In Pakistan, a country overshadowed by patriarchal norms and socio-economic complexity, female health remains a critical yet often neglected concern. Amidst this chaos of inequality and prejudice, financial inclusion emerges as a pivotal catalyst for change, promising to enhance healthcare accessibility and quality for women across the nation.
With over 21% of Pakistan’s population living below the poverty line, women’s healthcare concerns are becoming increasingly difficult to prioritize especially in rural settings and lower wealth quintiles where basic resource affordability is already scarce. Recent data from the Pakistan Demographic and Health Survey (PDHS) reveals a maternal mortality ratio (MMR) of 186 deaths per 100,000 live births (54th highest in the world) and fluctuating rates of modern contraceptive use, indicating persisting challenges in maternal and reproductive health (MRH). Despite advancements and increased health expenditure, restrictions in mobility and financial autonomy continue to impact MRH access for women.
The high social and economic dependence on men, especially in lower-income households, reduces female autonomy, restricting access to health resources.
In the current state of rising inequality, financial inclusion can be an impetus to bridge the healthcare divide in Pakistan. The potential of financial inclusion in mitigating barriers that impede MRH access for women in developing countries has been recognized in India and Bangladesh. Through increased digital literacy and financial autonomy, health prioritization can be promoted among women by increasing their knowledge of resource utilization, providing them independent access to finances, and combating issues of restricted mobility. These studies also indicate that women with access to formal financial services are more likely to avail healthcare resources and are afforded the autonomy to make informed health decisions and have greater participation in household decision-making.
The domination of cultural norms in Pakistan impacts women’s bargaining power within the household, reducing their participation in fertility and health decisions. The high social and economic dependence on men, especially in lower-income households, reduces female autonomy and confines them to the four walls of their houses, restricting access to health resources. Enhanced financial security and literacy can empower women by strengthening their bargaining position within the household, allowing them to have increased joint participation in decision-making regarding health expenditure.
Researches point out Grameen Bank, Bangladesh’s first microfinance bank’s example of how affiliation with a formal institution can provide greater exposure to public spaces and increased economic security which can have a positive impact on female mobility (Schuler & Hashemi, 1994). The existence of a bank account and involvement in microfinance programs encourage female employment and contraceptive use as women become more informed of their fertility choices and financial position. Financial and economic security further impacts women’s freedom from domination and violence in patriarchal households and enhances political and legal awareness which in turn affects their health decisions.
Apart from this, mobile banking can be a revolutionary step towards empowering women through digital and financial literacy. According to the PDHS survey, about two-thirds of women identified the challenges of mobility and distance from health facilities as significant barriers to accessing health resources. Not only can mobile banking make payments faster, but it can alleviate mobility restrictions through online payments. In rural areas where the number of banks is limited and at great distances, the lengthy, often impractical and unsafe journeys for cash transfers present a daunting challenge, especially for women restricted from traveling alone. Moreover, online payments create a pathway for women to independently manage their finances, thereby diminishing their reliance on men and ensuring direct access to healthcare resources when needed.
It goes without saying that enhancing digital literacy can promote women’s exposure to family planning messages via mobile phones. By partnering with local banks, family planning and health organizations can deliver healthcare information through banking apps that offer discounts on digital payments. Additionally, the government could offer financial rewards to pregnant women who choose to deliver in medical facilities, directly depositing these incentives into the beneficiaries’ bank accounts.
Collaborative efforts among financial institutions and private healthcare providers can further bridge the gap between the financial and healthcare sectors, especially for middle-income households. For instance, bundling health insurance with savings accounts can offer a dual benefit of economic security and healthcare access, providing women a robust safety net against financial hardships. Since women with limited education face greater challenges in MRH utilization, banking apps with voice commandments in local languages can make the payment process easier, accessible, and inclusive. Together, these initiatives can paint a picture of a future where the financial and healthcare sectors are not just aligned but integrated, allowing women to navigate financial transactions and avail resources with ease and dignity.
However, despite strong evidence of financial inclusion’s role in female empowerment, around 93% of the women in Pakistan remain unbanked and only 4% make use of mobile banking with the majority of women lacking mobile ownership. With the decision-making power resting solely in the hands of men, women are often discouraged from participating in financial systems and have little financial autonomy.
Disproportionate effects of poverty present as significant impediments in women’s utilization of digital and financial services. Strategies advocating for the provision of subsidized smartphones for women and targeted educational programs are essential in Pakistan’s public health policy. These programs should be designed to enhance digital skills and financial literacy, tailored to meet the unique needs of women across diverse socio-economic backgrounds. Collaboration with tech companies, financial institutions, and NGOs can further facilitate the deployment of these educational initiatives, leveraging their expertise and resources for broader reach and impact. It is important to note that the challenges of unbanked women, healthcare inaccessibility, and limited mobile ownership are not isolated phenomena but are deeply interwoven and endogenous to the broader socio-economic fabric. Addressing these issues in connection to one another is essential to advance the overarching objectives of improving women’s living standards and fostering economic development in Pakistan.
The pursuit of enhanced maternal and reproductive health services in Pakistan through the lens of financial inclusion is not just a health imperative but a strategic economic move.
The pursuit of enhanced MRH services in Pakistan through the lens of financial inclusion is not just a health imperative but a strategic economic move. The coalition of financial empowerment and healthcare access illuminates an economic pathway to better public health outcomes that can revolutionize the healthcare sector in Pakistan. Achieving this vision demands an innovative and inclusive policy-making that acknowledges the challenges faced by women in the financial, digital, and healthcare sectors.
The ultimate objective is establishing an inclusive financial and healthcare ecosystem that empowers women across all socio-economic tiers, setting the stage for a more equitable and prosperous Pakistan. Through the prioritization of financial and digital inclusion of women in public health policy, Pakistan can advance towards improved health access and equity and a sustainable future that can transform lives.