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Pakistan Demographic and Health Survey Main Report

Category : Cross-Sectional Surveys   18 June, 1991

  1. The Pakistan Demographic and Health Survey (PDHS) was fielded on a national basis between the months of December 1990 and May 1991. The survey was carried out by the National Institute of Population Studies with the objectives of assisting the Ministry of Population Welfare to evaluate the Population Welfare Programme and maternal and child health services. The PDHS is the latest in a series of surveys, making it possible to evaluate changes in the demographic status of the population and in health conditions nationwide. Earlier surveys include the Pakistan Contraceptive Prevalence Survey of 1984-85 and the Pakistan Fertility Survey of 1975.
  2. The total fertility rate is estimated to be nearly one child lower in major cities (4.7) than in rural areas (5.6). Women with at least some secondary schooling have a rate of 3.6, compared to a rate of 5.7 children for women with no formal education.
  3. There is a wide display between women's knowledge and use of contraceptives in Pakistan. While 78 percent of currently married women report knowing at least one method of contraception, only 21 per cent have ever used a method, only 12 percent are currently doing so. The two most commonly used methods are female sterilization (4 percent) and the condom (3 per cent). Despite the relatively low level of contraceptive use, the gain over time has been significant. Among married non-pregnant women, contraceptive use has almost tripled in 15 years, from 5 per cent in 1975 to 14 per cent in 1990-91.
  4. The Government of Pakistan plays a major role in providing family planning services. Eighty-five per cent of sterilized women and 81 per cent of IUD users obtained services from the public sector. Condoms, however, were supplied primarily through the social marketing programme.
  5. Among currently married women who know of a contraceptive method, 62 per cent approve of family planning. The appears to be a considerable amount of consensus between husbands and wives about family planning use: one-third of female respondents reported that both they and their husbands approve of family planning, while slightly more than one-fifth said they both disapprove.
  6. The educational levels attained by Pakistani women remain low: 79 per cent of women have had no formal education, 14 per cent have studied at the primary or middle school level, and only 7 per cent have attended at least some secondary schooling. In such populations, the proximate determinants of fertility (other than contraception) are crucial in determining.
  7. The mean age at marriage has risen sharply over the past few decades, from under 17 years in the 1950s to 21.7 years in 1991. Marriage patterns in Pakistan are characterized by an unusually high degree of consanguinity. Half of all women are married to their first cousin and an additional 11 percent are married to their second cousin.
  8. Women in Pakistan breastfeed their children for an average of 20 months. The mean duration of postpartum amenorrhoea is slightly more than 9 months. After the birth of a child, women abstain from sexual relations for an average of 5 months. As a result, the mean duration of postpartum insusceptibility (the period immediately following a birth during which the mother is protected from the risk of pregnancy) is 11 months, and the median is 8 months.
  9. In the PDHS, women were asked about their desire for additional sons and daughters. Overall, 40 per cent of currently married women do not want to have any more children.
  10. Gender preference continues to be widespread in Pakistan. Among currently married non-pregnant women who want another child, 49 per cent would prefer to have a boy and only 5 per cent would prefer a girl, while 46 per cent say it would make no difference.
  11. It is estimated that 25 per cent of currently married women have a need for family planning to stop childbearing and an additional 12 per cent are in need of family planning for spacing children. Thus, the total need for family planning equals 37 per cent, while only 12 per cent of women are currently using contraception. The result is an unmet need for family planning services consisting of 25 per cent of currently married women. This gap presents both an opportunity and a challenge to the Population Welfare Programme.
  12. Nearly one-tenth of children in Pakistan die before reaching their first birthday. The infant mortality rate during the six years preceding the survey is estimated to be 91 per thousand life births; the under-five mortality rate is 117 per thousand.
  13. One of the priorities of the Government of Pakistan is to provide medical care during pregnancy and at the time of delivery, both of which are essential for infant and child survival and safe motherhood. Looking at children born in the five years preceding the survey, antenatal care was received during pregnancy for only 30 per cent of these births.
  14. Tetanus, a major cause of neonatal death in Pakistan, can be prevented by immunization of the mother during pregnancy. For 30 per cent of all births in the five years prior to the survey, the mother received a tetanus toxoid vaccination.
  15. Eighty-five per cent of the births occurring during the five years preceding the survey were delivered at home. Sixty-nine per cent of all births were attended by traditional or trained birth attendants, while 19 per cent were assisted by a doctor or nurse.
  16. The expanded Programme on Immunization in Pakistan has met with considerable success. Among children 12 to 23 months of age, 70 per cent had received a BCG vaccination, 50 per cent a measles vaccination, and 43 per cent had received all three doses of DPT and polio vaccine. Only 35 per cent, however, had received all of the recommended vaccinations, while 28 per cent had received none at all.
  17. Inadequate nutrition continues to be a serious problem in Pakistan. Fifty per cent of children under five years of age suffer from stunting (an indicator of chronic undernutrition), as measured by height for age.
  18. Acute undernutrition, low weight for height, is less of a problem in Pakistan than chronic undernutrition. Nine per cent of children suffer from acute undernutrition (wasting).
  19. A systematic sub-sample of households in the women's survey was selected to obtain information from the husbands of currently married women. The focus was on obtaining information about attitudes, behaviour, and the role of husbands regarding family planning. Husbands' responses concerning knowledge and use of contraception were remarkably similar to women's responses: about four-fifths knew of at least one method, two-thirds knew of a source of supply, one-fourth reported that they and their spouses had used contraception sometime in the past, ad about one-seventh were current users.
  20. Although a majority of husbands (56 per cent) approve of family planning, wives are more likely to favour family planning than their husbands. Since husbands usually have a predominant role in family decision making, the family planning programme should increase efforts to educate and motivate husbands.

Tags : Demographic, Pakistan, Survey

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