LAHORE: Up to 20,000 community health workers from all four provinces have joined forces to form the Pakistan Community Health Workers Federation (PCHWF), the country’s first national union for these frontline healthcare providers. This landmark move addresses decades-long struggles faced by lady health workers (LHWs), polio workers and community midwives, including workplace harassment, delayed salaries, lack of minimum wages, and professional neglect. The LHW programme initiated in 1994 has grown to over 125,000 workers forming the backbone of the healthcare system in rural and underserved areas. While a 2012 Supreme Court ruling regularised the status of LHWs, polio workers remain excluded from regular pay structures, surviving on honorariums. The PCHWF unites five major provincial unions: the Punjab Ladies Health Workers Union (Sheikhupura), Ladies Health Workers Union (Faisalabad), All Sindh Lady Health Workers and Employees Union, All Khyber Pakhtunkhwa Lady Health Workers and Staff Union, and Balochistan Lady Health Workers Union. “We work in harsh conditions but are not treated as equals,” said Kinza Malik, PCHWF’s secretary of youth affairs from Punjab. “Through unity, we will demand our rights.” Chairperson Rifasiyat Bibi from Khyber Pakhtunkhwa said they educate and vaccinate communities but are ignored and neglected. Highlighting safety risks, Bibi Jan Baloch, Additional General Secretary from Balochistan, added: “We walk miles daily, often under threat, to save lives. We demand safety, respect, and a proper service structure.” The federation has also pledged to resist government efforts to privatize or outsource healthcare. “Our federation will ensure the safety and security of all Community Health Workers while protecting public health services,” stated Sindh President Halima Leghari. The PCHWF has garnered international support from Public Services International (PSI), a global union federation, which helped organize this historic initiative. “These women, who dedicate themselves to improving public health in remote communities, deserve respect, a living wage, and dignified retirement,” said Kate Lappin, PSI’s Regional Secretary. “Their unity is a beacon for workers in Pakistan and beyond.”