A Lady Health Worker conducting outreach work in Karachi West.
Since 2022, The Challenge Initiative (TCI) has partnered with the People’s Primary Healthcare Initiative (PPHI) Sindh across four districts in Karachi, Pakistan: Karachi West, Karachi East, Keamari, and Malir.
Established by the Government of Sindh in 2007, PPHI is a not-for-profit organization created to revitalize primary healthcare services across 26 districts, with an initial focus on rural and underserved communities. Over time, PPHI’s mandate has expanded beyond rural areas to include management of government health facilities in urban settings, including Karachi. In 2025, that expansion continued as PPHI took over 17 facilities across Karachi West, Karachi East, and Keamari.
Recently, Aziza Burfat, TCI’s Geography Portfolio Manager, noticed missing data on the Contraceptive Logistics Management Information System (cLMIS), the primary platform for recording and managing family planning data and stock. The system showed no client numbers, stock levels, or reported services. A closer look revealed data for the first quarter of 2026 had not been entered into the system, raising immediate concerns about service delivery and stock management.
Aziza raised the issue with Dr. Shazia Zeeshan, PPHI’s regional manager, and together they launched an investigation. The gap, they found, traced back to a password change at the district level following staff transfers: the employee previously responsible for managing cLMIS data had moved on, and the newly appointed staff member handling data entry and stock issuance had not yet been granted system access. With health facilities at risk of stock-outs if the issue wasn’t resolved quickly, Aziza and Dr. Shazia worked with Ahmad Shabbir, store manager, to conduct a rapid assessment of other possible causes.
Recognizing the urgency, Zafar Dehraj, TCI Sindh’s Provincial Lead, escalated the issue to the provincial level. His advocacy brought in Shah Faisal Zahir, Director of CTL at the Population Welfare Department, who moved quickly to help resolve it. Once access was restored, the team entered the full backlog of data, revealing 5,294 clients that had been missing from the system. This allowed for timely reporting and prevented stock-outs, keeping family planning services running without interruption.
This experience was more than a technical fix. It showed the power of teamwork, responsiveness, and strong collaboration between government departments and TCI – from identifying the problem at the district level, to advocating for it provincially, to national-level system support.
Ultimately, this story shows how effective coordination and shared commitment can turn a routine operational challenge into an opportunity to strengthen both systems and partnerships.
