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Interview with Muhammad Yousuf

Dr. Muhammad Yousuf is Principal Coordinator of the Urban Health Program (UHP) at Aga Khan University in Karachi, Pakistan. The UHP was established in 1983 and is run by the Department of Community Health Sciences. The program provides critical health and socio-economic support to the squatter settlements of Karachi while giving AKU students experiences and skills that contribute greatly to their education. The UHP won first prize in the 2009 MacJannet Prize for Global Citizenship, and Dr. Yousuf represented the UHP at the award ceremony for the Prize held in Talloires France this past June. Learn more about the MacJannet Prize or the Urban Health Program>>

TN: When and why did you first become involved with the Urban Health Program at AKU?

On Dec 01, 1997 I joined the Urban Health Program, Department of Community Health Sciences, Aga Khan University as Community Development Specialist.  
I wanted to join the Urban Health Program (UHP) because of my interest in the area of Primary Health Care and Social Development. The Urban Health Program was having the opportunity of doing work in both the areas of my interest.

 

TN: What is unique about the Urban Health Program?

To me it is a unique partnership between an academic institution of higher learning and local communities where different stakeholders work together such as faculty, staff, community leaders and the members along with other government and non-government organizations.

 

TN: All good programs learn from their mistakes and successes and adjust their activities accordingly. What lessons have been learned by the Urban Health Program, especially lessons that could be applied by similar health programs also working in urban settings?

It is difficult to narrate useful lessons learned over two decades; however I shall make an attempt as under:
First Phase from 1985 to 1995:

  • Opportunity for faculty, students and staff to learn community based heath care.
  • Significant reduction of mortality and morbidity
  • Community mobilization, including female community health workers
  • Strong surveillance system
  • Absence of control sites
  • Lesser focus on inter-sectoral approach
  • Community participation varied from active to passive

Second Phase from 1996 to 1999:

  • Inter-sectoral approach
  • Presence of control sites for comparison
  • Active community based organizations with byelaws and registration with government
  • The base was expanded to include TBAs, health care providers, teachers, religious and local community leaders
  • Enhanced linkages of communities with Governmental and non-governmental organizations
  • Women were effectively mobilized
  • Due to resource constraints impact assessment was not done
  • There was only center based surveillance system
  • Appropriate strategies for phasing out and sustainability was required

Third Phase from 2000 to date:

  • High acceptability of Primary Health Care program by the community
  • More opportunities for research by faculty and students
  • Women can be empowered by involving them in income generation activities
  • Capacity building of communities to resolve their issues on self reliance basis
  • High expectations from communities
  • More emphasis required for compliance to CBO by-laws
  • More resources should be allocated for developmental work
  • Saturation of communities due to increased research activities
  • Community based surveillance system was required
  • Need was felt for up-scaling the program

TN: What benefits do students gain from their involvement with the program, and what impact has the program had on students’ personal and professional development?

  • Students learn to do need assessment surveys and understand community dynamics
  • They learn about socioeconomic and health problems of communities living in urban slums and how to deal with them
  • They get acquainted with Primary Health Care
  • They learn simple research simple methods and conduct projects in the communities

Some of our graduates have chosen public health as their career. They have done so after having completed their clinical residencies in the US. Some of them are faculty members at universities in Pakistan and world renowned universities.

A few of our graduates are employed by federal and provincial health ministry’s and International and bilateral aid agencies in Pakistan and abroad.

 

TN: What are the UHP’s plans for the future? Are there plans to expand or change the program in any way? If so, what are the reasons for the changes/expansion?

  • A variety of preventive, promotive, curative and rehabilitative services
  • Continue providing training opportunities to different health and development cadres
  • A hub of community based research activities to address community issues
  • Replication of the program in other squatter settlements of Karachi
  • Promote public private partnership for planning and managing the program and test it as a model
  • Further develop relations with corporate sector for the support of the program
  • Introduce an effective surveillance system
  • Take one new field and phase out from one existing site every 3-4 years
  • Consolidate the present program and make it more sustainable by developing local capacities
  • Strengthen training programs for health managers, community leaders and other stake holders in Community Mobilization and Development; Comprehensive Primary Health Care and Gender Sensitization
  • Promote public private partnership for planning and managing the program. Cultivate relations with corporate sector for the support of the program
  • Take one new field site every 3-4 years, and phase out from one field site every 3-4 years
  • Establish community based surveillance system with emphasis on non communicable diseases, including mental health
  • Conduct the impact assessment of the program

TN: What does winning first place in the MacJannet Prize for Global Citizenship mean for the Urban Health Program?

It’s an honor, appreciation and recognition of our work; an encouragement and morale boosting for the Urban Health Program, its team, our faculty and students, the communities and all the other stakeholders involved. We shall work even harder to achieve more in partnership with communities.

 

TN: You represented the UHP at the MacJannet Prize Award Ceremony in Talloires, France. Could you describe your experience at the ceremony, in particular focusing on any benefits you gained by meeting and sharing your experiences with Talloires Network staff and representatives of the other winning programs?

I enjoyed the MacJannet Prize Award Ceremony at Talloires, France very much. It was a very organized and professionally managed program. I can’t forget the lovely places such as Talloires and Lake Annecy. I had a chance to meet with a number of dignitaries related to the MacJannet Foundation, Talloires Network and Tufts University at the ceremony and had an opportunity to exchange views and share experiences. It was a memorable moment of my life to share the information related to the Urban Health Program at such a prestigious international forum. The ceremony also provided me an opportunity to have orientation about the activities of the other two winners and had a chance to interact with their representatives. We are thankful to the MacJannet Foundation and Talloires Network for giving us this honor.