Harmony
Our Foundation is strongly committed to inclusivity and interfaith harmony. Before Easter, we distribute food packs to Christian communities, while during Ramadan we distribute support to all Muslims regardless of their sect. We organize interfaith Iftars in Lahore and invite Sikhs, Hindus, Sunnis, and Shias to participate together.
Unfortunately, we sometimes face resistance. For example, during interfaith Iftars near Wazir Khan Mosque, the mosque administration has repeatedly locked the gates, forcing us to hold the gatherings outside. Nevertheless, we continue these efforts because we believe welfare should serve everyone regardless of religious identity or social belonging.
One particularly meaningful initiative took place in Sundar Industrial Estate. Although thousands of women worked in factories nearby, they were excluded from community meal programs because factory management feared disturbances.
After discussions with administrators, we established a registration system allowing women laborers to safely access food services and return to their gated community with confirmed record. Today, around 500 women eat there daily.
Many of these women come from extremely marginalized communities. Meeting young girls already carrying heavy responsibilities at such an early age is both heartbreaking and eye-opening, reminding us how much work is still left for us to do collectively to ensure welfare for all.
Working in One Area of Welfare Leads to Branching Out
There are many welfare projects in the country that receive funding from international and local bodies, which serves as a strong incentive to work harder and direct resources where they are most needed. In fact, it is the commitment to the welfare of others that keeps me motivated in life!
Having worked in welfare for many years, people may think that I specialize only in maternal health and nutrition, but welfare workers also become aware of many other areas of deprivation that require support. For example, I became aware of the challenges related to low literacy and lack of specialization among youth. As a result, in 2011 I founded the Jinnah Executive Services Academy in Muslim Town, which prepares students for the CSS (Central Superior Services) examinations.
People gradually started helping through donations, and Shamsi Sahab oversees much of this work. More academies were later established in Multan, Rawalpindi, and Gilgit. Alhamdulillah, the Multan academy is now fully sustainable, while the Lahore academy is mainly funded by the Sheikh family of Narowal.
At present, with support from the Higher Education Commission, the Foundation is sponsoring 1,157 students studying medicine, engineering, and agriculture at government universities. Listening to the personal struggles of these students during scholarship interviews has deeply affected me. Many brilliant students come from extremely poor backgrounds and struggle even to afford food. We also organize two to three functions at Hali Masjid, Lahore, to encourage donors to sponsor children’s education.
As we worked across the communities of Pakistan and interacted with both healthcare providers and teachers of government schools, the latter started informing us of other preventive health challenges afflicting children, not just related to undernutrition. Many children in Pakistan have poor eyesight and refractive errors, which remains untreated.
In response, we launched a school vision program and eventually distributed over 16,000 eyeglasses. We also discovered that while around 17-18% of students had vision problems, nearly 80% of teachers also suffered from undiagnosed eyesight issues!
Allah Wale Foundation currently operates Khursheed Begum Hospital in Manga Mandi and AL Mustafa Maternity and General Hospital in Mansoora Bazaar, Multan Road, Lahore. A third hospital is under construction near Shaukat Khanum Hospital. It is planned as a ten-story diagnostic and healthcare facility that can provide services for MRI, CT scans, mammography, and laboratory services.
Welfare, Justice and an Autonomous Pakistan
If I had the opportunity to advise about welfare policy in Pakistan, I would focus on justice or “insaf for all”.
Pakistan does not lack resources. The real problem lies in unequal distribution and weak accountability. The National Finance Commission Award [1] should be reassessed according to actual population needs. More importantly, accountability must be strengthened at every level.
In my years of experience, I have found that there are four key commitments that are critically needed for meaningful and holistic social welfare development in Pakistan- 1. Programmatic Commitment; 2. Political Commitment; and 3. Financial Commitment; and, above all 4. Commitment to Accountability.
Unless accountability of state officers, providers, and governance leaders improves, Pakistan will continue facing decline. Citizens must also hold politicians accountable for their promises and performance for welfare development. Only then can meaningful change take place, with welfare justly distributed for all, as, when, and where it is needed!
Notes-
[1] The National Finance Commission Award is a constitutional mechanism in Pakistan under Article 160 of the Constitution, established every five years to dictate how national tax revenues are divided between the federal government (vertical distribution) and the four provinces (horizontal distribution).