[a][5] While 96 percent of married women were reported to know about at least one method of contraception, only half of them had ever used it. Waheed, a member of the All-Pakistan Women's Association, began advocating for birth control when her maid died from an attempt to abort her own pregnancy. In 2017, two Pakistani organisations discovered large cases of infanticide in Pakistani cities. ); while the overall quantum services by the Government and those that self procure commodities from stores remained the same. [13] Conflicts related to dowry often lead to violence. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion" and occurs in approximately 30% to 40% of pregnancies. Thus only around 14% of all married women of reproductive age (MWRA) access FP services in a given year. Despite legal restrictions that limit women’s access to abortion, the incidence of the procedure in Pakistan is high, and the abortion rate has increased during the past decade. The feuds of the Lakheras and upper Ravi Kharrals have been noticed. [20], Sex selective abortion - the practice of terminating a pregnancy based upon the female sex of the fetus - is happening in Pakistan, although it is illegal. "Islam, Women and Family Planning: A Primer." [20] According to an indirect estimation method, applied to the 2002 national data on abortions and its related complications in Pakistan, 1 in every 7 pregnancy terminates in an abortion. [4], Similarly to other countries in South Asia, Pakistani households have a strong preference for sons. Under Pakistan's law, abortion is only legal to preserve a mother's health. A research studies conducted in 2002 and 2003 (by Population Council-Pakistan) reveals that a n estimated 890, 000 induced abortions occur annually in Pakistan. 7 In one study, 70% of women were aged 25–39; 7 in another study, 78% were aged 25–34. JPMA April 2013, Research and Development Solutions Policy Brief Series #1: Overview of Family Planning in Pakistan, Research and Development Solutions Policy Brief Series #4: Utilization and Costs of Family Planning in Pakistan, National Health Accounts of Pakistan 2005-6, Research and Development Solutions Policy Brief Series #13: Services and Uptake and Trends over time, Research and Development Solutions Policy Brief Series #43. [1], According to Dr. Ansar Ali Khan, an advisor of reproductive health to the United Nations Population Fund in Pakistan, "A combination of factors like non-availability of services, baseless traditional beliefs and misconception play a big role. Roudi-Fahimi, Farzeaneh. Pakistan's high abortion and low contraception rates reflect a family planning policy in shambles, says Abdul Ghaffar Khan, director general of Pakistan's population program wing. Many women experiencing an unintended pregnancy resort to induced abortion: A nationwide study estimated that close to 900,000 unintended pregnancies were terminated by induced abortion in 2002. Hence, a likely reason why so many Pakistani women are self-inducing miscarriages. [7] Zia differed from his predecessors in that he "made the religious-right-wing his political ideology." * 1 In 2006–2007, 24% of all births in Pakistan were unintended. That should be avoided at any cost. But it is no longer a common practice both in Pakistan and India via steps taken by local polices and Governments and Ordinances made in both neighbours. [1][5] The rate of unwanted pregnancies is higher for women living in poor or rural environments; this is especially important since two-thirds of women live in rural areas. [24], In 2017, two Pakistani organisations discovered large cases of infanticide in Pakistani cities. The death of the victim is viewed as a way to restore the reputation and honour of the family. Every year 30.000 women die from pregnancy related causes in Pakistan. [17] However, the female paramedics had a more lenient attitude when it came to a question of whether an abortion was justified: to save a mother's life, when the fetus was either abnormal or when a woman was raped; whereas the gynaecologists and doctors felt it was less permissible to perform, especially in the case of rapes. Research and Development Solution - Evidence to Policy Action: Briefs on Family Planning, Rahnuma- Family Planning Association of Pakistan, Reproductive endocrinology and infertility, Birth control movement in the United States, Timeline of reproductive rights legislation, https://en.wikipedia.org/w/index.php?title=Family_planning_in_Pakistan&oldid=997401773, Articles with dead external links from August 2019, Articles with permanently dead external links, All Wikipedia articles needing clarification, Wikipedia articles needing clarification from September 2011, Articles with unsourced statements from September 2011, Creative Commons Attribution-ShareAlike License, This page was last edited on 31 December 2020, at 09:31. Changes in CPR between Pakistan DHS 2006 and 2012, "Assessment of a New Approach to Family Planning Services in Rural Pakistan". He had used the religious lobbies and conservative middle-classes as support for his take-over. [21], Extending beyond the reach of family planning and contraceptive methods is the issue of women's sexual and reproductive health. • In