Maternal Healthcare in Machar Colony

Project Overview

ADP is funding the expansion of a health clinic in Machar Colony, Karachi. Machar Colony remains one of the most underdeveloped areas of Karachi and is the city’s second largest urban slum. The area spans roughly 5 square kilometers and houses more than 700,000 people. Deplorable living conditions and lack of clean water and proper sanitation make the community vulnerable to high rates of water borne and respiratory illnesses.

Due to low income levels, the residents of Machar Colony are unable to afford basic healthcare in neighboring hospitals. They are also often at the receiving end of discriminatory treatment by hospital staff because they are of Pathan, Bengali, Burmese and Afghani origin. As a result, many do not visit hospitals even under critical conditions. In addition, many community women practice strict Pardah which makes it difficult for them to commute to hospitals and clinics outside of the colony.

ADP’s grant involves funding the expansion of and adding services to an existing clinic; the Mother Child Healthcare (MCH) clinic being operated by an NGO called Concern for Children (CFC) for the last 13 years. Currently, the MCH clinic only has one large room for out-patients, two small rooms for family planning services and a reception/waiting area. However, with 900-1,200 patients visiting the clinic per month, the clinic is struggling to operate with its limited space and lack of equipment.

CFC has the opportunity to double the size of the facility by expanding into the clinic’s adjacent plot of land. With this expansion, they will be able to occupy larger rooms, provide privacy to patients and install additional restrooms. In terms of patient care, the installation of important equipment like an X-ray and an ECG machine will improve diagnosis as well as the treatment provided.

Partner Profile

Concern for Children Trust (CFC) is a non profit, non government organization that was founded in 1997. CFC’s mission is to design, implement and replicate models for sustainable development for women and their children within at-risk populations. All CFC’s projects contain elements of awareness raising, capacity building, service provision, advocacy and monitoring. CFC’s largest project is the Community Driven Development Project (CDDP) in Machar Colony, Karachi. CDDP is a holistic approach to community development and includes programs in health, education and the environment.

CFC is deep rooted in Machar Colony. They have been providing their services there for 13 years and have developed a trusted bind with the locals. Machar colony houses over 700,000 individuals. The residents’ illegal settlement is used as an excuse by the government to not provide basic necessities like water, sanitation, education and healthcare to the community. CFC provides them with basic health facilities for women and children regardless of their background.

For further details on their programs, please consult their web site:

Key Metrics

ADP will track the number of patients that seek care at the MCH clinic. Though not a measure of success, doubling the clinic’s size will allow the staff to treat each patient with improved quality of care which may attract more patients.

Also, given that a significant amount of funds is being used to purchase an X-ray and ECG machine, ADP will track the number of patients that are treated with the new equipment. CFC estimates that roughly 10% of its patients need to be treated with such equipment.

Investment Rationale

ADP is excited at the opportunity to help expand a clinic that an impoverished community relies upon. CFC’s long standing presence and successful implementation of multiple projects points to its commitment towards helping the community. Most importantly, it has become very apparent that the surrounding Machar Colony residents trust CFC and its clinic.

A key differentiating factor of the MCH clinic with others in the area is that both of its full time staff are female. The primary physician has completed her MBBS, passed 1st division with distinction in Obstetrics and Gynecology (OBGYN) from Sindh Medical College. The lady health volunteer is a registered nurse.



Is ADP comfortable funding a project in what is technically considered an “illegal settlement”?

Amar Guriro, a Karachi-based environmental journalist and a Water Aid Fellow, has named Machar Colony “The town of miracles.” Explaining what he means by this, he says, “surviving here is only possible by the appearance of small miracles.”

Machar Colony is built on land reclaimed by the sea. In the past decade, the area has become the second largest slum in Karachi and a home to over 700,000 people. The slum is still considered an illegal settlement and the inhabitants have not been provided with much assistance by the government in terms of infrastructure development.

Witnessing the extremely difficult living conditions within the Colony, CFC (along with some other NGOs) has been playing an admirable role in providing support to the residents and ADP is very excited to be able to enhance CFC’s capacity to do so. ADP firmly believes that in light of the appalling living conditions in the area, the need for this particular project is very high.

Do the patients receive free healthcare?  If not, how much do they pay?

Patients are charged Rs. 20 for their first visit to the clinic as a registration fee.  Thereafter, visits are free.

If medicines are required, branded medicines are provided at a flat rate of Rs. 40. Visits requiring either the X-ray or ECG machines will be charged extra costing patients Rs. 100.

These fees are nominal, however, and affordable by the community.

How does the clinic operate with low fees and subsidized sales of branded medicines?

CFC was formed as an initiative by the Managing Director of GlaxoSmithKline (GSK), Pakistan. CFC therefore receives strong support from GSK.  Roughly 50% of its operations are funded by GSK (the remaining funding is provided by other donors) and medicines are provided to the clinic free of cost by GSK.

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  • As part of the project due diligence, Meherunissa Hamid visited the Mother Child Healthcare clinic in Machar Colony during April 2013. A detailed account of her site visit is available at

  • 02/15/2013
  • See Meherunissa Hamid’s account of her site visit to Machar Colony last year, as part of the project due diligence:

  • 01/10/2013
  • Thanks to support from kind donors, women and children will be provided better treatment at the Clinic, eventually reducing the risk of life-threatening diseases. Construction for the expansion of the Clinic has already started and will be complete in February 2013. Once the expansion is complete, ADP will fund the purchase of equipment for the clinic as well.

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Type: Health
Cost: 12,160

Location: Mohammadi Machar Colony, Karachi
Launched: August 2012