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Dr. Ayesha Khan is a public health and development professional with extensive experience in women’s economic empowerment, community-based health systems, and inclusive development in underserved urban and peri-urban settings. Her work sits at the intersection of health, livelihoods, and social policy, with a strong focus on translating research and grassroots engagement into scalable, impact-driven interventions.She currently leads the Akhtar Hameed Khan Foundation, a grassroots institution advancing women-led, community-driven solutions in health, livelihoods, and urban resilience, contributing to improved health equity and economic participation across Pakistan’s low-income urban communities.Following are the edited excerpts of a recent conversation BR Research had with her:BR Research: When AHKF enters a community for the first time, what is the very first question you ask the people who live there?Ayesha Khan: The first question we ask is simple and hard: what are your most important problems that you would like to change in the short and longer term?We believe that real change, starts from people’s self-introspection on what are the things (barriers) that are holding them back from achieving their own potential – whether that is livelihood, personal agency, their living environment or other challenges. Unless they recognize the barriers (both internal and external) change cannot happen. AHKF’s work is to listen to their self-introspection as individuals or as a collective.Every community already carries knowledge, coping mechanisms and aspirations. Our role is to help them arrive at their solutions as defined by the people themselves. This approach is the foundation of Dr. Akhter Hameed Khan’s belief that sustainable change begins with the wisdom and efforts of community.BRR: Why was Dhoke Hassu selected as one of AHKF’s focus communities, and what stood out during your first engagement there?AK: Dhoke Hassu has a long association with Orangi Pilot Project (Al-Falah Foundation’s Lala Aurangzeb received training in water, sanitation and micro-credit at OPP in the 1990’s and replicated the model in Dhoke Hassu). His presence helped the AHKF gain rapport and people’s trust within a short span of time and that is crucial to do effective work.Physical proximity (its 20 min or less from our Islamabad HO) makes it easier to engage in and take external visitors to see the demonstration pilots and carry out long term programming with the people.Lastly, DH is not the poorest community (they have moved beyond survival-mode, and are able to think of growth), which makes adoption of solutions more feasible.What stood out during our first engagement was the hidden potential and resilience of the women in the households, and communities. How they strived each day from caregiving to generating little income through tailoring, or selling things, just to help their households grow. We saw the clear desire for opportunities for health, family planning, enhancing skills and dignity. That’s why we opted to make Dhoke Hassu the natural starting point for testing community-driven urban solutions that could later be adapted elsewhere.BRR: How do you identify and support local leaders within these communities?AK: Leadership has many different faces in underdeveloped communities. It may be the helpful woman who knows all about her neighborhood issues and is trying to solve them with collective help, it may be the young student who offers to help other students ride-share his motorcycle for extra income, or it may be the school principal who does extra “life-learning classes” after school.We identify early adopters, we invest in their capacity through training, exposure and responsibility. We see leadership not as a title, but as continuous incremental growth and our role is to connect and mentor. People will do the restBRR: Urban poverty is often linked to systemic issues like governance gaps and service delivery failures. How does AHKF work within or challenge these systems to drive change?AK: My father, Dr. Akhter Hameed Khan said that NGO’s ladder to development is like a solicitor’s path which is, not to clash with the government but strengthening (complementing)its institutions. NGOs are institutions with the people.Our approach focuses on strengthening the linkages between communities and existing public and private sector systems. By generating reliable community-level data, building trust and demonstrating workable models, we help make systems more responsive. Rather than confrontation, we believe in collaboration and evidence. When communities are organized, informed and visible, systems naturally begin to respond more effectively.BRR: What lessons has AHKF learned from working in informal settlements that policymakers often overlook?AK: One key lesson is that informal settlements are organized and not static communities. There are unspoken rules, relationships, hierarchy, systems and accountability mechanisms already in place. Another lesson is that people are hesitant tochange because the risk of the uncertainty is most devastating when absorption margins are low. People lack trust and fear exclusion.When solutions respect their dignity, affordability and local rhythms, adoption is incremental and sustainable. These insights are often ignored because policy makers seldom engage with the end communities they serve.BRR: Can community-driven climate solutions influence broader urban planning and policy reforms in Pakistan?AK: Absolutely. Climate resilience begins at the household and neighborhood level. We cannot succeed without joint cooperation and collaboration.Our work on flood-adaptive housing, drainage mapping and public spaces shows that communities can co-design practical solutions. NGOs provide technical assistance and affordable solutions. When these models are documented and shared, they offer valuable learning for urban planners and institutions seeking scalable, grounded approaches to climate adaptation.BRR: Mental health remains a stigmatized issue in many communities. Is AHKF exploring ways to integrate psychosocial wellbeing into its programs?AK: Yes, somewhat and slowly. We see mental wellbeing as inseparable from women’s health, productivity and dignity. At Rawan Desk, our mental health initiative, we provide a safe space for professional dialogue on stress management, gender-based violence, domestic abuse, depression, anger etc. We have formed women’s groups in the different Mohalla’s. Our approach is slow, culturally sensitive and integrated into everyday programming rather than treated as a separate intervention.BRR: What skills or mindsets do AHKF believe are most critical for preparing young people in low-income urban areas for the future economy?AK: Beyond technical skills, personal efficacy such as good communication, negotiation, problem solving and having the ability to use digital AI based tools is essential. Digital literacy opens doors, but self-agency sustains progress. We focus on helping young people, particularly girls see themselves as capable contributors to the economy, whether through digital work, entrepreneurship or skilled employment. Exposure, mentorship and practical learning play a central role in this transformation.BRR: How can citizens, professionals, and changemakers contribute meaningfully to AHKF’s mission beyond donations?AK: There are three ways that people can join the AHKF journey. First is the financial contribution to our health and digital women’s enterprise programs – in this we teach women AI based skills and marketing that helps them grow their micro-businesses into the formal economy. Second is our volunteer program – by giving their time and supplies for the health camps, computer or other equipment (from our list of essential products). And third are the mentors – become AHKF mentors in our Karachi (Orangi), Rawalpindi Dhoke Hassu and Sahiwal localities.BRR: Looking ahead 10 years, what change would make you say AHKF has truly succeeded?AK: Success for us would mean thousands of small informal urban slums that are economically engaged in the supply chains and manufacturing in their local hubs connected to the broader markets. Communities would also be healthier through primary health care (diabetes and hypertension early detection, family planning, early maternal childcare, 100% immunization and good nutrition etc.).Economic prosperity breeds the voice of people to take care of themselves as well and we hope that is the future Pakistan heads for.