Iron and folic acid deficiency is a significant public health concern, especially in low and middle‐income countries, particularly among women of reproductive age, leading to adverse maternal and child health outcomes. In Pakistan, approximately 41.7% of women of reproductive age have iron deficiency. For this research, we conducted 33 key informant interviews and 32 focus group discussions with stakeholders from all four provinces and the two federally administered regions of Pakistan for in‐depth and representative bottleneck assessment. The modified Tanahashi model was used to inform the determinant codes and for coding reliability thematic analysis using NVivo 14. On the supply side, barriers relate to effective forecasting, procurement, and distribution of Iron Folic Acid supplements to the recipients. The demand–supply gap widened due to the supply bottlenecks, impacting the community's trust in the frontline health worker. These factors were gravely impacted by the governance challenges of ensuring sustainable funds, minimizing bureaucratic and procedural delays, and eliminating political pressure. Affordability of Iron Folic Acid and conservative social norms influenced the demand and awareness of Iron Folic Acid and nutritional knowledge among the target population. The stakeholder recommendations emphasize the need for intersectoral collaboration, mass media campaigns, frequent capacity building and incentivizing of healthcare workers, engagement of key community stakeholders, digitizing the health system, improvement in supply chain mechanism, and investment in small‐scale innovative solutions.

Background: Routine immunization programs in Pakistan rely heavily on estimated population denominators, limiting accurate identification and follow-up of zero-dose and under-immunized children, particularly in high-risk urban settings such as Quetta, Balochistan. Methods: A quasi-experimental, pre–post implementation study was conducted from June 2024 to June 2025 across three low-performing union councils. A CHW-based household tracking tool was integrated within existing PEI–EPI systems. Data were derived from CHW Books, Rapid Convenience Assessments (RCA), and routine MIS reports. Descriptive statistical analysis was employed to assess trends in immunization coverage and program performance; no inferential statistical tests were applied due to the use of complete programmatic (census-based) data rather than sampled observations. Results: Antigen-specific coverage improved substantially, with Penta-3 coverage increasing from 22% to 95%, zero-dose conversion from 45% to 65%, and defaulter follow-up from 14% to 79%. All three union councils transitioned to Category 1 operational status. Administrative coverage exceeding 100%, reflecting population-level coverage and denominator correction rather than true population-level coverage. Conclusions: Integrating CHW-based tracking with dynamic denominator verification enhances routine immunization, microplanning, equity, and operational performance in high-risk LMIC urban settings.

Pakistan is witnessing an alarming rise in suicide rates among its youth. There is a lack of consolidated national-level data on suicide, and the available statistics are often disproportionate due to misclassification, underreporting, and the absence of surveillance systems to track the actual burden of youth mental health and suicide rates. This situation underscores the urgent need for evidence-based models. The Zero Suicide (ZS) model offers a replicable and targeted suicide prevention strategy to be implemented in healthcare settings. Given the high prevalence in youth, we adapted the ZS model for school settings to simultaneously reach youth and their gatekeepers to implement structured interventions. This paper presents a series of programmatic case vignettes to illustrate the implementation of Dareecha: a school-based ZS program to reduce suicidal ideations and behaviors among students in Ghizer district, Gilgit-Baltistan, and to improve their mental health outcomes. The program focuses on ensuring student safety by integrating and initiating suicide care pathways in schools through a collaborative and humanistic approach. The core components include suicide risk identification, collaborative assessment, safety formulation and planning, evidence-based psychotherapeutic approaches, reducing access to lethal means, and follow-up monitoring. The adapted school-based ZS approach bridges research-practice and data gaps, showing potential for improved clinical outcomes and a positive cultural shift across individual, family, school, and system levels. Sustained suicide risk mitigation relies on the application of best clinical practices, continuous quality improvement, and the active engagement of school leadership and gatekeepers. The approach, including arts-based methods integrated within socio-emotional learning modules, offers early evidence on the feasibility and sustainability of the Dareecha program and highlights key lessons and recommendations for future studies.

Climate-induced floods disproportionately affect vulnerable rural communities within Pakistan due their immediate and long-term impacts on mental health. Over time, the community narrative around rain, mostly considered as God’s blessing, has shifted to fear and uncertainty, exacerbating flood-related trauma and anxiety. With excessive damage to infrastructure, disrupted health facilities, socioeconomic inequities and limited access to relief and emergency services, these remote communities are often neglected and remain deprived of basic psychological aid. This paper presents the integration of community-based mobile health services to deliver mental health and psychosocial support in six high-risk districts of Sindh and Balochistan, and provides policy and practice recommendations. Lived experiences of flood affectees have been highlighted to amplify community voices in transforming mental healthcare systems for underserved populations.