Study reveals alarming gaps in abortion care, reproductive health services

ISLAMABAD: Coordinator to the Prime Minister on National Health Services Dr Malik Mukhtar Ahmed Bharath has said that the government is fully committed to enhancing healthcare access, particularly for women in marginalized and underserved regions.

“We are working towards a system where every woman can receive the healthcare she needs, when she needs it, free from stigma or fear,” he said during the launch of the report titled “Safeguarding Women’s Health: Trends, Inequities, and Opportunities in Pakistan’s Abortion and Post-Abortion Care Services” in Islamabad.

The event unveiled findings from a comprehensive national study conducted by the Population Council, in partnership with the Guttmacher Institute. The report highlights the urgent state of women’s reproductive health in Pakistan, particularly focusing on abortion and post-abortion care. Dr Malik emphasized that, with maternal mortality standing at 186 deaths per 100,000 live births, the research underscores the need for comprehensive reforms in reproductive healthcare. He also stressed the importance of balancing population growth with resources, reaffirming the government’s commitment to achieving this through policies that improve access to family planning services.

The government plans to implement the report’s recommendations by investing in infrastructure, capacity building, and an enhanced referral system to improve emergency response capabilities, thereby strengthening reproductive health services across the country.

The “Women’s Health Study” is the third in a series of national assessments following similar studies in 2002 and 2012. It comes at a pivotal moment as Pakistan faces significant reproductive health challenges. The study reveals that 66 women of reproductive age (15-49) per 1,000 had an induced abortion annually in 2023. Additionally, 21-30% of women who underwent abortions faced complications, highlighting serious gaps in care and safety. While the rate of abortion-related complications has declined from 13.9 per 1,000 women in 2012 to 11.7 per 1,000 in 2023, significant inequities persist. Rural poor women are more likely to suffer complications compared to wealthier and urban women.

The study is a major eye-opener as the country’s intercensal population growth rate is recorded at 2.55% per annum, with contraceptive use stagnating. Moreover, 17.3% of women report an unmet need for family planning, contributing to high rates of unintended pregnancies, many of which result in unsafe abortions.

Dr Zeba Sathar, Country Director of the Population Council, emphasized the importance of the report. “Pakistan has made strides in improving healthcare, but this report reminds us that much work remains, especially in ensuring women have access to family planning and safe reproductive health services.” She also highlighted that empowering women through access to family planning and safe healthcare services is essential for achieving broader social and economic goals, contributing to a more just and equitable society.

Speaking at the event, Thomas Dahl, Deputy Head of Mission at the Royal Norwegian Embassy in Islamabad, expressed Norway’s support for the initiative, stating, “This issue impacts not just the health of women but also the overall well-being and development of society. Norway is proud to support efforts that improve access to reproductive health services in Pakistan.”

The event featured a panel discussion on “Safeguarding Women’s Health in Pakistan” moderated by Dr. Luay Shabaneh, Country Representative of UNFPA. Panelists included Prof Dr Azra Ahsan, President of the Association for Mothers and Newborns (AMAN); Dr. Yasmeen Sabeeh Qazi, CEO of QZ Catalyst; Prof. Naila Israr, former Executive Director of FG Polyclinic Islamabad; and Prof. Dr. Ghazala Mahmud, Patron-in-Chief of the Society of Obstetricians and Gynaecologists of Pakistan (SOGP), Islamabad. They discussed critical issues affecting women’s health in Pakistan, including barriers to accessing reproductive healthcare and the stigma surrounding abortion. The panel emphasized the importance of education, healthcare reform, and policy advocacy to create a safer and healthier environment for women nationwide.

A special session on “Unintended Pregnancies and Abortion Care” included a presentation by Dr. Susheela Singh, Vice President for Global Science and Policy Integration at the Guttmacher Institute. She provided valuable insights into the global context of unintended pregnancies and the need for comprehensive reproductive health services to reduce the incidence of unsafe abortions in Pakistan. This was followed by a panel featuring representatives from provincial Departments of Health and Population Welfare from KP, Punjab, AJK, and GB, moderated by the Director General of Health, Ministry of Health, Islamabad.

During the panel discussion, Imad Ali Lohani, Secretary of Population Welfare in Khyber Pakhtunkhwa, emphasized the role of women’s empowerment and education in reducing abortions by promoting the uptake of family planning services. He noted that abortion is often used as a method of family planning. Secretary Atta Ullah from Azad Jammu and Kashmir shared his department’s efforts to improve doorstep delivery of family planning services. Saman Rai, Director General of the Population Welfare Department in Punjab, highlighted her department’s initiatives, including launching BCC campaigns, and stressed the need for coordinated efforts to integrate family planning services into healthcare delivery systems. Gojar Khan, Deputy Secretary of Social and Population Welfare in Gilgit-Baltistan, discussed the challenges of providing family planning and post-abortion healthcare services in the region due to its difficult terrain, noting that the study’s findings will help improve the situation in Gilgit-Baltistan.

The event underscored a shared commitment to enhancing reproductive healthcare in Pakistan, emphasizing the crucial role of collaboration between the government, international partners, and health organizations in addressing the pressing health challenges faced by women, particularly in the area of reproductive health.