Pakistan has recorded an MMR of 300 per 100 000 live births in 2005.^[2] A low Contraceptive Prevalence Rate (CPR) of 29.6% (any method)^[3] and unsafe abortions are contributing factors to the high MMR. A study in 2009 by Shirkat Gah, ARROW’s partner in Pakistan found a “universal dissatisfaction towards the Government-run healthcare delivery system, particularly at the First Health Care Facility Level. Reasons attributed for the dissatisfaction include, improper timing of the facility; ill-equipped facility; under staff or no staff at the facility; poor supply and quality of the medicine; poor attitude of the staff; and the charging of fee, where there should be little or none. Disturbingly, the study also revealed that the pills distributed by the Lady Health Worker (LHW) in the Sindh Village were discarded by the communities, due to the fact that they were distributed free of cost. In the same village, men bought condoms secretly from local pharmacy for their use. The private health sector remains the preferred choice for all the respondents.”^[4]   

According to the Pakistan CEDAW Shadow Report, this high level of maternal mortality was because of poor or delayed access to health facilities, unsafe abortions, unskilled and untrained birth attendants, unhygienic conditions for deliveries, especially in slums, remote and rural areas.^[5]  

In Pakistan, abortion is allowed only under the condition of saving the mother’s life, with the professional judgment of two qualified doctors who testify that the letting the pregnancy run its course would be fatal for the mother.^[6]  

Gender discrimination in Pakistan exists everywhere: access to food, health care and education. This leads to a lower nutritional and educational of women and girls. Women and youth especially in rural areas have limited power to make important decisions affecting their lives. Women are particularly restricted especially in marriage decisions.^[7]

Religious fundamentalism in Pakistan has proven to be a major barrier for women and their sexual and reproductive health and rights. Pakistan’s constitution guarantees women equal rights, and empowers the government to take affirmative action to protect and promote those rights. But over the years, parallel Islamic legal systems have been promoted which undermine those rights, like the Federal Shari’a Court (FSC) established by General Zia ul-Haq in 1980. “The gender bias of Shari’a is undeniable. Women have unequal rights to inheritance, termination of marriage, minimum age of marriage, and natural guardianship of children. Polygamy is allowed, and there are grossly inadequate provisions for women’s financial security after divorce. Pakistan’s controversial Hudood Ordinances, particularly with regard to Zina (sex), are also discriminatory. By blurring the line between rape and adultery, the Zina Ordinance creates the possibility that a woman can be convicted of adultery if she cannot prove rape. The discriminatory nature of Islamic legal reforms for women in Pakistan is clear, but the extent of their impact is hard to measure. Islamic legal reforms and the Hudood laws in particular have served to reinforce male social control over women, limiting female bargaining power within the family and their control of resources. This has also contributed to an environment where violence against women is not sufficiently discouraged.”^[8]

“The promulgation of the Protection of Women (Criminal Laws Amendment) Act (WPA) 2006 provides protection to women in cases of violence and false accusations of zina (adultery). The promulgation of WPA 2006 was the result of concerted struggle for more than twenty-five years by women’s and human rights activists and NGOs through research, advocacy, and lobbying with policy makers, parliamentarians, and linkages with the media.”^[9] 

“A similar process has been followed for two more Bills; the Domestic Violence (Prevention and  Protection) Bill and The Criminal Law (Amendment) Bill have both been passed by the National Assembly and tabled in the Senate in 2009. Both Bills have been prepared with inputs from the women’s movement, Human Rights Commission Pakistan and the legal fraternity. The Criminal Law (Amendment) Bill includes amendments to the Pakistan Penal Code and Criminal Procedure Code to enhance punishment for offences relating to harassment of women.”^[10] 

ARROW's Work in Pakistan

ARROW's critical Cross-Country Indicators on Pakistan

ARROW's Monitoring Reports on Pakistan 

ARROW's Resources on Pakistan