Project Mukhtari is an innovative behavioral health initiative designed to improve immunization coverage in high-risk communities through Art-Based Methodologies (ABM) and Motivational Interviewing (MI) techniques. The project focuses on strengthening the emotional wellbeing and technical capacity of government vaccinators, thereby fostering greater community trust and confidence in immunization.

With essential support from Expanded Programme on Immunization Sindh (EPI Sindh) and District Health Office Malir (DHO), Mukhtari 1.0 was funded by Agha Khan University (AKU), and engaged 92 vaccinators within Malir, Sindh. The initiative provided a safe and creative space for participants to share experiences, express emotional and physical distress, and discuss systemic and environmental barriers they face in their line of work. Using art-based methodologies such as; story telling, role play and challenge mapping canvas, Mukhtari fostered both emotional resilience and professional growth. 

Using internationally validated tools—the Warwick-Edinburgh Mental Wellbeing Scale (WEMWS), Rosenberg Self-Esteem Scale, and Motivational Interviewing Knowledge Test—alongside measures of vaccinator attendance, vaccine coverage, and EPI micro-plan quality, Project Mukhtari demonstrated substantial impact. The intervention enhanced vaccinators’ self-efficacy and mental wellbeing, improved attendance rates, increased vaccine coverage in intervention UCs, and significantly strengthened EPI micro-plans. These findings highlight how emotional and technical support translated into sustained improvements in both personal wellbeing and field performance.

The project’s human-centered design not only empowered vaccinators with purpose and confidence but also generated valuable learning, such as the importance of flexible planning, context-sensitive scheduling, gender-inclusive sampling, and strong technical setups that can inform future scale-up. While sustained policy and resource support are essential for long-term impact, Mukhtari stands as a promising and innovative approach to strengthening Pakistan’s immunization workforce and coverage in vaccine hesitant communities.