Dr. Ziauddin Hospital Trust ("DZHT" or "the Trust") is a not-for-profit organization established in Pakistan through a Declaration of Trust executed on August 10, 1976. The Trust is duly registered under the Sindh Trust Act, 2020. During the year, DZHT was granted Not-for-Profit Organization (NPO) status under Section 2(36)(c) of the Income Tax Ordinance, 2001, thereby affirming its tax-exempt status and compliance with applicable regulatory requirements for non-profit entities in Pakistan.

The Dr. Ziauddin Group of Hospitals traces its origins to the 1950s with the establishment of Nazimabad Memorial Hospital, a 25-bed maternity facility founded by Dr. Aijaz Fatima, daughter of Sir Dr. Ziauddin Ahmed, and her late husband, Dr. Tajamul Hussain. This initiative laid the foundation for the Group’s development in the healthcare sector. Subsequently, Dr. Ziauddin Hospital was formally established in North Nazimabad in 1975, initially operating as a small maternity home. Over the years, the institution has expanded into a multi-campus hospital network comprising facilities in North Nazimabad, Clifton, Kemari, and Sukkur, providing secondary, tertiary, and quaternary healthcare services across a broad range of medical specialties.

DZHT operates a comprehensive multi-campus healthcare network spanning Karachi and Sukkur, with major facilities in North Nazimabad, Clifton, Keamari, and Sukkur, complemented by outreach centers including Dr. Ziauddin Cancer Hospital, Dr. Ziauddin Memorial Hospital, and Boat Basin Executive Clinics. The Trust's primary objective is to establish and operate hospitals for the sick while providing relief of a charitable nature at reasonable costs. The Trust delivers tertiary and quaternary healthcare services with a combined bed capacity of approximately 900 beds, offering a full spectrum of medical care that encompasses outpatient consultations, emergency services, inpatient treatment, surgical procedures, and critical care. The Head Office is located at Street No. 6, Block B, North Nazimabad, Karachi.

Dr. Ziauddin Hospital operates under the legal framework of a trust, formally registered as the Dr. Ziauddin Hospital Trust. The trust holds full ownership of the hospital and its associated institutions, ensuring that all assets and operations are managed in accordance with its objectives.

The ownership structure of Dr. Ziauddin Hospital Trust remains stable and well-entrenched, supported by the longstanding presence of the Ziauddin Group and its institutional trust-based framework. The Group’s diversified presence across healthcare and education further enhances ownership stability and reduces contagion risk.

Dr. Asim Hussain serves as the Chairman of the Group, recipient of Sitara-e-Imtiaz and Nishan-e-Imtiaz for his contributions to education and healthcare. His distinguished career includes serving as Chairman of the National Reconstruction Bureau (Federal Minister status), Chairman of Sindh Higher Education Commission (2014, reappointed 2018), and Honorary Personal Physician to the President of Pakistan (2009). Under his leadership, the Group has evolved from a single facility into a diversified network of hospitals and a chartered university, with a commitment to quality, transparency, and continuous improvement supporting long-term growth prospects.

The financial strength of Dr. Ziauddin Hospital is underpinned by its strategic integration within the Ziauddin Group alongside Ziauddin University. This integrated structure creates a synergistic model that enables consistent reinvestment in advanced medical technology and infrastructure development. The institutional framework provides a strong foundation for sustained financial resilience and supports the Hospital's long-term growth trajectory.

The Trust operates under a six-member Board of Trustees, comprising five executive directors and one non-executive director. The Board is led by Mr. Asim Hussain, who serves as Chief Trustee. The Board provides effective oversight and strategic direction, ensuring sound decision-making while upholding best practices across their respective areas of responsibility.

The Board members possess significant collective expertise in the healthcare sector, bringing diverse professional backgrounds and specialized qualifications. Dr. Asim Hussain serves as Chairman and Trustee of Dr. Ziauddin Hospital Trust and Chancellor of Ziauddin University, Karachi. A prominent figure in healthcare and education, he has been instrumental in the expansion and institutionalization of the Ziauddin Group. He holds an MBBS from Dow Medical College, a D. Ortho from Vienna, Austria, following postgraduate training in orthopaedics in Europe, and an MS in Surgery from Ziauddin University. He is a Member of the College of Physicians and Surgeons Pakistan (CPSP). In 1995, he established Ziauddin University, which is chartered by the Government of Sindh and recognized by the Higher Education Commission (HEC) of Pakistan.
Dr. Ammad Hussain serves as Chief Executive and Trustee. He holds an MBChB from the University of Birmingham, UK, and completed his radiology training at King's College Hospital, London, followed by a fellowship in Interventional Radiology from Barts Health NHS Trust. He has served as a consultant in the UK's NHS and currently works as a part-time consultant with NHS England and the Dr. Ziauddin Hospital Group. Dr. Arif Hussain serves as Trustee and holds the position of Director (Laboratory) and Consultant Pathologist at Dr. Ziauddin Hospital. He is also an Associate Professor of Pathology at Ziauddin University. His qualifications include an MBBS from Dow Medical College, an MSc in Clinical Biochemistry (Molecular Biology) from the University of Surrey, UK, and a PhD from the University of Karachi. Dr. Nida Hussain serves as Pro-Chancellor of Ziauddin University, Trustee of Dr. Ziauddin Hospital Trust, and Chairperson of the Ziauddin Education System. She holds an MBBS from Dow University and is a Diplomate of the American Board of Internal Medicine from Mount Sinai, New York, USA. Belonging to the founding family of the Ziauddin Group, she carries forward the legacy of Sir Dr. Ziauddin Ahmad with a strong commitment to advancing healthcare and education.

