• Experts ask what benefit PPHI has brought to healthcare in past 20 years that justifies the transfer
• Questions raised over PPHI’s non-medical personnel running health facilities ‘poorly’
• Young Doctors body strongly opposes the ‘new arrangement’

KARACHI: Rejecting government claims regarding the People’s Primary Healthcare Initiative (PPHI), representatives of medical bodies have once again strongly opposed the transfer of all basic health units (BHUs) across the province to the PPHI, while raising questions with the government about setting up a “parallel healthcare system” in Sindh.

Sources said that healthcare providers in different parts of the province had been holding protests against the government move to hand over the BHUs to the PPHI, which they see as a direct threat to their employment.

“We strongly oppose this move and plan to hold a press conference on this issue soon,” said Dr Farrukh Rauf representing the Young Doctors Association Sindh, adding that the government had deprived doctors of employment opportunities by handing over the BHUs to a private body.

“Each BHU has seats for healthcare providers including doctors. The government has done grave injustice by privatising the healthcare system,” he claimed.

Dr Abdul Ghafoor Shoro, representing the Pakistan Medical Association (PMA) Centre, said his organisation had already registered its strong reservation over the move.

“The PPHI has been running the health facilities poorly and that, too, under the leadership of non-medical personnel at the provincial and district levels.

“Primary healthcare is the backbone of the medical delivery system, serving the most vulnerable segments of society. Decisions of this magnitude should not be taken in isolation through bureaucratic directives without taking key stakeholders, including the medical leadership and representative bodies, into confidence,” he said.

The PMA, Dr Shoro pointed out, strongly questioned the rationale behind bypassing the established public healthcare infrastructure and outsourcing the vital public assets to a private/semi-autonomous entity.

The general public and the medical fraternity, he noted, have the right to ask the health department to show the concrete success and measurable achievements of the PPHI that justify handing over the entire primary healthcare network to the PPHI.

“The PPHI Sindh has been operational for around two decades and already manages an extensive network of government health facilities across the province. We want to ask whether the PPHI has brought about any improvement in health indicators,” Dr Shoro asked.

It might be recalled that the health department had gradually handed over 1,400 BHUs to the PPHI over around two decades. Over two months back, it transferred the remaining 700 plus BHUs to the PPHI.

PPHI already running 1,400 health facilities

A spokesperson of the health department has termed “the claims that BHUs are being privatised as entirely incorrect and misleading”. “The PPHI is already managing around 1,400 healthcare facilities in Sindh; the remaining primary facilities have been transferred to the PPHI for uniformity of quality services.”

The spokesperson categorically stated that the arrangement does not constitute privatisation.

“The PPHI is a not-for-profit company established under Section 42 of the Companies Act, 2017. It is fully owned and funded by the Sindh government and is neither a private-sector entity nor a public-private partnership.”

According to him, the members of the company, its board of directors and chief executive officer are appointed by the government.

“Its policies, management structure and use of public funds remain subject to the applicable legal, regulatory, audit and accountability requirements.”

The spokesperson explained that the operation through the Section 42 provided greater administrative and operational flexibility.

“It enables the PPHI to recruit personnel on a contractual basis and manage healthcare facilities more efficiently, while government funding is provided through single-line grants. This arrangement is designed to facilitate timely decision-making, strengthen institutional management and ensure the effective utilisation of public resources.”

The spokesperson claimed that the transfer of BHUs to the PPHI would have no adverse effect on the employment status, salaries or existing service rights of employees working at these health facilities.

“There have been complaints (against the health department), which forced the government to come up with an improved system,” the spokesperson said, when asked about the rationale behind setting up a parallel system of healthcare.

“The purpose of the arrangement is to improve management and service delivery, not to alter the legitimate rights and benefits of serving employees.”

Published in Dawn, September 13th, 2026