Source: Federal Bureau of Statistics. Labour Force Survey 99-00 & 2001-2002.
The above table shows some encouraging developments. The percentage of females who worked as unpaid family helpers has fallen from 63.3 % in 1997-98 to 46.86% in 2001-2002. The percentage of self-employed females has risen from 11.7% in 1997-98 to 15.72% in the same period after touching 16.7% in 1999-2000. In 1997-98 women 0.1% of all females in the work force were employers. This figure rose to 0.30 in 2001-2002. The figure for males declined slightly from 1.0% to 0.91%.
Source: Federal Bureau of Statistics. Labour Force Survey 2001-2002.
The tables given above show that women lag behind men in almost every area covered by Article 11 of the Convention. There are however signs of change. The Female Labour Force Participation while still quite low, is increasing. In 1981 it was 2.1%. It had moved up to 9.9% by 2001-2002. However the unemployment rates give a mixed picture. The one exception is that the unemployed rates for women falling in the 15-19 age group has decreased from 40.7 in 1999-2000 to 20.5 in 2001-2002. Women’s unemployment has increased by about 2-3 points, for other age groups (20-24, 25-29, 30-34, 35-39, 40-44, 45-49, 50-54 and 55-59 years). The unemployment rate for women is many times higher for every age group. This points to the fact, true of most developing and many developed countries, that women are the last to get jobs and the first to lose them. At the same time it is apparent that the percentage of both sexes in the formal and informal sectors is about the same. Women do not seem to making a preponderant proportion of the informal sector workers.
A number of factors may be responsible for the relatively low female labour force participation rate. Many women prefer to remain at home as homemakers rather than join the work force. Many may be prevented from working by family or spouses or other factors such as the need to take care of children. It is also possible that many women are not qualified enough to beat men in open competition for jobs. There may also be a bias against recruiting women by some employers in the informal sector. Additionally issues such as mobility, security and workplace environment also have a significant bearing in women decision to joint the workforce either in formal or informal sector.
The labour force participation rates of women while rising, do not suggest that parity between men and women in this area will be reached any time soon. There are a number of reasons. Many women have not yet considered or felt the need for pursuing a career as an option. Many attach greater importance to looking after the kids and the families. Many feel under-equipped, particularly academically, to venture into the labour market. Many are not aware of the opportunities available to them. At least some are discouraged from pursuing a career by their families. This complex mix of factors will only be addressed through the spread of education and a working system of career guidance and vocational training. Absence of protection of labour laws to agricultural labour, the area where most women workers are active, also needs to be considered. It is a complicated issue which impacts on the entire national economy. A solution to it will however need to be devised if agricultural workers are to enjoy the protection of the labour laws.
Constitution does not specifically contain an article relating to health. Article 38 (a) speaks of “raising the standard of living” of the citizens. Standard of living could be said to also indirectly address health.
The Federal Ministry of Health and the provincial health departments run an extensive system of hospitals, dispensaries, maternal and child health centers, rural health centers and basic health units. The general arrangement is: Basic Health Unit at the Union Council Level; Rural health center at the tehsil level (These rural health centers also contain maternal and child health centers); a district hospital at the district headquarters; teaching hospitals in the large cities (These hospitals are attached to medical colleges and post-graduate institutes); specialised hospitals in the larger cities.
The Government adopted the National Health Policy in 2001 to bring about an overhaul of the Health Sector in Pakistan13. An important aspect of the policy is the focus on the health needs of women and girls.
There are ten specific areas of focus with a number of programmes under each area. Definite timelines have been established to ensure efficiency, focus and accountability. Areas relating directly or indirectly to women / girl health are given below.
Reducing prevalence of communicable diseases.
A National Programme for immunizing mothers against neo-natal tetanus will be implemented in 57 selected High-Risk districts of the country.
Addressing inadequacies in primary / secondary health care facilities.
58,000 Lady Health Workers under the Ministry of Health and 13000 village based family planning workers under the Ministry of Population Welfare have been integrated to create a cadre of 71,000 family health workers under the National Programme for Family Planning and Primary Health Care.
Provinces will improve District/ Tehsil Hospitals. At least 6 specialties (Medicine, Surgery, Paediatrics, Gynae, ENT and ophthalmology) will be available at these facilities.
Promoting greater gender equity.
Focused reproductive health services to childbearing women through a life cycle approach at their doorsteps. This will ensure provision of Safe Motherhood facilities.
Emergency obstetric Care facilities through “Women friendly hospitals” in 20 districts of Pakistan under the Women Health Project.
Bridging basic nutrition gaps in the target population.
Vitamin A supplements will be provided annually to all under 5 children (about 30 million) along with Oral Polio Vaccine on National Immunisation Days through the EPI network.
Provision of iodised salt will be ensured along with introduction of fortified flour and vegetable oil by addition of micronutrients like iron and vitamin-A.
States Parties shall take all appropriate measures to eliminate discrimination against women in the field of healthcare in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning.
The health infrastructure in Pakistan is accessible to all citizens of Pakistan regardless of gender. The same is true of family planning services.
The present health infrastructure in the public sector consists of 906 hospitals, 4,590 dispensaries, 550 Rural Health Centres, 5,308 Basic Health Units and 98,264 hospital beds. This compares well with other developing countries. However, the availability of one doctor for 1,466 persons, one dentist for 29,405 people, one nurse for 3,347 and one hospital bed for 1,517 persons underlines the need for further improvement in the physical infrastructure. An even bigger challenge is improvement in the qualitative aspect of the health care system in Pakistan. The quality of care and services provided in these facilities is not uniform. Apprehensions have been expressed that some facilities such as Basic Health Units are either partially functional or not functional at all.
The total number of doctors in Pakistan in September 2003 was 91,392 of which 33,649 (36.8%) were women. There were 5108 dentists of which 2040 (39.9%) were women. There were 44,520 registered nurses almost all of whom were women.14
Maternal mortality in Pakistan remains high. It is estimated to be 340 per 100,000 live births and some estimates put it higher. Two out of five pregnant women are anaemic and four out of five deliveries are not assisted by trained health officials. The life expectancy at birth in 2001 was 64 years for males and 66 years for females.