Publishing Date: April 15th 2011

By Bushra Khaliq

Published at:  (www.arrow.org.my): www.arrow.org.my/publications/AFC/v17n1.pdf

The issue of sexual and reproductive health and rights (SRHR) in Pakistan is very important, and can be assessed from three interrelated perspectives: women’s social status, state priorities and donors’ agenda. As a traditional patriarchal, as well as feudal and tribal society, Pakistan harbors strong values on issues regarding family, sexuality, SRHR and gender relations. The state of SRHR in Pakistan cannot be understood without Islamic, social and cultural norms shaping society’s collective attitude towards SRHR in general and women’s issues in particular.
This situation is generating dismal facts, such as low literacy rates, gender-based violence, lack of discussion and education on sexuality issues, whether formal or in public discourse, and women’s lack of autonomy to make decisions regarding their bodies. These in turn translate to poor sexual and reproductive health. Consequently, poor women’s health in Pakistan is as
much a social as a medical problem. Since its inception through 1980s, the National Family Planning Programme—the main reproductive health service provider in Pakistan—has been poor in terms of density, service provision and quality. There are number of socio-economic, religious and cultural reasons behind this poor performance but a main factor is the lack of priority given to this issue by state.
The security-obsessed state of Pakistan, which allocates its maximum resources to fight the US-led war on terrorism, has very low priority for social sector spending and women’s development. Even its other South Asian neighbors, like Bhutan and Nepal, are spending 10 times more on the health sector. The sexual and reproductive health-related initiatives in Pakistan have been mainly donor-dependent. Donors’ funding is mainly related to mother and child care however, and though it brought the MMR down to marginal extent (from 346 to 276/100,000 in one decade), much more is needed to provide comprehensive sexual and reproductive health services, provide comprehensive sexuality education, and address sexual and reproductive rights.
Another issue is the question of enhancement and effectiveness of donors’ aid. Donor’s national security interests as conditionality for aid is a bottleneck to the improvement of SRHR. For instance, USAID’s financial aid for Pakistan in the field of reproductive health has waxed over the decades according to the political interests of the US in the region. Such aid should always be free of strings.