Pakistan, abortion is legally allowed only to save the life of a woman or to provide “necessary treatment” early in pregnancy. Abortion in Pakistan is not a go-to option. "[7], Near the end of Zia's era of power, family planning and population control became tied to the Ministry of Health (Pakistan). Dr.Zeba A. Sathar Country Director, Population Council Islamabad Disclaimer: This document is an output from a project funded by the UK Department for International Development It was said to be "safe, cheap, reversible," and it required "little user action. The infanticide was mainly almost all were female infants. [14] In 1990, the penal code was provisionally adapted in order to better reflect Islamic Law, and finally was made permanent in 1997. [5] In Pakistan, many local religious figures are supportive of family planning and have begun discussions in their communities in order to promote the health of women and children.[5]. Women bearing at least one son have higher say in household decision-making. • An est… Abortion laws vary considerably between countries and have changed over time. Prenatal sex-selection is more common among the upper classes who have access to medical care and technology, while abuse after birth (infanticide and abandonment) is more common among the lower classes. Pakistan's high abortion and low contraception rates reflect a family planning policy in shambles, says Abdul Ghaffar Khan, director general of Pakistan's population program wing. [7] Soon after the seminar, the National Board of Family Planning was established as a policy-advising body for the federal government. Abortion is illegal in Pakistan, except if needed to preserve the pregnant woman' life or health. The policy's goals include reducing population growth (from 2.1 percent in 2002 to 1.3 by 2020), reducing fertility through voluntary family planning (from 4 births per woman in 2004 to 2.1 births per woman by 2020), and as a signatory to the Programme of Action developed at the International Conference on Population and Development in Cairo in 1994, Pakistan pledged to provide universal access to family planning by 2010. This was lead by the Edhi Foundation and Chhipa Welfare Foundation. UN Office for the Coordination of Humanitarian Affairs. [1] Challenges to Pakistani's well-being, opportunities for education and employment, and access to health care are escalated due to the country's continuously-growing population. Additionally, it appears that the if the amount of commodities that are being reported by the Pakistan Bureau of Statistics in its "Annual Contraceptive Prevalence Reports" is accurate, the overall increase in population may mean that the CPR for modern methods may have actually declined. Muslim populations are incredibly diverse, varying by race, language, and degree of religious conservatism. The infanticide was mainly almost all … The tragic adventure of Mirza and Sahiban is said to have been the cause of desperate quarrels. And Karachi has topped in this notorious ranking with 180 cases in 2017. The Family Planning Association of Pakistan (FPAP), now called "Rahnuma", was founded in Lahore by Saeeda Waheed in 1953. Instead, govt must encourage use of contraceptives through advertisement campaigns. These murders were cause of such bloody feuds between the clans that it at the length was thought inauspicious to have daughters, and as soon as they were born, they were strangled as Sahiban had been. In 2009 the Ministry of Population sought to revise the Population Policy. 4 billion (US$42 million) a year on FP but nearly 90% of this goes towards salaries and overheads and commodities account for 7-14% of these funds. There is no abortion-specific legislation in Pakistan. When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". Pakistan Penal Code (Act XLV of 1860), Chapter XVI, Section 338 (A)- (C). As, babies born out of wedlock in Islam is considered a sin.[25]. Population Reference Bureau. Volume 11, Number 1, 30-51. This report is cited in a 2010 book on son preference, giving the context of the Mirza Sahiban tragic romance, and putting the practice in a wider socio-economic analysis. Demographics play a large role in Pakistan's development and security since the recent change from military rule to civilian leadership. 1 According to a recent national study, women in Pakistan had an estimated 2.25 million abortions in 2012, equivalent to an abortion rate of 50 abortions per 1,000 women of reproductive age—nearly double the rate estimated … The total change in users of FP services between 2006 and 2012 was around 700,000 women. Volume 4, Number 6, 4-7. Among Kharal people, female infanticide was common. − Whoever, causes woman with child whose organs have not been formed, to miscarry, if such miscarriage is not caused in good faith for the purpose of saving the life of the woman, or providing necessary treatment to her, is said to cause isqat-i-haml. [1] Though Pakistan was one of the first Asian countries to begin a family planning program with some help from international donors, fertility has declined slower than in neighboring countries. A more accurate picture will emerge with the release of the data from the Pakistan Demographic and Health Survey 2012. Islamic