Investing in the Sexual and Reproductive Health of Adolescents in Pakistan

Many adolescents in Pakistan are at risk of experiencing poor reproductive health, which is associated with adverse consequences such as early childbearing and parenthood, pregnancy complications, and maternal death and disability.

For instance, about one in five married adolescent women aged 15–19 years in Pakistan have begun childbearing, often without the support of policies and programs that would enable them to make informed and voluntary decisions to protect their health and exercise their reproductive rights.

The data below come from the Adding It Up project, which examines the need for, impact of and cost of fully investing in reproductive health care in low- and middle-income countries, and the 2017–2018 Pakistan Demographic and Health Survey. This fact sheet presents data on the unmet needs for reproductive health care for adolescent women aged 15–19 in Pakistan, as well as the related benefits and costs of meeting such needs.

Adolescents’ needs for reproductive health services

• An estimated 617,000 pregnancies take place among adolescent women aged 15–19 years in Pakistan each year, as of 2019. Some 36% of these pregnancies are unintended, meaning that they were wanted later or not at all.
• More than half (58%) of unintended pregnancies among these adolescents end in abortion. In addition, 30% end in birth and 12% result in miscarriage or stillbirth.

• Among adolescent women aged 15–19 years in Pakistan, 461,000 want to avoid a pregnancy, 97,000 whose need for modern methods is met and 364,000 who have an unmet need. In other words, more than three-fourths of adolescent women who want to avoid pregnancy have an unmet need for modern contraceptives.
• Each year, 397,000 adolescent women give birth in Pakistan, and many of them do not receive the care they need. More than half (238,000) make fewer than the recommended four antenatal care visits, and 126,000 do not deliver in a health facility.
• The most common causes of maternal deaths among adolescent women in Pakistan are hypertension (114 deaths per 100,000 live births), followed by unsafe abortion (41 deaths per 100,000 live births) and hemorrhage (24 deaths per 100,000 live births).

Impact of meeting adolescents’ service needs

• If all needs were met for contraceptive, maternal and newborn, and abortion care for adolescents aged 15–19 in Pakistan:
  • Unintended pregnancies would be reduced by 72%, from 221,000 to 62,000 per year.
  • Abortions would decrease by 72%, from 128,000 to 36,000 per year.
  • Maternal deaths would be reduced by 76%, from 1,020 to 250 per year.
  • Postabortion care cases would decrease by 72%, from 48,000 to 13,000 per year.

Costs of expanding services for adolescents

• An additional US$0.37 per capita would fulfill the unmet needs for reproductive health services among adolescent women in Pakistan.
• The cost of abortion care would decrease by 51% if all unmet needs for reproductive health care for adolescent women were met.
• Contraception yields cost savings by reducing unintended pregnancies. For every additional dollar spent on expanding contraceptive services, Pakistan would save US$4.52 in the cost of maternal, newborn and abortion care for all women of reproductive age in the country.

The way forward

• Expanding modern contraceptive services is an effective strategy for reducing the cost of maternal and newborn health care, while also reducing injury and death among women and infants. This would empower women and couples—particularly adolescents—to plan the size of their families.
• Pakistan’s federal and provincial governments, private sector and international development partners share responsibility for meeting the demand for modern contraceptives.
• Reproductive health care benefits individuals and families by saving lives and improving women’s health and well-being—all of which contributes to Pakistan’s social and economic development.