Victory for Pakistan’s Lady Health Workers: Sindh Government Reverses Privatisation Plan

Spontaneous cries of jubilation rang through the summer night on 12 June as sisters of the All-Lady Health Workers Program Union (ALPU) received official confirmation from the Government of Sindh Province, Pakistan, that it is withdrawing alleged plans to privatise the Lady Health Workers (LHW) programme.

Thousands of lady health workers had earlier that same day converged from across all corners of Sindh and commenced a sit-in protest in front of the Provincial Assembly in Karachi. The protest was led by sister Bushra Arain, ALPU Chairperson, alongside union leaders and supporters—just one day before the provincial budget was scheduled to be tabled.

Despite a heavy police presence, the peaceful protesters remained united with a clear message of “No Budget Without Our Rights!”, and presented five key demands in response to the structural and administrative threats they had publicly flagged a month earlier:

1. Implementation of the Supreme Court’s ruling to regularise all LHWs.
2. Conversion of the LHW programme into a permanent government department.
3. Service structure, pensions, and grade-wise salary scales as per law.
4. Recognition of 14+ years of service for seniority and retirement benefits.
5. Issuance of seniority and regularisation letters for over 31,000 LHWs and support staff.

The most alarming of ALPU’s concerns was the potential privatisation of the programme.

Taken aback by the scale and unity of the protest, representatives of the Health Department engaged in urgent dialogue with ALPU leaders. The successful negotiations resulted in a Health Department proclamation affirming that there are “no any (sic) plan to privatize the Sindh Lady Health Workers Program under consideration.”

Sister Bushra Arain, Chairperson of ALPU, exclaimed:

“We came to the Sindh Assembly because our voices were being ignored. We will not let the rights of women health workers be trampled in the name of administrative decisions. This is not just our victory—it’s a win for every woman in Pakistan who stands up for her dignity and labour rights.”

She added: “We are very grateful to the support from the UNI Asia & Pacific. Through their network, we exchanged experiences with other sister unions, learnt to strategise campaign plans, and strengthened our capacity for organising and training. We also received tremendous encouragement and solidarity from UNI Pakistan Liaison Council (UNI PALC) and community health workers community throughout this critical campaign.”

The ALPU win in Sindh is significant as the province is the third largest by land size in Pakistan and, with a population of 55 million, the second most populous after Punjab. Any dismantling of the Lady Health Workers programme would disrupt essential healthcare services to millions and threaten the livelihoods of more than 31,000 LHWs and support staff across the province.

UNI Asia & Pacific Regional Secretary Rajendra Acharya said: “Inspiring! Not symbolic! This hard-earned victory to protect essential community health and care infrastructure in Pakistan reaffirms the transformative power of organised labour, led by women. We are all very proud of our sisters!”

The union has pledged to remain vigilant and to monitor the implementation of their broader demands with respect to pension restoration, structural appointments, and recruitment.

Background

The UNI Asia & Pacific Regional Organization in the beginning of 2025 launched a network to strengthen the Community Health Workers (CHW) movement across South Asia. The initiative, backed by the SAGE Fund, has helped build the confidence and capacity of CHW unions in the region—including in Pakistan. On 7 May 2025, the ALPU held a press conference at the Karachi Press Club that raised the alarm on several pressing issues:

• Denial of pensions for retired LHWs with more than 10 years of service.
• Abolition of 19 essential technical posts, undermining decades of field-based structure.
• Irregular recruitment processes leading to unfilled positions.
• Abrupt financial mismanagement by shifting the programme back to development budget mode.
• A technical working group recommendation to privatise the programme via outsourcing to People’s Primary Healthcare Initiatives (PPHI).