scholars permit an abortion within 120 days of pregnancy in Pakistan. The Official Abortion Law. 9–11 Moreover, almost all the women were married. Oxford, 1996. [21][22][23] [12] In Pakistan, extremely conservative Islamic beliefs predominate in many parts of the country, in which purdah restricts women to their homes unless chaperoned by a male relative. In order to avoid such problems related to the honor culture, families reject altogether the idea of having daughters. Boys are often given better access to resources, healthcare, and education. There is however provision of ‘necessary treatment’ which allows for abortion if a woman’s pregnancy has not gone beyond 120 … From January 2017 to April 2018, Edhi Center foundation and Chhipa Welfare organisation have found 345 such new born babies dumped in garbage in Karachi only and 99 percent of them were girls. A study released in 2005, by the Population Council of Pakistan and the Guttmacher Institute, found that 890,000 abortions occur in Pakistan every year and, given that this data was collected mostly through women hospitalized for post abortion complications, one can expect this figure to be grossly understated. [6] Waheed, a member of the All-Pakistan Women's Association, began advocating for birth control when her maid died from an attempt to abort her own pregnancy. One study in 2002 showed that in areas with 2 or more community-based workers there was a 7% increase in the use of modern, reversible contraceptive methods. However, Bhutto found that he could not fund many of his socialist promises, and so allowed economic assistance from USAID. An honor killing is the homicide of a member of a family or social group by other members, due to the belief the victim has brought dishonour upon the family or community. However, under the 18th Amendment to the Constitution, the Ministry was devolved and its responsibilities were shifted to Provincial Population Welfare Departments. [2] Though Pakistan's fertility rates still exceed those of neighboring South Asian countries with a total fertility rate at 4.1 (3.3 children in urban settings and 4.5 children in rural areas) and contraception use is lower than 35 percent, approximately one-fourth of Pakistani women wish to either delay the birth of their next child or end childbearing altogether. This is primarily because of the belief that it is forbidden. According to this change in the abortion law, preservation of "the physical and mental health" of a woman, early on in the pregnancy, also became legal grounds for a permissible abortion. World Health Organization and Global Health Workforce Alliance. In August last year, a representative from the United … Nevertheless, many women nevertheless seek an abortion rather than give birth to a child they cannot afford. USAID funding was suspended, and Pakistan became alienated "from the Western powers that Ayub Khan had so carefully cultivated. [13][1] Most women who say they do not want any more children or would like to wait a period of time before their next pregnancy do not have the contraceptive resources available to them in order to do so. [1], The first abortion penal code (Article 312) of this region dates back to 1860, during British colonial rule which stipulated that unless an abortion was to "save a woman's life," it was expressly illegal and punishable by law, and the same applied for (self)induced miscarriages. However, the large discovery in Karachi shows that many of the female infants were killed because of the local Islamic clerics, who ordered out of wedlock babies should be disregarded. 06 Apr 2011. The shortcomings of Pakistan’s law has produced devastating results. This is comparable to the late C20th sex ratio in the area, now divided between India and Pakistan.[2]. The revisions sought to conform better to Islamic teachings regarding offenses against the human body. Her parents betrothed her to a youth of the Chadar tribe, but before the marriage could place, Mirza ran away with her. [1] It was estimated in 2005 that Pakistan's population totaled 151 million; a number which grows 1.9 percent annually, equaling a 2.9 million population growth per year. The Guttmacher Report on Public Policy. In 2006–07, the Pakistan Demographic Health Survey of Pakistan (PDHS 2006-7) showed that approximately 30% of married women of reproductive age (MWRA) were using some form of Family Planning. [23] The DHS also dispelled the popular notion that religious reasons keep families from using family planning. In a move looking to counter Bhutto's government and as a gesture to his religious constituency, Zia froze the existing family planning program and banned publicity for family planning activities. In Pakistan, as in many Islamic and South Asian countries, induced abortion is against the law except to save a woman’s life. These translate into 7 million FP users, 5 million users of modern methods and 6 million with an unmet need. The reason given by the local authorities were poverty and local customs, where boys are preferred to girls. At least 77 people have been killed and 94 injured in northeast Pakistan after a series of avalanches destroyed and buried houses. A brief version of the Pakistan Demographic and