National health indicators over the past five years have significantly improved in Pakistan, said Pakistan Demographic and Health Survey (PDHS) 2017-18. The 2017-18 PDHS has been the fourth DHS survey conducted in Pakistan since 1990-91. The survey results, released on Monday at a national seminar in Islamabad organised by National Institute of Population Studies (NIPS), highlighted major improvements in child survival and maternal healthcare, while progress has been slower in nutrition and family planning use among women. The survey states that families in Pakistan are getting healthier.
The survey said that more children in Pakistan are surviving early childhood than ever before as under-5 mortality has sharply declined. Currently, the under-5 mortality rate is 74 deaths per 1,000 live births; a decline from 89 deaths per 1,000 live births in 2012-13, showing that approximately 1 in every 14 children in Pakistan does not survive to their fifth birthday. Basic vaccination coverage has improved in Pakistan.
Two in three children age 12-23 months have received all eight basic vaccinations, an increase from more than half of children in 2012-13. Basic vaccination coverage is the lowest in Balochistan (29 percent) and the highest in Punjab (80pc), states the survey.
Pakistan has one of the highest fertility rates in the region with an average of 3.6 births per woman, besides challenges remain particularly in nutrition, family planning, and domestic violence, the PDHS maintained.
Reproductive healthcare coverage in Pakistan is also improving. Nearly 9 in 10 women age 15-49 receive antenatal care from a skilled provider such as a doctor, nurse, midwife, or lady health visitor. Additionally, more than half of women have their first antenatal care visit in the first trimester, as recommended. Half of women make four or more antenatal care visits, a notable increase from 37 percent in 2012-13. More births are delivered in a health facility, from 48 percent in 2012-13 to 66 percent in 2017-18. Yet, 1 in 3 births are delivered at home.
For the first time, the 2017-18 PDHS provides information on disability. Among adults age 15 and older, 9% of women and 7% of men have a lot of difficulty or cannot function in at least one domain of disability-seeing, hearing, communicating, remembering or concentrating, walking or climbing steps, and washing all over or dressing.
According to survey one in nine Pakistanis has migrated over the period, 14 percent of households had at least one out-migrating member. The most common reasons for out-migration are better economic opportunity and marriage.
Parliamentarian Secretary Dr Nosheen Hamid said the 2017-18 PDHS provides vital data for monitoring and evaluating health programmes in Pakistan and also assesses Pakistan's progress towards meeting the Sustainable Development Goals.
Dr Ruth Lawson, Head of Basic Services at the UK's Department for International Development (DFID) stated, "The UK is proud to have partnered for the survey, as good data leads to evidence-based decision making both by the government and development partners. I'm glad that this survey reports on disability as well, as DFID's programmes are especially focused on leaving no-one-behind."
While the 2017-18 PDHS reports progress in many areas, challenges remain particularly in nutrition, family planning, and domestic violence. The survey shows that many children in Pakistan suffer from poor nutrition. One sign of chronic under-nutrition is stunting, or being too short for one's age. Although stunting has declined since 2012-13 when 45pc of children under 5 were stunted, yet 38pc of children in Pakistan are too short for their age. Currently, women in Pakistan are more overweight or obese than ever before, 52pc of women age 15-49 in 2017-18 as compared to 40pc in 2012-13.
The use of family planning among married women has stagnated around 34 percent over the last five years. The unmet need for contraception remains high at 17 percent.
USAID Deputy Mission Director, Helen Pataki noted that the PDHS is not just a report card on the last five years.
"It also directs our efforts for the next five. Together, we can review what has worked well and where further support could make a difference to improve basic health care and end preventable deaths," said Pataki.
More than 1 in 4 ever-married women (28pc) have experienced physical violence since age 15, and 6pc have experienced sexual violence. Seven percent of women who have ever been pregnant have experienced violence during pregnancy. Three in ten women who have ever experienced physical or sexual violence sought help to stop the violence, yet 56pc neither sought help nor told anyone.
The UNFPA Representative Lina Mousa said, "The UNFPA is very proud to have contributed both financially and technically to the successful implementation of the 2017-18 PDHS and congratulates the National Institute of Population Studies (NIPS)." She commended the strategic partnership of UNFPA with NIPS and Pakistan Bureau of Statistics on strengthening the national data system that is essential for development planning in the context of the SDGs and the International Conference for Population and Development. "Population censuses and PDHS surveys are crucial to the development of national strategies and socio-economic plans as well as localisation of the SDGs."
The 2017-18 PDHS provides estimates at the national level; for urban and rural areas separately; for four provinces including Punjab, Sindh, Khyber Pakhtunkhwa, and Balochistan; for two regions including Azad Jammu and Kashmir (AJK) and Gilgit-Baltistan (GB); Islamabad Capital Territory; and erstwhile Fata.