Revolutionising healthcare access: student-led clinics as catalysts for change in an underserved urban community in Karachi, Pakistan

Background: Karachi, Pakistan's largest metropolitan city, faces profound healthcare disparities, with an estimated 45-49% of the population residing in underserved informal settlements. Within these communities, the primary healthcare system is not merely under-resourced but structurally fractured, leaving patients to navigate prohibitively expensive private providers or overcrowded public hospitals. To address these systemic gaps, the Humanity Initiative, a student-led non-governmental organisation, implemented student-led clinics (SLCs) as a community-embedded, cost-effective model to bridge critical care deficits. Methods: We conducted a descriptive study examining the implementation and early outcomes of two SLCs conducted in Agra Taj Colony, Lyari Town, Karachi. Operating every three weeks under licensed physician supervision, each SLC provided free primary consultations, dispensed essential medications, and delivered structured health education. We analysed patient demographics, disease burden, operational costs, and process-level indicators across both clinic cycles. Results: A total of 371 patients were seen across SLC1 (n = 194) and SLC3 (n = 177), with a higher proportion of female patients (n = 224, 60.4%). The disease burden was dominated by non-communicable diseases, including hypertension (14.3%) and diabetes (8.6%), alongside a notable number of acute infections and multi-system complaints reflecting the dual epidemiological burden characteristic of urban low- and middle-income country (LMIC) settings. Operational costs were maintained at PKR 128-136 (USD 0.45-0.48) per patient, demonstrating exceptional cost-efficiency. We found significant gaps in health literacy, particularly regarding chronic disease self-management, and gendered barriers to healthcare access. Conclusion: The SLC model demonstrates proof-of-concept as a viable, scalable strategy for bridging structural gaps in fractured primary healthcare systems in LMICs. By embedding care within the community, SLCs advance Universal Health Coverage, rebuild community trust in allopathic medicine, and provide supervised experiential learning opportunities for future healthcare professionals. Replication of this model across similar underserved communities holds significant potential for reducing healthcare inequity in resource-constrained urban settings.