Pakistan’s 20 Districts Facing Worst Reproductive Health, Development Gaps: Experts

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ISLAMABAD: New national evidence shows that 20 districts across Pakistan are trapped in deep, overlapping deprivation where reproductive health services are scarce, fertility rates remain high, schools and health facilities are far from communities, housing conditions are poor and exposure to climate risks is among the highest in the country.

These districts, most of them in Balochistan, continue to face severe structural disadvantages that shape every aspect of life for women and children. The findings were presented at a Media Coalition Meeting organised by the Population Council with support from UNFPA, where experts shared updated district level data highlighting widespread inequities in health, education, communication, transport, and housing.

Experts at the session noted that in several of these highly deprived districts, essential services have failed to reach communities for years, leaving families with limited pathways to well being or resilience. Welcoming the participants, Population Council Senior Director Dr Ali Mir said Pakistan’s development agenda cannot progress unless the country acknowledges the depth of inequity that district level analysis has exposed. He said the numbers clearly show that millions still do not receive the most basic health, education and livelihood services. He added that these are not abstract data points but real daily struggles that demand visibility and collective action.

A detailed breakdown of the evidence was shared by Technical Advisor Dr G M Arif and Communication Manager Ikram ul Ahad, who explained that the District Vulnerability Index ranks all districts on six indicators, including health, education, communication, transport, housing and demographic pressure. Based on this analysis, 20 districts emerged as the most deprived. Most are located in Balochistan, where basic services remain thin and infrastructure weaknesses limit access to care. The presenters said deprivation in these districts is compounded by high fertility, weak family planning access and severe shortages of frontline workers.

In Chagai, Jhal Magsi, Kohat, Umerkot and Lodhran, many rural households did not receive a Lady Health Worker visit in the past month, leaving women without essential reproductive health counselling. In Kohistan and Kohlu, the nearest girls secondary school can be more than 70 kmaway, blocking education and limiting women’s empowerment across generations.

Demographic pressure remains another defining challenge. In districts such as Zhob and Kohistan, the proportion of children under five is unusually high, placing heavy strain on already fragile systems. Poor housing conditions and limited transport and communication access further restrict mobility and service uptake. Experts said these deep gaps fuel a cycle of deprivation that becomes harder to break as population pressure increases. Climate vulnerability is tightening its grip on many of the same districts. Flooding, drought and extreme heat in parts of Balochistan and Sindh are disrupting access to health and education services, while inadequate infrastructure leaves communities unable to recover from repeated shocks.

Ikram ul Ahad said the purpose of the Index is to help policymakers focus on the most deprived areas so that structural weaknesses can be addressed and resources prioritised. He said the data must guide investment in health, education, infrastructure and housing to strengthen resilience and reduce vulnerability.

UNFPA Program Specialist Dr Jamil Ahmad Chaudhry said reproductive health must be integrated into broader planning for vulnerability reduction. He emphasised that reducing population pressure and improving access to services will remain central to improving wellbeing in these districts. He said targeted investments and stronger coordination are essential for moving the most deprived districts towards equitable development.

News Published in The NEWS on November 28, 2025. 

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