Health Survey 2012 was released in October 2013. Laws may permit, prohibit, restrict, or otherwise regulate the availability of abortion.A few countries ban abortions entirely. It showed that the overall CPR had climbed to 33.4% of which approximately 25% was from modern methods. [18] The conduct of family members reflects upon family honor and the way the family perceives itself, and is perceived by others. [5] Though Pakistani couples commonly cite religious reasons for avoiding birth control, there is not one definitive agreement about family planning and contraception in Islam. Family Planning in Pakistan: Applying What We Have Learned. [27], In the 1990s, two agencies in Pakistan started village-based community health worker programs in Pakistan. Even though there is considerable demand for family planning in Pakistan, the adoption of family planning has been hampered by government neglect, lack of services and misconceptions. The given data is just tip of the iceberg as Edhi foundation maintains the data of those cities where it provides services.[25]. [1] One-fourth of married women are estimated to have an unmet need. 23 percent of these women are hospitalized for treatment of complications. [citation needed], In 1977 Bhutto's Chief of Army Staff, General Zia ul-Haq, deposed the leader and declared martial law. While Pakistan is not among those countries which lets women make this decision on her body, the abortion laws … [29] In 2006 there were 96,000 lady health workers. For medical abortion (MA), a combination of two drugs, Mifepristone and Misoprostol is used. Of the 2.4 million unwanted pregnancies, 900,000 are end in induced abortions. [30], Rural and Urban Healthcare Disparities That Contribute to Pakistan’s High Child Mortality Rate. Historically, political strife and cultural restrictions on women constraining their empowerment have hampered implementation of family planning strategies throughout the country. Even when one adjusts for underreporting for private sector and NGO services, it is likely that the current CPR may actually be unchanged from the PDHS 2006-7. [7], Pakistani journalist/researcher Ayesha Khan has suggested various reasons for Ayub Khan's position on population control. Since 1997 abortions carried out before the unborn child’s organs have been formed are prohibited except when performed in good faith for the purpose of saving the life of the woman or providing necessary … Secondly, development ideology during Khan's time of power warned of the economic risks of high population growth rates. If the women hospitalized for abortion complications are typical, most women who have induced abortions in Pakistan are married and already have more children than the average Pakistani woman wants . [18][19], When a comparison of the private sector and public sector was made with regards to abortion and post-abortion care provided, it was noted that the private sector performed more abortions and took on double the case-load of post-abortion care, as opposed to the public sector. Extrapolating these results to estimated populations suggest that there are 8.8 million users of any FP, 5.5 million users of modern methods and 3.65 million women who avail FP services in any given year. Due to a lack of access (especially in the rural areas), no clarity (dearth of awareness, understanding and education), fear of legal persecution (especially in the public sector), an inability of health care professionals to interpret the law, as well as a form of FP, women are often forced to seek abortion by untrained providers. [7] At the onset of the program, condoms were the most available method of contraception, but by 1966 the Intrauterine Device (IUD) had replaced it has the "corner-stone" of the Scheme. [14][15], Pakistan has a strong 'culture of honor', where a female can easily tarnish the 'honor' and 'reputation' of her family through certain behaviors (often related to chastity), whether these behaviors are real or suspected by the community. This custom of female infanticide was common among the Kharrals till Colonel Hamilton, Commissioner of Multan, persuaded them to discontinue it. Wajihuddin Ahmed, the Family Planning Commissioner during Yahya Khan's rule, focused on reducing pregnancies in women "rather than meeting contraceptive targets alone" and introducing the pill to Pakistani women. The government spends on average around Rs. According to the UN Inter-agency Group for Child Mortality Estimation, Pakistan's rates of child mortality (neonatal mortality rate: 44.2; infant mortality rate: 61.2; child under 5 mortality rate: 74.9)[10] nearly double the worldwide average (neonatal mortality rate: 18; infant mortality rate: 29.4; child under 5 mortality rate: 39.1)[11] set by UNICEF Global. Surgical procedures that are available are Manual Vacuum Aspiration (MVA) and Dilation and Evacuation (D&E). "[7] However, due to extreme and unrealistic goals,[vague] the USAID program was highly ineffective. "[1], Dating from 2002, Pakistan's current family planning policy reflects the government's concern with rising population trends and poverty. He was pursued and slain. The unmodified word abortion generally refers to an induced abortion. This is exactly