BIRTH CONTROL, ABORTION AND FAMILY PLANNING IN PAKISTAN

FAMILY PLANNING IN PAKISTAN

The government of Muslim countries like Pakistan, Indonesia and Egypt strongly support family planning. Family planning efforts have not been successful due to lack of funding and the difficulty of reaching remote areas. Pakistan has a population growth reduction program that was established in 1960. The program is underfunded and reaches few people.

Karin Brulliard, Washington Post: “Pakistan has South Asia’s highest fertility rate, at about four children per woman. Amid massive electricity shortfalls, failing schools, high unemployment and rising Islamist militancy, many here say the booming population is a ticking time bomb. “Do we want to become the fifth-largest nation with large segments of the population falling below the poverty line who are uneducated and unhealthy?” Prime Minister Yousuf Raza Gilani said on World Population Day in July, 2011. [Source: Karin Brulliard, Washington Post, December 14, 2011]

Population growth rate: 2.07 percent (2020 est.); compared with other countries in the world: 45. [Source: CIA World Factbook, 2020]

Pakistan's extremely high rate of population growth is caused by a falling death rate combined with a continuing high birth rate. In 1950 the mortality rate was twenty-seven per 1,000 population; by 1990 the rate had dropped to twelve (estimated) per 1,000. Yet throughout this period, the birth rate was fortyfour per 1,000 population. On average, in 1990 each family had 6.2 children, and only 11 percent of couples were regularly practicing contraception. [Source: Peter Blood, Library of Congress, 1994]

Diaa Hadid reported on Morning Edition of NPR: “The issues with family planning are partly why Pakistan has one of the world's fastest population growth rates, says demography expert Mehtab Karim, vice chancellor at Malir University of Science and Technology in Pakistan. That population boom has strained Pakistan's land and water resources, crowded its schools, outstripped development plans and may lead to more instability in this nuclear-armed state. "It has a tremendous impact," Karim says. [Source: Diaa Hadid, Morning Edition, NPR,, November 28, 2018]

Fertility Rate and Sex Ratio in Pakistan

Total fertility rate: 3.6 children born/woman (2020 est.); compared with other countries in the world: 40; and compared to 1.5 in Germany and 7.2 in Niger. This entry gives a figure for the average number of children that would be born per woman if all women lived to the end of their childbearing years and bore children according to a given fertility rate at each age. The total fertility rate (TFR) is a more direct measure of the level of fertility than the crude birth rate, since it refers to births per woman. This indicator shows the potential for population change in the country. [Source: CIA World Factbook]

Between 1960 and 2010, Pakistan’s fertility rate dropped from about six children per woman to an average of about four. But the decline has been far too slow for the country to reach its target of 2.2 children per woman by 2020. Zero population growt is achieved when the birth rate of a population equals the death rate, which occurs when the fertility rate is around 2.1 to 2.4 children per woman. [Source: Karin Brulliard, Washington Post, December 14, 2011; Wikipedia]

Sex ratio: Sex ratio: at birth: 1. 05 male(s)/female
0-14 years: 1. 04 male(s)/female
15-24 years: 1. 05 male(s)/female
25-54 years: 1. 05 male(s)/female
55-64 years: 1. 02 male(s)/female
65 years and over: 0.86 male(s)/female
total population: 1. 04 male(s)/female (2020 est.)
106 males for every 100 females in 2005.

This entry includes the number of males for each female in five age groups — at birth, under 15 years, 15-64 years, 65 years and over, and for the total population. Sex ratio at birth has recently emerged as an indicator of certain kinds of sex discrimination in some countries. For instance, high sex ratios at birth in some Asian countries are now attributed to sex-selective abortion and infanticide due to a strong preference for sons. This will affect future marriage patterns.

Mother's mean age at first birth: 23.6 years (2017/18 est.). This entry provides the mean (average) age of mothers at the birth of their first child. It is a useful indicator for gauging the success of family planning programs aiming to reduce maternal mortality, increase contraceptive use – particularly among married and unmarried adolescents – delay age at first marriage, and improve the health of newborns. Mother's mean age at first birth:

Contraceptive in Pakistan

Contraceptive prevalence rate: 34.2 percent (2017/18). This figure is the percent of women of reproductive age (15-49) who are married or in union and are using, or whose sexual partner is using, a method of contraception. [Source: CIA World Factbook, 2020]

Contraceptive use (any method, women ages 15-49): 34 percent (2018, compared to 12 percent in Sudan and 84 percent in the United Kingdom) [Source: World Bank ]

Top method of contraception: male condom [Source: Birth Control Around the World onlinedoctor.superdrug.com ]

Types of birth control used (2015); female sterilization: 9.8 percent; male sterilization: 0.3 percent; pill: 1.8 percent; injectible: 3.3 percent; IUD: 2.6 percent; male condom: 9.9 percent; vaginal barrier: 0.9 percent; early withdrawal: 8.4 percent; rhythm method: 0.8 percent; traditional 1.5 percent total: 38.5 percent [Source: Trends in Contraceptive Use Worldwide 2015 — the United Nations un.org/en/development/desa/population/publications ]

