Safeguarding Women's Health - Addressing Gaps in Abortion and Post-Abortion Care in Pakistan

ISLAMABAD: “The government is fully committed to enhancing healthcare access, especially 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,” stated Dr. Malik Mukhtar Ahmed Bharath, Coordinator to the Prime Minister on National Health Services. He made these remarks while addressing 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 by the Population Council, in partnership with the Guttmacher Institute, highlighting the urgent state of women’s reproductive health in Pakistan, with a focus on abortion and post-abortion care. Dr. Malik emphasized that, with maternal mortality 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 and resources, reaffirming the government’s commitment to achieving this through policies and improved 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, strengthening reproductive health services nationwide.

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 time as Pakistan grapples with 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. Moreover, between 21-30% of women who underwent an abortion still faced complications, indicating 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 remain. The study found that rural poor women are more likely to suffer from complications compared to wealthier women and those living in urban areas.

The study is a major eye-opener when 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 Population Council, emphasized the importance of the report. “Pakistan has made strides in improving health care, but this report reminds us that there is still much work to be done, especially in ensuring women have access to family planning and safe reproductive health services”. She also emphasized women empowerment through access to family planning and safe healthcare services is fundamental in achieving broader social and economic goals, contributing to a more just and equitable society.

Speaking at the event, Mr. Thomas Dahl, Deputy Head of Mission, Royal Norwegian Embassy Islamabad, expressed Norway’s support for the initiative, stating, “This is an issue that impacts not just the health of women, but 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 an expert panel discussion on “Safeguarding Women’s Health in Pakistan” moderated by Dr Luay Shabaneh, Country Representative of UNFPA. The panelists included Prof. Dr. Azra Ahsan, President of Association for Mothers and Newborns (AMAN); Dr. Yasmeen Sabeeh Qazi, CEO, QZ Catalyst; Prof. Naila Israr, former Executive Director FG Polyclinic Islamabad and Prof. Dr. Ghazala Mahmud, Patron in Chief, Society of Obstetricians and Gynaecologists of Pakistan (SOGP), Islamabad. They discussed critical issues affecting women’s health in Pakistan, including the 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 across the country.

A special session on “Unintended Pregnancies and Abortion Care”, included a presentation by Dr. Susheela Singh, Vice President for Global Science and Policy Integration, 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 representing provincial Departments of Health and Population Welfare from KP, Punjab, AJK and GB, moderated by Director General 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, noting 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 Punjab, highlighted her department’s initiatives in launching BCC campaigns and stressed the need for coordinated efforts to enhance access by integrating family planning services into healthcare delivery systems. Gojar Khan, Deputy Secretary of Social and Population Welfare, Gilgit-Baltistan, discussed the challenges of providing family planning and post-abortion healthcare services in the region due to its difficult terrain, stating that the study’s findings will help improve the situation in Gilgit-Baltistan.

The event underscores 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.