equal to the increase in number of women served by NGOs (supported by donors such as USAID, DFID, KfW, GIZ, David and Lucile Packard Foundation etc. [10][11] Son preference has effect on the status of Pakistani women. It is also important to note that other elements of population development such as education, capacity building, economic development, climate etc. Our antiquated Penal Code does however criminalise abortion seekers and providers. [1], The Family Planning Association of Pakistan (FPAP), now called "Rahnuma", was founded in Lahore by Saeeda Waheed in 1953. [1], During the 19th century, the Northwest British India one-fourth of the population preserved only half the daughters, while other 3/4th of the population had balanced sex ratio. [1], In 1950, Pakistan's population reached 37 million people, making it the world's 13th most populous country. Research and Development Solutions Policy Brief Series #15: The Role of Lady Health Workers in Family Planning in Pakistan. The giving and expectation of a dowry is part of the culture, with most marriages in every region of Pakistan involving transfer of a dowry from the bride's family to a groom's family. In essence it showed that the overall increase in CPR since the previous DHS had been around 1% per annum overall and around 0.5% in modern methods. [1] Also in Pakistan's Poverty Reduction Strategy Paper is the objective of increasing contraceptive use 57 percent by 2012. [1] At present there is no federal ministry of health or population welfare and therefore no population policy. [7] Son preference prevails in rural areas, due to male inheritance of agricultural land, and males being seen as better suited to work the land. "[2] Unlike family planning in Iran, a neighboring Islamic republic, Pakistan's family planning program has failed in recent years due to neglect and constant policy changes as a result of political upheaval. "[7], In 1969, Ayub Khan was overthrown by the joint action of Islamist parties and the leftist Pakistan People's Party. “I have read the report titled “Post‐Abortion Care in Pakistan: A National Study”, and acknowledge and agree with the information, data and findings contained". [7] The FPAP was unsuccessful in changing family planning policies until President and military leader Ayub Khan took interest in the problem of overpopulation in the late 1950s. In 2007, Pakistan had increased in world population ranking to 6th, with over 164 million people and the United Nations (UN) has projected that in 2050 it will move into 5th place with around 292 million people. It left us wondering whether our society is heading back to primitive age,” Anwar Kazmi, a senior manager in Edhi Foundation Karachi, told The News. This program recruited married women, with at least 10 years of schooling, that lived in rural areas, and trained them to provide family planning services to their communities. Misoprostol hotline Pakistan, June 2010. One of Pakistan's largest problems is its rapidly expanding population and their limited access to necessary essentials such as readily available healthcare, doctor's, and basic sexual education. [17] Honor killings in Pakistan are known locally as karo-kari. In 1990, the Pakistan government revised the colonial-era Penal Code of 1860 with respect to abortion. Induced abortions are known to occur in Pakistan, [26][27] The extent to which this is attributable to infanticide is contested; see Missing women of Asia. Abortion is illegal in Pakistan, except if needed to preserve the pregnant woman' life or health. The Ministry of Population Welfare started planning a program in 1992 based on a similar program in Bangladesh. [5] Additionally, levels of schooling are very low in Pakistan, allowing men to have more power in decision-making. The Kharrals were Rajputs... and never got on with each other. Pakistan's Lady Health Worker programme. [7] Its leader, Zulfiqar Ali Bhutto, needed to gain legitimacy and popularity by taking an anti-American, anti-capitalist, and anti-Ayub Khan-stance. However, murdering of the fetus – abortion, is one of the most sinister taboos of our society… In a country like Pakistan, where abortion is considered to be the one of the most perplexing of all difficulties a couple or an individual faces, almost 900,000 cases of premature-murders are reported annually. [8] Although the nation has recently been making active efforts to adhere to the United Nations Millennium Development Goals[9] that aims to reduce global infant mortality by two-thirds, their efforts have fallen short as a large population of the Islamic Republic of Pakistan resides in rural areas where the nation's efforts have rarely been seen. In fact, many NGOs have implemented interventions where they have worked with local or national clergy. The Ministry of Health (Pakistan) started a similar program in 1994 called "lady health workers." "[7] This ideology is still present in Pakistan, as the organized religious party opposes family planning because it is "un-Islamic". Over the 15-year span of 1964-1979, USAID "spent over $30 million on Pakistan's population programme; during 1965–75 US AID provided 40% of total programme inputs.
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