The average age of marriage for women was 19.8 between 1980 and 1990, and, with the rate of contraception use reaching only 12 percent in 1992, many delivered their first child about one year later. Thus, nearly half of Pakistani women have at least one child before they complete their twentieth year. In 1988-90 only 70 percent of pregnant women received any prenatal care the same proportion of births were attended by health workers. A study covering the years 1975 to 1990 found that 57 percent of pregnant women were anemic (1975 to 1990) and that many suffered from vitamin deficiencies. In 1988 some 600 of every 100,000 deliveries resulted in the death of the mother. Among women who die between ages fifteen and forty-five, a significant portion of deaths are related to childbearing.

The inadequate health care and the malnutrition suffered by women are reflected in infant and child health statistics. About 30 percent of babies born between 1985 and 1990 were of low birth weight. During 1992 ninety-nine of every 1,000 infants died in their first year of life. Mothers breast-feed for a median of twenty months, according to a 1986-90 survey, but generally withhold necessary supplementary foods until weaning. In 1990 approximately 42 percent of children under five years of age were underweight. In 1992 there were 3.7 million malnourished children, and 652,000 died. Poor nutrition contributes significantly to childhood morbidity and mortality.

Progress has been made despite these rather dismal data. The infant mortality rate dropped from 163 per 1,000 live births in 1960 to ninety-nine per 1,000 in 1992. Immunization has also expanded rapidly in the recent past 81 percent of infants had received the recommended vaccines in 1992. A network of immunizations clinics--virtually free in most places--exists in urban areas and ensures that health workers are notified of a child's birth. Word of mouth and media attention, coupled with rural health clinics, seem to be responsible for the rapid increase in immunization rates in rural areas. By 1992 about 85 percent of the population had access to oral rehydration salts, and oral rehydration therapy was expected to lower the child mortality.

Data as of April 1994