Pakistan Bulletin
An up-to-date and informed analysis of key issues of Pakistan.
Breaking Barriers: Advancing Gender-Sensitive Healthcare for Women in Pakistan
November 2024
Gender inequality in Pakistan fuels a persistent health crisis. Systemic barriers, cultural norms, and inequitable healthcare access disproportionately harm women. Addressing these challenges is critical to enabling sustainable human development.
A persistent health crisis in Pakistan is deeply intertwined with gender inequality.
Across bustling cities and remote villages, systemic gaps in healthcare delivery disproportionately affect women, compounded by deeply rooted patriarchal norms, insufficient infrastructure, and restricted access to healthcare services. Addressing this dissimilitude is not only about improving health outcomes but also about fostering social equity, bridging economic disparities, and enabling sustainable human development.
Healthcare challenges in Pakistan impact all segments of society. However, the effects are felt most acutely by women, whose struggles are heightened by barriers such as gender-based discrimination, lack of healthcare infrastructure, inadequate education on health matters, and restricted access to affordable medical services. In rural areas, where healthcare infrastructure is sparse, women must often walk miles to reach medical facilities that are frequently inaccessible, unhygienic, or poorly equipped. Even then, cultural norms often require women to seek permission from male family members before accessing care, leading to delays that can turn treatable conditions into life-threatening complications. In urban areas, a stark divide emerges: while affluent women benefit from advanced medical care, those from marginalized communities face significant hurdles, such as navigating underfunded and overcrowded public hospitals. This stark inequality reveals how wealth becomes a decisive factor in accessing healthcare. For women living in poverty, the lack of financial resources amplifies the effects of deep-rooted social inequities, pushing them further into the shadows of maternal health risks, malnutrition, and preventable diseases.
In Pakistan, only 69% of births occur with the assistance of skilled healthcare providers, with rural women facing even greater access disparities.
The maternal mortality rate in Pakistan, according to the United Nations Population Fund (UNPF), estimated at 186 deaths per 100,000 live births , is a grim reflection of these challenges. These figures translate into thousands of preventable deaths annually, rooted in factors such as inadequate prenatal care, a shortage of skilled birth attendants, and widespread malnutrition among expectant mothers. The 2017–18 Pakistan Demographic and Health Survey (DHS) highlighted that only 69% of births in Pakistan occur with the assistance of a skilled provider, with rural women facing significantly lower access to healthcare compared to those in urban settings.
To address these disparities, healthcare policies must prioritize access to institutional delivery, increased immunization coverage, and enhanced antenatal services, especially in underserved regions. Comprehensive reproductive health education is equally critical. By embedding such education into school curriculums, engaging communities through awareness campaigns, and leveraging digital platforms for outreach, these measures can empower women with the knowledge needed to take control of their health.
Cultural and societal norms further deepen the healthcare crisis in Pakistan. In many regions, societal taboos around reproductive health, coupled with the lack of female healthcare providers, deter women from seeking medical attention. Hospitals in conservative areas often lack female doctors, creating an insurmountable barrier for women who are uncomfortable being treated by men. Increasing the recruitment and training of female healthcare professionals, particularly in rural regions, can help address this gap. A suggestion outlined in the International Journal of Private Higher Education (2023) and echoed in Pakistan’s National Health Vision 2016-2025 advocates for the expansion of the government’s initiative requiring public hospital graduates to serve in rural areas for a set period. The proposal includes incorporating targeted incentives specifically for female healthcare workers. These incentives aim to address both the gender disparity in healthcare access and the shortage of medical professionals in rural regions. By ensuring that female healthcare workers are supported through culturally sensitive measures, the policy could significantly improve healthcare delivery for women in underserved areas, where cultural norms often limit their access to care.
Grassroots community health programs, such as the Lady Health Worker (LHW) initiative, have shown significant potential in bridging these gaps. LHWs, who are often trusted members of their communities, provide doorstep care, promote immunization, and facilitate access to reproductive health services. By leveraging these workers and investing in their training and resources, the healthcare system can enhance trust, accessibility, and outcomes, particularly in rural areas. However, chronic underfunding of such programs undermines their effectiveness.
Modern technological advancements like telemedicine can also play a pivotal role in overcoming accessibility challenges. By connecting rural patients with specialists in urban centers through digital platforms, telemedicine eliminates the need for travel and provides women with timely consultations. To realize its potential, the government must ensure reliable internet connectivity in remote areas and create culturally appropriate telehealth programs that address the specific needs of women.
The success of gender-sensitive health care policies also depends on challenging patriarchal attitudes. Programs that engage male family members as allies in promoting women’s health can yield transformative results. For instance, involving men in reproductive health education and decision-making has been shown to improve contraceptive use and maternal health outcomes in parts of South Asia. By shifting perspectives within households, such initiatives can create ripple effects, fostering healthier communities and advancing gender equity.
Programs like the Lady Health Worker initiative and telemedicine show promise in bridging healthcare gaps, especially for rural women. However, sustained investment and culturally sensitive implementation are crucial to ensuring these solutions achieve their full potential.
Addressing the gender gap in healthcare aligns with Pakistan’s international commitments that emphasize universal access to healthcare and gender equality. These include the Sustainable Development Goals (SDGs) and the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW). However, translating these commitments into actionable policies requires tailoring global ideals to Pakistan’s unique sociocultural and economic realities. For example, programs promoting the use of contraception, often stigmatized in conservative areas, must be accompanied by culturally sensitive education campaigns to ensure their acceptance.
The economic argument for prioritizing women’s health is equally compelling. Studies have consistently shown that investing in maternal health and broader healthcare services for women generates significant returns. Healthier women contribute more effectively to their families and communities, leading to improved educational outcomes, increased workforce participation, and enhanced productivity. A report by the World Health Organization highlighted that every $1 spent on maternal and child health yields a $7 return in economic benefits. This underscores the transformative impact of equitable healthcare policies on both individual lives and national prosperity.
Pakistan’s healthcare system is at a defining crossroads. While the challenges of inefficiency, resource scarcity, and societal barriers are significant, they are not insurmountable. In investing in women’s health, Pakistan has the opportunity to ignite a revolution—one that not only reshapes the healthcare landscape but propels the country toward a more prosperous, inclusive future. The question is not if change is possible but whether we dare to rise to the occasion.
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