KARACHI: In a sudden move that has drawn strong flak from the medical fraternity, the provincial health department has handed over all the remaining more than 700 basic health units (BHUs) across the province to Peoples Primary Healthcare (PPHI) initiative, a government-funded private organisation.
Sources said that, prior to the latest decision, the health department had gradually handed over 1,400 BHUs to PPHI over around two decades.
According to a health department letter dated June 30, 2026, all district health officers have been directed to hand over all medicines, medical equipment, supplies and other consumable and non-consumable inventory available at and for the primary healthcare facilities under their control to PPHI with effect from July 1, 2026.
Health dept transfers control of 700 BHUs to PPHI; PMA calls move worrisome
“You are, therefore, requested to ensure a complete inventory (consumables and non-consumables) is prepared and verified prior to handing over to PPHI. The transfer shall be carried out through a jointly signed handling/taking over report, duly documenting the quantity and condition of all medicines, equipment and other supplies handed over to PPHI Sindh. The joint report may be submitted at the DG Office at the earliest,” says the letter, a copy of which is available with Dawn.
Call for performance evaluation
Reacting to the development, Dr Abdul Ghafoor Shoro, representing the Pakistan Medical Association (PMA) Centre, said the decision was extremely worrisome as PPHI had been running the health facilities poorly 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 association, Dr Shoro pointed out, strongly questioned the rationale behind bypassing the established public healthcare infrastructure and outsourcing vital public assets to a private/semi-autonomous entity.
The general public and the medical fraternity, he noted, had the right to ask the health department to show the concrete success and measurable achievements of PPHI that justify handing over the entire primary healthcare network.
“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 PPHI has brought about any improvement in health indicators”, Dr Shoro said.
Criticising the decision, he further stated that the government should have sought an independent and critical review of PPHI’s performance before expanding its scope and operation.
In a statement, the PMA emphasised that placing a heavily burdened, already struggling healthcare system under “non-medical administrators compromises professional oversight, clinical priorities, and effective healthcare delivery”.
“Public health infrastructure is built with taxpayers’ money. Handing over public assets, equipment, and medicine procurement to an external entity without a clear, publicly accessible audit of their performance across the existing centres raises serious governance questions,” it says.
It also highlights that PPHI is already facing allegations regarding workplace security and hostile environments for female medical staff, especially in rural areas of Sindh.
“The recent tragic and shocking suicide of a health worker in Tharparkar highlights the immense, unaddressed psychological distress and lack of administrative protection faced by healthcare professionals operating under their management.
“The sudden shifting of administrative control jeopardises the job security, service structures, and professional dignity of public sector doctors, paramedics, and support staff who have been serving at these facilities for years,” the association stated.
It regretted that instead of building the capacity of the government’s own health department and district management, the provincial administration was consistently outsourcing its core responsibilities, showing a lack of confidence in its own institutional mechanisms.
‘Latest decision based on PPHI’s positive performance’
Responding to the concerns, PPHI CEO Javed Ali Jagirani, former deputy commissioner Qamber-Shahdadkot, said the health department “carried out monthly performance evaluations of PPHI and that its latest decision was based on the organisation’s positive performance”.
“Over the past 19 years, a total of 1,468 health units have been handed over to the organisation. Now, the remaining 730 facilities have also been given to PPHI. This reflects its good performance.”
Regarding improvements in health indicators, he said PPHI did not run the entire healthcare system in the province, and there were many private practitioners and private health facilities.
“We are also not involved in immunisation. Over the years, we have been able to increase the number of deliveries at hospitals, reduce stunting among children and raise outpatient numbers.
“Over 400,00 deliveries are annually reported at our centres, and the number of outpatient department (OPD) patients has risen from 25m to 45m in three years. There has been a six per cent decline in stunting across Sindh under a project that we are carrying out with the support of partner organisations.”
According to him, the government’s budgetary allocations stand around Rs16 billion.
About the allegations of harassment, he said an “inquiry was conducted into the Tharparkar case, but no person was found guilty”. He added that “even then, we transferred the staff against whom allegations were raised”.
About his conviction in a graft reference in 2021, Mr Jagirani said the decision was set aside by the Sindh High Court a year later.
Published in Dawn, July 5th, 2026