Types of birth control used (1994): female sterilization: 4.1 percent; male sterilization: 0.1 percent; pill: 2.1 percent; injectible: 0.4 percent; IUD: 2.7 percent; male condom: 3.4 percent; vaginal barrier: 0.9 percent; early withdrawal: 3.4 percent; rhythm method: 0.9 percent; total: 18.2 percent [Source: Trends in Contraceptive Use Worldwide 2015 — the United Nations un.org/en/development/desa/population/publications ]

The Guardian reported: “The most popular contraceptives are the injectable contraceptive and birth control pills, says Babar. Ease of use makes them particularly attractive for women labouring in the field. Almost every contraceptive method is sold for five Pakistani rupees (about five U.S. cents) apiece to a family, allowing Marvis [Marginalised Area Reproductive Health Viable Initiative, See Below] to generate an income from the sale of the products, which Marvis obtain at a government-subsidised rate of 3 rupees per piece. [Source: Sabrina Toppa and Allah Bachayo Khaskheli, The Guardian, June 1 2016]

Family Planning in Pakistan

In 1952 the Family Planning Association of Pakistan, an NGO, initiated efforts to contain population growth. Three years later, the government began to fund the association and noted the need to reduce population growth in its First Five-Year Plan (1955-60). The government soon combined its population planning efforts in hospitals and clinics into a single program. Thus population planning was a dual effort led by the Family Planning Association and the public sector. [Source: Peter Blood, Library of Congress, 1994 *]

In the mid-1960s, the Ministry of Health initiated a program in which intrauterine devices (IUDs) were promoted. Payments were offered to hospitals and clinics as incentives, and midwives were trained to treat patients. The government was able to attract funding from many international donors, but the program lost support because the targets were overly ambitious and because doctors and clinics allegedly overreported their services to claim incentive payments. *

The population planning program was suspended and substantively reorganized after the fall of Mohammad Ayub Khan's government in 1969. In late December 1971, the population was estimated at 65.2 million. In an attempt to control the population problem, the government introduced several new programs. First, the Continuous Motivation System Programme, which employed young urban women to visit rural areas, was initiated. In 1975 the Inundation Programme was added. Based on the premise that greater availability would increase use, shopkeepers throughout the country stocked birth control pills and condoms. Both programs failed, however. The unmarried urban women had little understanding of the lives of the rural women they were to motivate, and shopkeepers kept the contraceptives out of sight because it was considered mannerless to display them in an obvious way. *

Following Zia ul-Haq's coup d'état in 1977, government population planning efforts were almost halted. In 1980 the Population Division, formerly under the direction of a minister of state, was renamed the Population Welfare Division and transferred to the Ministry of Planning and Economic Development. This agency was charged with the delivery of both family planning services and maternal and child health care. This reorganized structure corresponded with the new population planning strategy, which was based on a multifaceted community-based "cafeteria" approach, in cooperation with Family Welfare Centres (essentially clinics) and Reproductive Health Centres (mostly engaged in sterilizations). Community participation had finally became a cornerstone of the government's policy, and it was hoped that contraceptive use would rise dramatically. The population by 1980 had exceeded 84 million. *

Population Policy of Pakistan

Karin Brulliard wrote in the Washington Post: “Pakistan’s family-planning efforts have lagged far behind those of other large Muslim-majority nations, including Iran and Bangladesh. In those countries, governments have stuck to population-control policies and backed them with money and political will, according to researchers. In Pakistan, where the powerful military consumes a large chunk of the budget and development spending has stagnated, family-planning efforts have consistently fallen victim to tumultuous and weak governance. [Source: Karin Brulliard, Washington Post, December 14, 2011]

In preparing the Sixth Five-Year Plan (1983-88), the government projected a national population of 147 million in the year 2000 if the growth rate were to be a constant at 2.8 percent per year, and of 134 million if the rate were to decline to the desired 2.1 percent per year by then. By the Seventh Five-Year Plan (1988-93) period, the multipronged approach initiated in the 1980s had increased international donor assistance and had begun to enlist local NGOs. Efforts to improve maternal and child health were coupled with education campaigns. Because of local mores concerning modesty, the government avoided explicit reference to contraceptive devices and instead focused its public education efforts on encouraging couples to limit their family size to two children. [Source: Peter Blood, Library of Congress, 1994 *]

The key to controlling population growth, according to activists in the women's movement, lies in raising the socioeconomic status of women. Until a woman's status is determined by something other than her reproductive capabilities, and especially by the number of sons she bears, severe impediments to lowering population growth rates will persist.

