BackgroundChild marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes. Our aim is to describe women’s knowledge and attitude towards child marriage practice who themselves were married as children.MethodsWomen of reproductive age (15–49 years) who were married prior to 18 years, for at least 5 years and had at least one child birth were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes.ResultsNineteen of 20 participants who agreed to participate were married between 11–17 years. Most respondents were uneducated, poor and were working as housemaids. The majority participants were unaware of the negative health outcomes of child marriages. They appeared satisfied by the decision of their parents of marrying them before 18 years, and even condemned banning child marriages in Pakistan. Strong influence of culture and community perceptions, varying interpretation of religion, and protecting family honor are some of the reasons that were narrated by the participants, which seems playing a role in continuation of child marriage practice in Pakistan.ConclusionRaising awareness of the negative health outcomes of child marriage, implementing and enforcing strict laws against child marriage practice, promoting civil, sexual and reproductive health rights for women, can help eliminate child marriages in Pakistan.

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Pakistani women living in rural areas are particularly vulnerable to violence because of their relatively weaker social position and lack of awareness about their legal rights. We investigated domestic violence against rural women and its association with women's health. A cross-sectional survey was conducted from Rural Health Center of five selected districts by conducting face-to-face interviews from 490 randomly selected women of reproductive age. The data showed that about 65 % of the interviewed women had experienced different types of violence, with psychological violence being the most common. Multivariate logistic regression analysis showed that women's low education, low income, and marriage at an early age were significantly associated with domestic violence. Additionally, Domestic violence was significantly associated with poor mental and reproductive health. These findings may be useful in developing public health programs to address domestic violence against rural women.

BackgroundChild marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes including intimate partner violence (IPV). Our aim is to describe the types and circumstances of IPV against women who were married as children in urban slums of Lahore, Pakistan.MethodsWomen of reproductive age (15–49 years) who were married prior to 18 years, for at least 5 years were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview guide were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes.ResultsAll 19 participants were married between 11 and 17 years. Most respondents were uneducated, poor and were working as housemaids. Majority of participants experienced verbal abuse, and threatened, attempted and completed physical violence by their husbands. A sizeable number of women reported unwanted sexual encounters by their husbands. Family affairs particularly issues with in-laws, poor house management, lack of proper care of children, bringing insufficient dowry, financial problems, an act against the will of husband, and inability to give birth to a male child were some of the reasons narrated by the participants which led to IPV against women.ConclusionsWomen married as children are vulnerable to IPV. Concerted efforts are needed from all sectors of society including academia, public health experts, policy makers and civil society to end the child marriage practice in Pakistan.

Background Women’s empowerment has always remained a contested issue in the complex socio-demographic and cultural milieu of Pakistani society. Women are ranked lower than men on all vital human development indicators. Therefore, studying various determinants of women’s empowerment is urgently needed in the Pakistani context. Methods The study empirically operationalized the concept of women’s empowerment and investigated its determinants through representative secondary data taken from the Pakistan Demographic and Health Surveys among women at reproductive age (15–49 years) in 2012–13 (n = 13,558) and 2017–18 (n = 15,068). The study used simple binary logistic and multivariable regression analyses. Results The results of the binary logistic regression highlighted that almost all of the selected demographic, economic, social, and access to information variables were significantly associated with women’s empowerment (p < 0.05) in both PDHS datasets. In the multivariable regression analysis, the adjusted odds ratios highlighted that reproductive-age women in higher age groups having children, with a higher level of education and wealth index, involved in skilled work, who were the head of household, and had access to information were reported to be more empowered. Results of the multivariable regression analysis conducted separately for two empowerment indicators (decision-making and ownership) corroborated the findings of the one indicator of women empowerment, except where ownership did not appear to be significantly associated with number of children and sex of household head in both data sets (2012–13 and 2017–18). Conclusions A number of social, economic, demographic, familial, and information-exposure factors determine women’s empowerment. The study proposes some evidence-based policy options to improve the status of women in Pakistan.