September: World Sexual and Reproductive Health Month

By Tuba Khan

Sexual and reproductive health is an integral part of overall wellbeing; nevertheless, it is usually one of the least discussed subjects in the healthcare sector of Pakistan. Sexual and reproductive health is not only limited to pregnancy or childbirth; it includes many other issues such as family planning, diagnosis of fertility problems, motherhood and child care, prevention of sexually transmitted diseases, respecting consent, protection from sexual abuse and sex education. September is a month through which we get the chance to create awareness of these issues and come to know that reproductive health means life and respect.

Pakistan is facing numerous problems in providing quality reproductive health services to women and young girls. According to the most recent international comparative data for Pakistan, the maternal mortality rate in Pakistan was 154 per 100,000 live births in 2020. The majority of these deaths could easily be prevented if there were adequate antenatal care. Moreover, more than 700 children are estimated to be dying daily in Pakistan, which is unfortunate as most of them could have been saved. Despite grim statistics, the health budget of Pakistan as of 2026 stands at 2.2% of the total federal budget.

One of the major problems in sexual and reproductive health is that there is an absence of access to family planning and lack of sex education. As per statistics by the United Nations Population Fund Pakistan (UNFPA), 34 percent of married women in Pakistan use contraceptive methods and about 17.8 percent of the population has an unmet need for family planning. It should also be noted that about 2.2 million unsafe abortions take place annually in Pakistan. This figure illustrates the outcomes when women do not have access to proper family-planning and healthcare facilities.

The challenge is even more difficult among adolescents. Early marriages can cause the young girls to get pregnant too soon, before their bodies are ready for motherhood. Pakistan is one of those countries which have a higher rate of child marriages. Approximately, 18 percent of the girls get married before turning 18 years and about 4 percent of girls before turning 15. Early marriages put them at great risk of reproductive health hazards. According to UNICEF, almost 55 percent of the Pakistani teenage girls are anemic, further highlighting the severity of the issue.

Another critical aspect in relation to this issue is the state of the healthcare facilities available. In Pakistan, there are hospitals, Basic Health Units, Rural Health Centers, as well as private healthcare facilities, but the availability and quality of such services differ significantly in urban and rural areas. The lack of health practitioners, equipment, medicines, emergency services and health budget pose a danger to women in terms of receiving adequate treatment in case of complications. However, there are huge disparities from one region to another. The figures released by UNICEF reveal that skilled attendance at birth is 88% in Islamabad while in Balochistan this figure drops to 18%. This huge gap clearly depicts that despite having a national healthcare policy in Pakistan, the equal delivery of health care services is not guaranteed. Women in rural areas have to travel long distances to get treatment for complicated pregnancies and emergency conditions.

In Pakistan, concrete steps to deal with sexual and reproductive issues are essential. To begin with, primary healthcare centers have to be well-equipped with qualified doctors, nurses, midwives and community health workers. Medicines, contraceptives, diagnostics, blood banks and emergency obstetrics should always be available. Secondly, referral and ambulance services need to be upgraded so that women facing problems get admitted to the right hospitals in time. Finally, reproductive health awareness sessions and sex education must be ensured for youth so that they can be able to understand puberty, hygiene, consent, healthy relationships and protection from infections.

On the other hand, we cannot ignore the existence of social barriers that can stop people from going for treatment. Illiteracy, gender discrimination, early marriage and the stigma associated with discussing issues of sexual and reproductive health exacerbate the situation. People, especially women and adolescents must be provided with scientifically correct information without any stigmatization.

Reproductive and sexual health is ultimately not just an issue for women; it is a public health and human development issue. Good reproductive healthcare facilities will help decrease the number of maternal and newborn deaths and unwanted pregnancies. Reproductive health requires information, dignity, informed choices and good health care, which should be accessible to all.