The Cholistan Health Sector Plan is grounded in a comprehensive situational analysis of the health system in the Cholistan region — an arid desert landscape in southern Punjab covering approximately 10,000 square miles. The analysis identifies critical lagging areas in health infrastructure, service delivery, and health outcomes, using a mixed-method research approach combining quantitative indicator analysis and qualitative assessment. Given the challenges of service delivery in a low-density desert terrain, the plan proposes contextually adapted investment and governance strategies to improve health outcomes for Cholistan’s underserved population, within the framework of the broader Cholistan Regional Development Plan.