HYDERABAD, SINDH — Once a month, the tiny one-room thatched house of 27-year-old Salma and her husband, Shaukat, in the dusty village of Dost Mohammad Hajano becomes a makeshift immunisation centre. On a bright Friday morning in March during Ramadan, health worker Hamza Lakho arrived to find a small crowd already gathering outside.

Parents clutching orange vaccination cards filed into the cramped space — some balancing crying infants in their arms, others soothing restless toddlers — all carrying the quiet hope that a simple vaccine could protect their children's future.

Nearly 300 of the village's 2,000 residents are children under five — the group most vulnerable to vaccine-preventable diseases. Pakistan is among the ten countries that account for more than half of the world's "zero-dose children" (ZDC). In 2023, there were an estimated 396,000 ZDC and 925,000 un- and under vaccinated children in the country.

Across Hyderabad district's 163 union councils (UC is the smallest administrative unit of a district), the Sindh government is engaging with VITAL Pakistan Trust (VPT) to support immunisation services in three. The non-profit works to expand maternal and child healthcare in underserved parts of Sindh.

Dost Mohammad Hajano in UC 17 — a cluster of 45 villages with a population of over 65,000 — is just a 20-minute drive from Hyderabad, the province's second-largest city. Despite its proximity to the city, Dost Mohammad Hajano remains cut off from basic services. There is no school, no dispensary, no gas supply, and no electricity. Water must be fetched from a hand pump nearly a kilometre away.

Livelihoods are fragile. Shaukat works as a daily wage labourer earning about PKR 800 (USD2.86) a day. Nearly PKR 300 ($1.07) of that goes toward meals, tea and transport while he is at work. "The biggest setback for us is when our children fall sick and we have to take them to a health centre," said Subhai Amir Baksh, mother of three daughters.

Salma and Shaukat's commitment to hosting vaccination sessions is particularly striking given the tragedy they once faced: their three-year-old daughter died of measles despite being vaccinated. Their loss is far from unique. In 2025, Pakistan recorded more than 17,000 measles cases nationwide.

"I think vaccines are good for our children and will keep them healthy," said Shaukat. "What happened was God's will," said Salma. Even in grief, the couple continues opening their home each month so other families can protect their children.

Vaccinator Hamza Lakho has become a familiar trusted presence. Initially, only about 40 percent of children had completed routine vaccinations. VPT's Hyderabad field coordinator Aijaz Ali led awareness sessions and explained vaccination schedules. Within six months, inroads were made and the monthly sessions became well attended.

"It took time to build trust," Lakho added. "But now people understand we are here for the wellbeing of their children."

Health authorities have prioritized expanding immunisation coverage. They launched evening and weekend vaccination shifts, improved micro-planning, and set up medical camps in high-refusal areas. In supported zones, ZDC coverage rose to 99 percent from 82 percent and geographic coverage is now 100 percent.

Sindh introduced the Zindagi Mehfooz electronic immunisation registry, with smartphone apps, dashboards, SMS reminders, and call centre support. This means all children's vaccination histories are now digitized and remain available even if physical cards are lost.

From November 2025 to March 2026, not a single measles outbreak was reported in VPT-supported areas. Yet health workers caution that clean water, sanitation and hygiene awareness remain vital alongside vaccination. Next month, Salma and Shaukat's home will again fill with mothers and infants—quietly becoming their village's lifeline.