Pakistan is situated in the northwestern part of the south Asian subcontinent. Comprising a total
land area of 796,096 square kilometers, it features a diversified terrain and topography. The country’s northern areas include five of the world’s 14 highest mountain peaks. Pakistan is an agricultural country, and about 64 percent of its population lives in rural areas. The country gained its independence on 14 August 1947, after the subdivision of the Indian subcontinent then ruled by the British Empire.
Pakistan is now the sixth most populous country in the world, with its population reaching 184.5 million in 2012-13. At present, the population density is 231 persons per square kilometer. The overall sex ratio is 102 males per 100 females, a decline from the ratio of 108 males per 100 females shown in the 1990-91 PDHS. The marked difference in the sex ratio between the two surveys could be the changing survival rates of females. 53 percent of women have no education, as compared with 34 percent of men.
Source: Extracted from Pakistan Demographic & Health Survey (PDHS) 2012-13
Sexual and Reproductive Health
Key findings from the 2012-13 PDHS on the situation of SRHR in Pakistan are as follows:
- The maternal mortality rate in Pakistan is 276 maternal deaths per 100,000 live births, indicating the dire state of reproductive health care and women’s rights.
- More than 6 in 10 women face at least one problem in seeking healthcare for themselves when they are sick.
- More than 7 in 10 mothers receive antenatal care from a skilled provider.
- Thirty-seven percent of women make four or more antenatal care visits during their pregnancy.
- The median duration of pregnancy at the first antenatal visit is 3.7 months.
- Three-fifths of women giving birth in the two years preceding the survey received postnatal care for their last birth in the first two days after delivery.
- Sixty-four percent of mothers with a birth in the five years preceding the survey had their last birth protected against neonatal tetanus.
- Women with more than a secondary education and in the highest wealth quintile are one and a half times as likely to receive antenatal care from a skilled health provider (97 percent) as women with no education (60 percent).
- Knowledge of contraception is universal in Pakistan.
- The total fertility rate for the three years preceding the survey is 3.8 births per woman, with rural women having one child more on average than urban women.
- Women and men report an ideal family size of more than four children.
- More than one-third of currently married women of reproductive age are using a method of contraception, with most women using a modern method (26 percent).
- Childbearing begins early, with 15 percent of women age 25-49 giving birth by age 18 and 32 percent by age 20.
- The two most popular modern contraceptive methods are the male condom and female sterilization (9 percent each).
- The government sector remains the major provider of contraceptive methods, catering to the needs of nearly one in two users (46 percent).
- Twenty percent of currently married women have an unmet need for family planning services, with 9 percent having an unmet need for spacing and 11 percent having an unmet need for limiting.
- Sixty-nine percent of births occur within three years of a previous birth, with 37 percent occurring within 24 months.
- In Pakistan, induced abortion is illegal except in instances in which the life of the mother is at risk.
- In the 2012-13 PDHS report, twelve percent of pregnancies resulted in miscarriages in the five years before the survey, almost 2 percent resulted in an abortion, and 3 percent resulted in a stillbirth.
- Given that induced abortions are illegal, it is likely that some induced abortions are reported as miscarriages.
- Overall, Pakistani women have about one child more than their wanted number. This implies that the total fertility rate of 3.8 children per woman is 31 percent higher than it would be if all unwanted births were avoided.
HIV & AIDS:
- Four in 10 ever-married women and 7 in 10 ever-married men age 15-49 have heard of AIDS.
- Comprehensive knowledge of AIDS is not widespread among either women (7 percent) or men (12 percent).
- Only 12 percent of women and 18 percent of men know of ways to prevent mother-to-child transmission of HIV.
- Only 17 percent of women and 15 percent of men express accepting attitudes toward people living with AIDS.
- Thirty-six percent of men and 11 percent of women know of a place where they can go to get an HIV test.
- Only 32 percent of women are aware that the risk of contracting the AIDS virus can be reduced by limiting sexual intercourse to one uninfected partner who has no other partners.
- 22 percent know that using condoms every time they have sexual intercourse reduces the risk of getting the AIDS virus.
Sexual and Reproductive Rights
Child Early & Forced Marriage (CEFM):
- The minimum legal age at marriage in Pakistan is 18 years for males and 16 years for females.
- The percentage of women who were married by age 15 decreased from 10 percent among those age 45-49 to 2 percent among those age 15-19.
- There is evidence that age at marriage among women in Pakistan is rising; the median age at first marriage increased from 19.1 years in 2006-07 to 19.5 years in 2012-13.
- A higher proportion of teenage girls age 15-19 (14 percent) are married than teenage boys (2 percent).
- Pakistan has a high rate of marriages between cousins, with approximately half of all marriages occurring between first cousins (49 percent). There is evidence that children born in marriages between first cousins have double the risk of congenital anomalies.
Violence Against Women (VAW):
- Thirty-two percent of ever-married women age 15-49 have experienced physical violence at least once since age 15, and 19 percent experienced physical violence within the 12 months prior to the survey.
- Overall, 39 percent of ever-married women age 15-49 report ever having experienced physical and/or emotional violence from their spouse, and 33 percent report having experienced it in the past 12 months.
- Among ever-married women who had experienced spousal physical violence in the past 12 months, 35 percent reported experiencing physical injuries.
- One in 10 women reported experiencing violence during pregnancy.
- Fifty-two percent of Pakistani women who experienced violence never sought help or never told anyone about the violence they had experienced.