PACRA Maintains the Entity Ratings of Dr. Ziauddin Hospital Trust

The assigned ratings reflect Dr. Ziauddin Hospital Trust’s (“DZHT” or “the Trust”) positioning as one of Pakistan’s prominent private healthcare institutions, underpinned by its established brand legacy, multi-campus footprint, and its integral role in delivering tertiary and quaternary healthcare services. The Trust operates under a not-for-profit framework in accordance with the Sindh Trust Act, 2020, which provides significant fiscal advantages through tax exemptions and enhances financial flexibility. DZHT’s long-standing association with Ziauddin University further reinforces its institutional strength, ensuring a steady pipeline of skilled medical professionals and supporting clinical research, supplemented by academic excellence. Following the operationalization of the 5th floor at the Clifton campus and the addition of the 180-bed Sukkur campus, the Trust’s total capacity has increased to around 900 beds. The Sukkur facility has surpassed its breakeven point and is now contributing positively to overall profitability. In parallel, the Trust has invested in advanced diagnostics, including the installation and commissioning of Cyclotron and PET-CT facility, enabling in-house isotope production for oncological diagnostics and strengthening the hospital’s position in high-end cancer care.
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. However, the net margin remained modest due to the impact of deferred taxation adjustments, which compressed profitability despite operational performance. Energy optimization initiatives, including solar installations across Clifton, Kemari, and Sukkur campuses, resulted in cost savings of approximately PKR 100mln, partially mitigating inflationary and utility cost pressures.
The financial risk profile of the trust is considered adequate with a low leveraged capital structure. Total borrowings stood at PKR 3.3bln (FY24: PKR 2.6bln), translating into a total leverage of around 31.3% (FY24: 29.0%). Liquidity is adequately supported by internal cash generation, with FCFO increasing to PKR 1.6bln. Coverage indicators have improved, with EBITDA-to-finance cost rising to 4.1x, reflecting improved operational cash flows and lower interest rates during the year. Going forward, leverage metrics are expected to be elevated moderately due to the planned initiative of an Islamabad-based hospital project, financed primarily through long-term debt with a structured grace period to support cash flow stability during the initial phase.
The ratings are dependent upon the management’s ability to capitalize on growth opportunities in a competitive landscape, operate at an optimum level, and improve margins and coverage. Going forward, adherence to the debt matrix at an adequate level is a prerequisite for the assigned ratings.

About the Entity
Dr. Ziauddin Hospital Trust (DZHT) is a leading private healthcare institution in Pakistan, operating a multi-campus hospital network across North Nazimabad, Clifton, Kemari, and Sukkur. Established in 1975, the Trust provides tertiary and quaternary healthcare services across a wide range of medical specialties. The Trust is governed by a six-member Board of Trustees. Mr. Asim Hussain is serving as the Chief Trustee. DZHT is affiliated with Ziauddin University, supporting clinical excellence through medical education and research.