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June 2011, Volume 61, Issue 6


State of children in Pakistan — confronting reality

Aisha Mehnaz  ( Department of Paediatrics, Dow University of Health Sciences, Karachi. )

Pakistan ranks sixth among nations with largest population and fifth among countries with largest youth population. It is predicted that Pakistan\\\'s population will almost double in the next 40 years and so also its youth population.1 Sixty three percent of our population are less than 25 years,2 53% individuals are below 19 years of age and 35% of our population are between 15 to 24 years of age. This is in sharp contrast to 16% youth population witnessed in more stable countries like USA and Japan.2
Pakistan was among the 150 representative states that met at the world summit for convention for the rights of the children (CRC) in 1990 at Geneva and made a pledge with the other nations to improve the health and well being of children and women by the end of the century. The CRC has 54 articles that cover the full spectrum of civil, political, economic, social and cultural rights of a child ranging from the child\\\'s basic needs such as food, shelter, and access to health care to other fundamental rights like right to education, freedom of thoughts and religion.3
In 1993 at the convention of SAARC countries on children, five goals were laid down. These included childhood immunization, universal primary education, and child nutrition, provision of drinking water and adequate shelter by year 2000. The year 2000 had also been set as the deadline to end child labour in hazardous conditions and year 2010 as the deadline for eradication of all kinds of child labour.
Over a decade has passed since we entered into the new millennium; the state of children of Pakistan is still far from satisfactory.
Let us look at the state of children in Pakistan. Of the total population of Pakistan i.e. 164.6 million children below 19 years of age comprises of more than half of our total population.4 The annual growth rate of Pakistan (3.43 in 2009) is steady over the last few decades with insignificant change. Increase in childhood mortality and early marriages are two important factors resulting in high fertility rate.
Pakistan ranked 43rd among the countries of south East Asia with highest under five mortality rate,4 while countries which are much smaller than ours and facing similar socio-political problems fair better than us. An exemplary example of that is Sri Lanka where the under five mortality has significantly declined.
On the other hand in Pakistan there is no significant decline in the mortality figures of children below five years (<5 years) and those below one year (5 Hardly a significant improvement. Majority of theses children succumb to disorders which can easily be prevented with timely intervention.
The immunization coverage for Tb, DPT and polio and measles is still far from satisfactory. New cases of polio continue to emerge and there is a resurge in the cases of tuberculosis. The percentage of children born with low birth weight a state of intrauterine malnutrition is still 19 % (a drop in only 4-5% in the last two decades), majority of these new born continue to suffer from malnutrition in infancy and childhood. Nearly 40% of children less than five years of age suffer from malnutrition.5-7 Of these 10% are severely malnourished, those surviving the consequences of malnutrition in early childhood ends up as stunted underweight adolescents. Early marriages of such an adolescent girl results in birth of another low weight baby and thus the cycles goes on.
Education is the fundamental right of every child .on it rest the development of the nation. Only 56% of our children are enrolled in primary school. Percentage of girls enrolled in primary education are far less (51% vs. 60% boys). Of those enrolled 2/3 rd girls and half of boys do not complete primary school.7
Child protection is a concept still alien to the concerned authority. Child abuse and neglect is of global prevalence. There has been a sharp rise in the reported cases of child abuse and neglect over the last few decades. In Pakistan there still exist no official data on the incidence and prevalence of CAN. Nearly all forms of CA exist in our country cases of sexual assault, gang rape and sodomy, corporal punishment are increasingly being reported. Nearly eight to ten million children are employed as child labourers in various industries; there are no official estimates of children employed as domestic workers. Nearly 25, 0000 children are living on the street of big cities like Karachi.8
There has been an unprecedented rise in violence and crime against children and adolescent females in the last few years. The youth of today are not only subjected to injustice and discriminatory attitude, but are increasingly being found involved in unhealthy activities like substance abuse. The state of children and youth in Pakistan thus presents a very dismal picture. Have we really done any planning for this large population of our country? Considering the aftermath of lawlessness, violence frustration and denial of basic rights to which we have subjected our children and the youth, can we expect a better future for ourselves? Is it not time to confront realty?


1.(Online) (Cited 2010 June 16). Available from URL: population dated 6/6/2010.
2.(Online) (Cited 2010 June 16). Available from URL: /
3.United nation convention on the rights of children. (Online) (Cited 2010 June 16). Available from URL:
4.Pakistan Demographic Health Survey, MOH 2008. (Online) (Cited 2010 June 10). Available from URL: by country/pakistan_pakistan background .html.
5.State of world\\\'s children, 2009, UNICEF. Basic Indicators, 176-7.
6.Black RE, Morris SS, Bryce J. Where and Why 10 million children dying every year. Lancet 2003; 361: 2226-34.
7.Presentation by Joint secretary, (2007) Ministry of social welfare, National consultation organized by SC-UK, august 2009.
8.Pakistan Child labor Survey, Ministry of labour, Federal Bureau of statistics and ILO, 1996.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: