The 2022 and 2025 floods in Pakistan forced more than 33 million people to flee from their homes, destroyed medical facilities across a large portion of Punjab, Khyber-Pakhtunkhwa, Sindh, and Balochistan, and revealed major deficiencies in government management, healthcare systems, environmental protection, and climate preparedness. Pakistan emits <1% of worldwide greenhouse gases, yet remains among the most climate-sensitive nations, reflecting global inequities in climate impact. Floods destroyed basic health determinants, thus contributing to infectious disease epidemics, malnutrition, and mental health problems. To evaluate the short- and long-term flood impacts, this article applies the Disaster Management Cycle, along with the One Health, Planetary Health, and Doughnut Economy frameworks. The framework demonstrates the impact of floods on the health and healthcare system while simultaneously eroding the ecosystem and making the population more susceptible. The article identifies priorities for climate-adaptive health care infrastructure, environmental recovery, equity-centered disaster preparedness, and integration of One Health principles into medical education.

During the perinatal period, women in low- and middle-income countries experience high rates of common mental disorders (CMDs). We aimed to estimate CMD prevalence at 6 and 12 months postpartum in Rahim Yar Khan (RYK), Pakistan, and identify factors associated with postpartum mental health. We conducted secondary analysis of a longitudinal birth cohort study, which was nested within the control arm of a community-based, cluster-randomized trial that enrolled pregnant women in their third trimester (n = 2,122). Mental health was assessed using the Self-Reporting Questionnaire. Factors associated with postpartum mental health were explored using mixed-effects linear regression, and associations between preconception, antenatal and postpartum CMDs were assessed using robust Poisson regression. The prevalence of CMDs was 16% and 17% at 6 and 12 months postpartum, respectively. Women who reported that their husbands were unhappy had poorer postpartum mental health, whereas high social support was associated with improved postpartum mental health. History of antenatal CMDs was associated with increased risk of CMDs at 6 and 12 months postpartum (adjusted risk ratio = 2.60 and 1.90, 95% confidence interval: 1.69–4.01 and 1.40–2.58, respectively). Mothers with identified risk factors may benefit from targeted mental health support during the perinatal period.

This article has a two objectives. The first objective is to investigate the history of identity politics in Bangladesh from the British and Pakistani periods to the post-independence era. It argues that the syncretic culture that flourished during the Muslim rule was deliberately disrupted by the British divide-and-rule policy of partitioning Bengal in 1905 along religious lines, fomenting such communal hatred between Hindus and Muslims that resulted in the partition of 1947, with East Bengal joining Pakistan. This also sowed the seeds of identity politics and a “pendulum syndrome” in future Bangladeshi politics, marked by a perpetual strife between advocates of ethnolinguistic nationalism on one side and religious nationalism on the other, which has become a perennial source of violence and volatility for the nation, hindering its growth and progress. The second objective is to explore how Nobel laureate Rabindranath Tagore has been drawn into this strife, facing accusations of being an Islamophobe and a Hindu chauvinist, and why there have been recurrent attempts to replace his song as the country’s national anthem. The article concludes with a rebuttal to such accusations based on evidence highlighting the song’s historical contributions to the nation despite the ongoing campaigns against it.

Extant research has focused on the role of philanthropy in the socio-economic development of western countries, but little is known about the role of indigenous voluntary organisations in bridging social divides in the developing world. To help redress this imbalance, we present findings on the motivations, strategies, methods, and impact of five large philanthropically funded voluntary organizations in Pakistan. We ask how and why such organizations are formed and gain traction to provide valuable services for large numbers of poor people in a society riddled with inequalities. Although differing considerably in their relations to markets and philanthropy, we find that success in all cases followed from commitment to Islamic philanthropy and the ideal of social inclusion, social innovation, exploitation of social capital, and scaling-up. Our contribution is to demonstrate how in developing countries philanthropy and social entrepreneurship together can play a decisive role in realizing a more just society.

Islamic welfare organizations are currently going through processes of ‘NGOization’. Drawing on qualitative data from Pakistan, Norway and the UK (2012–2015), this article examines how two Islamic welfare organizations which are embedded in Islamic political movements, become ‘Muslim NGOs’. The NGOization of Islamic charity signifies not only a change in organizational structure and legal status, but also more profound changes in organizational discourse and practice, and in the ways the organizations make claims to legitimacy. To claim legitimacy as providers of aid in changing institutional environments, the organizations draw on both religious and professional sources of authority. By analysing the NGOization of Islamic charity, the paper brings out the importance of normative frameworks in shaping organizational legitimacy and sheds light on the continued significance of both moral and transcendental aspects of the discourses, practices and identities of Muslim NGOs.

The paper explores donors’ efforts to promote government-NGO partnership for the purpose of improving public services. Following a brief discussion of partnership, two illustrations support a relative definition of partnership and its added value. The examples represent alternative approaches to improving public services through partnership work, the choice of which may depend on (1) the will of the partners to change—particularly government, (2) the preexistence of effective public services, and (3) depth of mobilization and social capital sought. The examples similarly reveal alternative approaches to addressing partnership challenges either bureaucratically or through behavioral norms and organization culture. Implications of donors’ participation in such partnerships are highlighted.

First under the Millennium Development Goals and now under the Sustainable Development Goals, partnerships for development, especially between state and NGOs, remain a valued goal. Partnerships are argued to improve provision of basic social services to the poor: the state is viewed as providing scale, with NGOs ensuring good governance. Close study of three leading partnership arrangements in Pakistan (privatization of basic health units, an ‘adopt a school’ program, and low-cost sanitation) shows how state–NGO collaborations can indeed improve service delivery; however, few of these collaborations are capable of evolving into embedded partnerships that can bring about positive changes in government working practices on a sustainable basis. In most cases, public servants tolerate, rather than welcome, NGO interventions, due to political or donor pressure. Embedded partnerships require ideal-type commitment on the part of the NGO leadership, which most donor-funded NGOs fail to demonstrate. For effective planning, it is important to differentiate the benefits and limitations of routine co-production arrangements from those of embedded partnerships.

This systematic review and meta-analysis was a study that enquired into the prevalence and epidemiology of depression in university students in Pakistan, between 2000 and 2025. Depression is a significant global mental illness with high prevalence in young adulthood. University students are the most susceptible to this risk because of the factors related to it, i.e., academic stress, financial hardships, social pressure, and cultural stigma of mental illness. Although the concerns have been on the increase, the prevalence rates of depression have been widely varied among Pakistani students, with some studies reporting as low as 2.5% to as high as 85%, primarily because of the sampling techniques, assessment instruments, and geographical settings. The present review is based on the findings of 35 studies involving over 11,000 students and suggests that the prevalence rate is approximately 51% in a pooled form, meaning that about 50% of university students in Pakistan are subjected to depressive symptoms. The high level of heterogeneity of the selected studies highlights the acute necessity of the formulation of a standard-based diagnostic criteria and culturally competent mental health assessment instruments. Moreover, systemic challenges, such as the shortage of trained mental health professionals and the general unawareness of the disorder, are continuing to affect the diagnosis and treatment of the disorder at an early stage. According to the results, the necessity of a multi-faceted approach toward mental health, including the establishment of counseling facilities in universities, the development of stress management training, and the federal stigma-reduction campaign, is pressing. The most significant elements of enhancing the well-being of students and the mental health landscape of Pakistan as a whole are early intervention and empowering mental health infrastructure.

Given the surging economic and health costs associated with childhood stunting, identifying its associated factors is crucial. This study therefore explores a key determinant of long-term nutritional status, women’s participation in household decision-making in the context of Pakistan. To empirically estimate this association, three-level modelling was employed by pooling the data from two recent nationally representative survey rounds PDHS 2012–13 and PDHS 2017–18. Multilevel analysis was better suited compared to traditional methods for robust estimates because of the hierarchical nature of the data. Women’s decision-making power was measured by formulating an index through factor analysis from the direct questions about women’s participation in household decisions. This study found a positive association between women’s decision-making power and children’s nutritional growth at the national level, with no significant changes across the survey years. However, this relationship was moderated by regional variations, which was more pronounced in Sindh and relatively modest in other regions. The sensitivity analysis showed that among the different decision-making domains, only women’s participation in large household purchases was significantly and positively associated with child linear growth. The insights of this research suggest that nutrition-oriented policies should also consider non-nutritional factors, like women’s decision-making power when designing projects for target population. Meanwhile, it is also crucial to recognize that decision-making power is a contextual factor and its effect on child nutritional growth may vary across regions.

This article theorises Pakistan’s role in the Afghan–Soviet War (1979–1989) as a form of ‘conflictual world-making’ – a process through which postcolonial states and societies simultaneously contest and reproduce global orders. Moving beyond Eurocentric narratives of superpower rivalry, it demonstrates how Pakistan’s state and societal actors actively reshaped the Cold War from the margins. Drawing on state archives and movement periodicals, the analysis reveals a dialectical struggle: while the military establishment enforced a U.S.-led imperial order, borderland movements pursued alternative, anti-imperial world-making projects. The article develops the concept of ‘imperial-anti-imperial relationism’ to capture this entanglement. By centring these South-South encounters and transboundary mobilisations, it recasts the Afghan war not as a mere proxy conflict between the superpowers, but as a decisive crucible where late Cold War geopolitics collided with the unfinished project of decolonisation. The argument compels a rethinking of world order struggles, insisting that the Global South’s generative margins are essential to understanding the end of the Cold War and the violent birth of our contemporary world disorder.

Rapid population declines of three species of Gyps vultures endemic to Asia were caused by unintentional poisoning by the non-steroidal anti-inflammatory drug (NSAID) diclofenac. Despite a ban on its veterinary use across South Asia, diclofenac has continued to be supplied for this purpose. Here, we report updated results from undercover pharmacy surveys, conducted between 2012 and 2024, in India, Nepal, Bangladesh, and Pakistan to investigate the availability and prevalence of veterinary NSAIDs. The purpose was to establish whether sales of diclofenac had continued and to determine which other veterinary NSAIDs were available. In India, the availability of diclofenac had declined in all Vulture Safe Zones (VSZs), but it was still readily available (up to 25% of sales) in Rajasthan where intensive conservation advocacy had not occurred. Elsewhere in the region, prevalence of diclofenac was low. The vulture-safe meloxicam continued to be the most commonly available veterinary NSAID throughout most of the region, especially in Nepal (85–100%), but still accounted for only 25–45% of products offered in other countries. In Bangladesh, the vulture-toxic ketoprofen was the most prevalent drug overall, but levels declined to a low level (<1% in 2024), following the nationwide ban on veterinary use of the drug in 2023. Fourteen different NSAIDs were recorded in our surveys, several of which are known or suspected to be toxic to vultures. Of special concern is a rapid increase in the prevalence of flunixin in Bangladesh. Flunixin has not been banned in any of the South Asian vulture range states. Conservation priorities should include awareness campaigns, stronger measures to implement current bans, safety-testing of other NSAIDs, especially flunixin, followed by bans on veterinary use of all NSAIDs found to be toxic to vultures. Prior evidence of safety to vultures should be a requirement for the licensing of all new veterinary NSAIDs.

Compliance with court decisions is essential for the rule of law. Generally, regimes comply with decisions that serve their interests; however, compliance with decisions against government interests is less certain. In 1947–2005 and 2014–2023, the Supreme Court of Pakistan (SCP) decided many politically important cases in favour of the prevailing authoritarian and hybrid regimes. However, between 2005 and 2013, although the SCP reached decisions against the government’s interests in politically important cases, the government still complied. Why would authoritarian and hybrid regimes, such as those in Pakistan between 2005 and 2013, comply with decisions in politically important cases that were against their interests instead of disobeying or ignoring them? Very few studies have addressed this puzzling phenomenon. This article argues that increasing public support for courts coupled with reinforcement mechanisms—supported by both the judiciary and external actors—contributes to such compliance. The article concludes that a combination of social, political, and legal factors is essential for compliance by authoritarian and hybrid regimes in politically important cases.

Generative artificial intelligence (GenAI) has been heralded by some as a transformational force in education. It is argued to have the potential to reduce inequality and democratize the learning experience, particularly in the Global South. Others warn of the dangers of techno-solutionism, dehumanization of learners, and a widening digital divide. The reality, as so often, may be more complicated than this juxtaposition suggests. In our study, we investigated the ways in which GenAI can contribute to independent language learning in the context of Pakistan. We were particularly interested in the roles of five variables that have been shown to be particularly salient in this and similar contexts: learners’ Generative Artificial Intelligence-mediated Informal Digital Learning of English (GenAI-IDLE) participation, AI Literacy, Foreign Language Enjoyment (FLE) and Foreign Language Boredom (FLB), and their second language Willingness to Communicate (L2 WTC). Employing a structural equation modelling approach, we surveyed 359 Pakistani English as a foreign language (EFL) learners to investigate their interrelationships between variables. The results demonstrate that EFL learners’ GenAI-IDLE activity directly and positively influences AI literacy and FLE. Students’ AI literacy and FLE play a chain-mediating role in the relationship between GenAI-IDLE participation and L2 WTC. However, FLB lacks predictive power over L2 WTC. We discuss the implications of these results for language learning, in particular in low-resource contexts.