The Board demonstrates effective oversight through a balanced composition of executive and non-executive directors, ensuring diverse perspectives in strategic decision-making. Board meetings are convened regularly on a need basis, maintaining responsive governance aligned with operational requirements. Meeting agendas encompass comprehensive review areas including policies and procedures, products and services evaluation, and strategic planning discussions. This structured approach ensures that governance activities remain closely aligned with the Trust's operational needs and long-term strategic objectives, supporting informed decision-making and accountability across the organization.

BDO Ebrahim & Co., Chartered Accountants, are the external auditors of the Trust and are categorized under Category “A” of the State Bank of Pakistan’s panel of auditors. The auditors have expressed an unqualified opinion on the financial statements for the year ended June 30, 2025.

The Trust maintains a lean organizational structure designed to ensure operational efficiency and effective communication across all levels. Operational staff report to the CEO and Managing Director through various management heads, creating clear reporting lines and accountability. The organizational framework is supported by functional committees responsible for overseeing operations and conducting regular assessments of internal controls, ensuring adherence to established policies and risk management protocols.

The Trust's operations are led by an experienced management team with specialized expertise across healthcare administration, clinical operations, and organizational development. Mr. Osama Ahmad, Managing Director of Dr. Ziauddin Group of Hospitals, brings over 25 years of leadership experience across healthcare, education, and multiple industries. A Chartered Accountant with expertise in financial and operational planning, strategy, governance, and risk management, he focuses on technological advancement, transparency, and quality to drive patient care, sustainability, and growth. Dr. Ashar Ekhlaq Ahmed serves as Medical Director of Dr. Ziauddin Group of Hospitals and Director of Postgraduate Medical Education (Clinical) at Ziauddin University. A specialist Rheumatologist, he oversees clinical operations and ensures high standards of patient care. He previously served as Clinical Director of Medicine at Southport and Ormskirk NHS Trust, UK, and is a member of the Pakistan Society of Rheumatologists, British Rheumatology Society, and the Faculty of Medical Leadership and Management, UK.
Ms. Samina Naushin serves as COO – Head Office and Group Head of HR, bringing over 25 years of experience in organizational leadership and strategic HR management. She oversees hospital operations and leads HR initiatives across the group, focusing on workforce strategy, employee engagement, and operational efficiency. Ms. Sabina Khalid serves as COO of the Clifton Campus, overseeing comprehensive hospital operations. Initially joining as GM (HR & Administration) to strengthen HR policies and administrative functions, she now focuses on process optimization, patient care enhancement, and overall operational efficiency. Dr. Arbas Waleed serves as COO of the Sukkur Campus, bringing over 14 years of experience in healthcare operations and strategic management. He focuses on optimizing hospital operations, ensuring high-quality patient care, and enhancing efficiency through effective resource and cost management.

The management team exercises comprehensive oversight of daily operations while ensuring adherence to established quality standards. Department heads are responsible for both operational efficiency and quality assurance, maintaining a dual focus on smooth execution and excellence in service delivery. This integrated approach ensures that departmental activities are completed efficiently while consistently meeting the organization's defined standards of quality and performance.

DZHT operates an integrated technology framework to support clinical and administrative operations. A comprehensive Hospital Management Information System (HMIS) manages patient care functions including patient registration, emergency services, pharmacy operations, and other clinical areas. Financial operations, billing, and supply chain management are handled through Oracle ERP, which is fully integrated with the HMIS to ensure seamless data flow across systems. To enhance business continuity, security, and operational efficiency, the Trust has implemented Hyper Converged Infrastructure (HCI) alongside other IT controls and applications, providing a robust and secure technology environment for critical hospital operations.

