Pakistan

Government ministries use SystemSolving to develop data-backed health systems and fuel sustainable, locally owned progress. We have helped deliver historic gains in immunisation, safe childbirth, and health equity.

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full immunisation coverage nationally

81%

full immunisation coverage nationally

Between 2013 and 2026, the government raised national full immunisation coverage from 54% to 81%, with massive progress in areas like Sindh (29% to 75%), KP (53% to 72%), and Balochistan (16% to 57%), while Punjab rose from 66% and stabilised at 90%.

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point drop in under-five mortality

38

point drop in under-five mortality

Punjab health officials slashed child mortality from 93 to 55 deaths per 1,000 live births between 2014 and 2024.

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more safe births every year

350K

more safe births every year

Punjab medical teams expanded skilled birth attendance from 68% to 83%, securing critical care for newborns during their first moments of life.

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Spotlight Impact

The Government of Punjab converted 8am–2pm birth facilities into 24/7 care, enabling 350,000 more safe births annually – that’s more deliveries than the NHS handles in the UK each year.
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Our Insights

How Sindh turned urgency into better maternal care
How Sindh turned urgency into better maternal care

November 24, 2025

4 min read

When we began working with the Government of Sindh on maternal and newborn health, the challenges were daunting – overstretched facilities, unreliable…

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Punjab’s health revolution: how simple fixes saved thousands of lives
Punjab’s health revolution: how simple fixes saved thousands of lives

November 13, 2025

4 min read

When we began work in Punjab, Pakistan in 2014, one in eleven children died before their fifth birthday – far worse than in Punjab, India, where focus…

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The best innovation isn’t always tech. Often, it’s human.
The best innovation isn’t always tech. Often, it’s human.

August 28, 2025

2 min read

It makes sense to associate innovation with technology. But in the toughest settings, the most creative solutions are those that empower, recognise, a…

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Doing big things, fast: how scaling with urgency drives breakthroughs
Doing big things, fast: how scaling with urgency drives breakthroughs

July 18, 2025

3 min read

In March 2020, the world locked down overnight. No pilots. No randomised controlled trials. Just bold action in the face of uncertainty. Because the s…

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Delivery is a skill. And it can be learned.
Delivery is a skill. And it can be learned.

July 10, 2025

3 min read

In March 2024, Ethiopia launched its first single-dose HPV vaccine campaign. This was a huge first step for preventing cervical cancer in the country.…

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Too much data, too little insight: what governments need to improve health outcomes
Too much data, too little insight: what governments need to improve health outcomes

June 26, 2025

4 min read

In 2022, Dr. Azra Pechuho, Minister of Health in Sindh, Pakistan, reviewed data suggesting maternal health facilities across the province were functio…

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Building political commitment to deliver, sustain and scale change
Building political commitment to deliver, sustain and scale change

June 6, 2025

4 min read

Adversity doesn’t stop leaders. It reveals them. When systems are strained and budgets tight, political commitment makes the difference between well-i…

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How fuel cards are helping Pakistan’s vaccinators go further
How fuel cards are helping Pakistan’s vaccinators go further

April 29, 2025

2 min read

Low immunisation coverage in low- and middle-income countries is often the result of limited outreach vaccination capabilities. Often needed for the m…

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Combining rapid coverage assessments with demand surveys
Combining rapid coverage assessments with demand surveys

February 27, 2025

3 min read

Gathering data on low immunisation communities is an important first step to increasing vaccination coverage for citizens. Once immunisation coverage…

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Supporting citizens through flooding crises
Supporting citizens through flooding crises

August 20, 2024

2 min read

Citizens often face a wide variety of problems during flooding crises, but strong support from governments, NGOs and partners can overcome these chall…

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Improving labour services in low- and middle-income countries
Improving labour services in low- and middle-income countries

August 19, 2024

2 min read

Labour services have not always been up to the standards needed for expectant mothers, but significant improvements are being made in low- and middle-…

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Increasing investment in primary education
Increasing investment in primary education

July 10, 2024

3 min read

Investment in primary education is falling short of targets in many low- and middle-income countries (LMICs). But there are proven strategies to turn…

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Improving immunisation coverage through health worker accountability
Improving immunisation coverage through health worker accountability

June 17, 2024

2 min read

The vast majority of frontline staff work exceptionally hard. But governments require evidence of performance to address concerns. Accountability is i…