DZHT holds multiple national and international certifications, reflecting its commitment to quality healthcare and patient safety. The hospital is licensed and regulated by the Sindh Healthcare Commission (SHCC), ensuring compliance with provincial healthcare standards. Its clinical laboratories are certified with ISO 15189 and by the Pakistan National Accreditation Council (PNAC), confirming adherence to international and national standards in laboratory quality and competence. Additionally, DZHT has achieved ISO 9001:2015 certification for quality management systems across its campuses. The Trust regularly undergoes surveillance audits and licence renewals, demonstrating sustained compliance with regulatory and quality benchmarks, and reinforcing its reputation as a leading healthcare provider in Pakistan.

According to the Economic Survey of Pakistan 2024–25, Pakistan's public health expenditure reached approximately PKR 925bln for FY2024–25. Despite a year-on-year increase in total outlays, this represents less than 1% of GDP. The healthcare workforce has experienced expansion, with the number of registered doctors increasing to nearly 319,000 and dentists to over 39,000. This professional base is supported by approximately 138,000 nursing personnel, 46,801 midwives, and 29,000 lady health workers. The physical infrastructure comprises around 1,696 hospitals and 5,434 Basic Health Units (BHUs) nationwide, reflecting modest growth in healthcare facilities. Despite these developments, the sector continues to face significant challenges. Critical doctor-to-population ratios persist, alongside substantial gaps in service delivery between urban and rural areas. Key operational constraints include reputational risks, capacity and infrastructure development requirements, quality-of-care standards, and the high costs associated with imported medical equipment and consumables. Additionally, the sector contends with elevated energy requirements that further strain operational efficiency.

The hospital industry in Pakistan operates within a highly fragmented landscape characterized by numerous independent providers and limited market concentration. Within this competitive environment, Dr. Ziauddin Hospital Trust maintains a significant presence with an operational capacity of around 900 beds across its network. This bed capacity positions the Trust among the larger healthcare providers in the country, reflecting an adequate market share within Pakistan's hospital sector.

During FY25, the topline of the trust enhanced by 33.4% clocking at PKR 12.9bln (FY24: PKR 9.6bln), supported by diversified revenue streams across pharmacy, laboratory, radiology, wards, and diagnostic services. Revenue generation is concentrated across two main campuses: North Nazimabad (Head Office) leads with a 45% contribution, while Clifton follows closely at 44%. The remaining 11% is collectively contributed by the Kemari and Sukkur campus. In terms of payment composition, 63% of revenue is derived from direct patient payments (cash and credit card), while the remaining 37% originates from corporate client agreements.

As of FY25, the Trust’s margins remained under pressure despite strong revenue growth. The gross margin declined to 16.9% (FY24: 17.8%) due to escalating input costs, higher energy expenses, and upward revisions in wage rates. While the operating margin improved to 10.1% (FY24: 7.6%) on the back of better cost absorption from higher volumes. However, the net margin moderated to 1.8% (FY24: 2.6%), due to the impact of deferred taxation adjustments, which compressed profitability despite operational performance.

The Trust is actively pursuing strategic expansion initiatives to enhance capacity and geographic reach. The flagship project involves the development of a healthcare facility in Islamabad, for which 20 acres of land have been acquired and architectural designs finalize. At the Clifton campus, following the successful operationalization of the 5th floor, the grey structure for the 6th floor has been completed. Additionally, management has planned the construction of two additional floors at the North Nazimabad campus to accommodate rising healthcare demand in the catchment area and enhance operational capacity. These expansion initiatives reflect the Trust's commitment to scaling infrastructure in line with growing service delivery requirements.

In FY25, net working capital days increased to 22 days (FY24: 13 days), primarily driven by a decrease in trade payable days, which contracted to 48 days (FY24: 57 days), while gross working capital days remained stable at 70 days (FY24: 70 days). To fuel its working capital requirements, the trust relies on a mix of short-term borrowings and internally generated cashflows. The current ratio improved slightly to 1.2x (FY24: 1.1x), indicating adequate short-term liquidity. 

During FY25, the Trust’s coverage indicators strengthened, underpinned by improved operating performance and robust cash flow generation. Free cash flow from operations (FCFO) increased to PKR 1,579mln (FY24: PKR 971mln), reflecting a strong growth of 62.5%, which enhanced the Trust’s liquidity position. The interest coverage ratio improved to 4.1x (FY24: 2.6x), indicating a more comfortable ability to meet debt obligations.

DZHT maintains a relatively low-leverage capital structure, with total borrowings accounting for 31.3% of total capitalization in FY25 (FY24: 29%). Short-term borrowings represent approximately 25.8% of total debt, indicating a moderate reliance on short-term financing to meet liquidity requirements. The Trust’s equity base remains the primary source of funding, totaling PKR 8,073mln in FY25 (FY24: PKR 7,561mln), supported by capital and revenue reserves. Over the years, DZHT has gradually increased its leverage to support expansion and capital expenditure, while maintaining a robust equity buffer to safeguard financial stability.