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Giving frontline health workers a stronger voice
Giving frontline health workers a stronger voice

June 14, 2024

2 min read

Some of the world’s best organisations are seeing positive change by letting frontline workers take the lead in suggesting and creating solutions. Und…

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Why incremental improvements are the pathway to change
Why incremental improvements are the pathway to change

June 11, 2024

2 min read

Governments and donors often want to address major health and education issues with one large policy adjustment. But it is the small, daily, improveme…

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Delivering sustainability in low- and middle-income countries
Delivering sustainability in low- and middle-income countries

June 10, 2024

3 min read

Many people agree that sustainability is the right path to follow, but delivering it is something else entirely. Sustainability is an important goal i…

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Reaching 20 million children in two weeks: learnings from Sindh, Pakistan
Reaching 20 million children in two weeks: learnings from Sindh, Pakistan

March 9, 2023

3 min read

The province of Sindh in Pakistan ran one of the largest Measles-Rubella (MR) vaccination campaigns, reaching around 20 million children in two weeks.…

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My new table: a first week at Acasus
My new table: a first week at Acasus

December 5, 2022

2 min read

Sue advises Acasus on technical issues in the health sector. September 14  Our founder, Fenton Whelan, invited me to an all-staff meeting in Duba…

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What routine immunisation can learn from mass vaccination campaigns
What routine immunisation can learn from mass vaccination campaigns

August 4, 2022

2 min read

Immunisation coverage in Balochistan stands at 38%, the lowest in Pakistan. The province faces unique challenges in increasing routine immunisation; i…

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Making data work for governments
Making data work for governments

April 5, 2022

2 min read

We summarise four challenges below and mention some of the best practices that can help partners and implementers overcome them. Reliance on self-repo…

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The gender gap in Covid-19 vaccination – and what to do about it
The gender gap in Covid-19 vaccination – and what to do about it

August 10, 2021

2 min read

A few weeks ago, Taimur Khan Jhagra, Health Minister and Finance Minister in Khyber Pakhtunkhwa, Pakistan, used his Twitter account to highlight gende…

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Our People

Hunain Mandvia

Hunain Mandvia

Project Director | Pakistan and Ethiopia

Hunain Mandvia serves as a Project Director at Acasus, overseeing the Pakistan and Ethiopia offices, which comprise approximately 80 team members spread across all…

Shaheryar Manzar

Shaheryar Manzar

Project Director | Pakistan

Shaheryar Manzar is a Project Director in Pakistan, specialising in improving primary health care delivery, with a strong focus on maternal and child health outcomes and…

Zubair Basra

Zubair Basra

Project Director | Pakistan

Zubair Basra is a Project Director in Pakistan. He leads strategic public health initiatives and oversees multidisciplinary teams to strengthen health care systems and…

WHAT WE DO

Our Work

Afghanistan

Afghanistan

Chad

Chad

DRC

DRC

Ethiopia

Ethiopia

Mozambique

Mozambique

Nigeria

Nigeria

Pakistan

Pakistan

Afghanistan

Afghanistan

Chad

Chad

DRC

DRC

Ethiopia

Ethiopia

Mozambique

Mozambique

Nigeria

Nigeria

Pakistan

Pakistan

Government Engagement & Reform

Government Engagement & Reform

Data, Technology, AI

Data, Technology, AI

Performance Management

Performance Management

Improving Last Mile Services

Improving Last Mile Services

Demand

Demand

Capacity Building & Transition

Capacity Building & Transition

Government Engagement & Reform

Government Engagement & Reform

Data, Technology, AI

Data, Technology, AI

Performance Management

Performance Management

Improving Last Mile Services

Improving Last Mile Services

Demand

Demand

Capacity Building & Transition

Capacity Building & Transition

MNCH

MNCH

Immunisation

Immunisation

Primary Health Care (PHC)

Primary Health Care (PHC)

Sexual and Reproductive Health Rights (SRHR)

Sexual and Reproductive Health Rights (SRHR)

Polio

Polio

Malaria

Malaria

Nutrition

Nutrition

Education

Education

MNCH

MNCH

Immunisation

Immunisation

Primary Health Care (PHC)

Primary Health Care (PHC)

Sexual and Reproductive Health Rights (SRHR)

Sexual and Reproductive Health Rights (SRHR)

Polio

Polio

Malaria

Malaria

Nutrition

Nutrition

Education

Education

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