In 2002, the government initiated the Population Policy of Pakistan, which aimed to stabilize population growth by 2020 by lowering both the fertility rates and mortality rates. The projected population for the year 2025 was 228,822,000. The policy didn’t meet its goals. Pakistan’s population in 2020 was 233,500,636.

Birth Control Obstacles in Pakistan

Karin Brulliard wrote in the Washington Post: “In fits and starts, public and private agencies in Pakistan are advocating contraception to curb the country’s surging population, prevent deaths during childbirth and help provide better lives for those who are born. But in this deeply conservative society, women themselves are often the least able to decide, and the people who can — husbands, mullahs, mothers-in-law — still prize many children, particularly boys. [Source: Karin Brulliard, Washington Post, December 14, 2011]

“Contraception is shunned under traditional social mores that are fiercely defended as fundamentalist Islam gains strength. Yet religion is hardly the main obstacle, public health workers say. Although some clerics scorn birth control, health workers have persuaded other imams. The bigger cultural hurdles, the workers say, are husbands and mothers-in-law, as well as the inability of many women to make decisions for themselves.

“These days, the campaigns emphasize “birth spacing,” or waiting three years between births — a message that family-planning programs emphasize is endorsed by the Quran, which encourages breast-feeding for 24 months. But men are difficult to convince, health workers said. At a men’s meeting in Mirwah, a man with a cigarette dangling from his mouth and a baby in his arms stormed away, muttering that birth control amounted to “interfering in God’s ways. Others said they were unopposed but uninterested.“Our mothers, they are the deciding figures,” one man said. “Our wife? What does she know?”

“The government says it is committed to slowing population growth, which it referred to in a report last year as a “major impediment to [Pakistan’s] socioeconomic development process.” But public health experts say they have seen little beyond lip service. In rural areas, access to family-planning services is limited and hampered by deteriorating security, while government health workers are overburdened. International donors want bang for bucks, and working in the countryside is more expensive, said Mohsina Bilgrami of the Marie Stopes Society, another nongovernmental organization.”

Low Contraceptive Use in Pakistan

In 2011, just one in five Pakistani women ages 15 to 49 used modern birth control. Karin Brulliard wrote in the Washington Post: Contraception is shunned under traditional social mores that are fiercely defended as fundamentalist Islam gains strength. Rates of contraceptive use are particularly low in rural Pakistan, which is home to two-thirds of the about 180 million people in the nation. In this area of Sindh province, literacy rates are dismal, teenage marriage rates are high, and 10-children families are not uncommon. [Source: Karin Brulliard, Washington Post, December 14, 2011]

“Even in Sindhi deserts and the northwestern mountains, Pakistani women have heard of modern contraception, survey data show. That is in part because government and private health agencies, some funded by U.S. assistance, have churned out advertisements featuring jingles about condoms and vignettes about couples visiting health clinics.

“Greenstar is the country’s largest contraceptive provider, but “we’re a drop in the bucket in a country of 180 million,” said Shirine Mohagheghpour, the technical adviser for Greenstar, an affiliate of the Washington-based Population Services International. “You have to do this community by community.”

“In urban, middle-class areas, the message is slowly resonating. Two hours away, in the city of Mirpurkhas, a similar talk with women and a few mothers-in-law sparked boisterous discussion. Several said children were simply too expensive. “If it’s a sin, there shouldn’t be doctors who offer it,” one said of contraception, eliciting nods.

“At a private clinic in Mirwah, a woman named Buri, 35, said firmly that a small family is best. But it was too late: Married at age 13, she was pregnant 12 times before she opted for tubal ligation, a sterilization procedure. Ten of her children lived. None attends school. “They are uninterested in school,” she said. “Parents are too busy in the fields to pay attention.” Next to Buri lay her sister-in-law, silently shivering under a floral sheet, in labor with her first child. Presiding over the scene was their mother-in-law, a woman in ornate silver jewelry, who matter-of-factly stated that the newborn should be the first of at least eight children.

Birth Control Worker in Pakistan

Karin Brulliard wrote in the Washington Post: “Shazia Shahid, a community health educator, went to the tiny house to speak with the slight young woman about birth control. It was morning, a good time because the woman’s husband was out working. But the woman shrank behind a green veil — and behind her wizened mother-in-law, who smiled but made clear that she saw no need to discuss the topic. [Source: Karin Brulliard, Washington Post, December 14, 2011]

“It was a typical exchange in this remote village, and in much of the nation. Young brides commonly live with their husbands’ families after marriage. In most such units, the mother-in-law runs the house. If a health educator stops by, the mother-in-law must first be approached, as Shahid experienced in Mirwah.“So what? I will take care of the children,” the mother-in-law, her arms covered in bangles, said when Shahid expressed concern that the daughter-in-law, still a teenager, was not using birth control.

“Leaving the house, Shahid — who works for Greenstar Social Marketing, a nongovernmental organization that trains health providers and markets subsidized contraceptives — vowed to woo the mother-in-law in successive visits. ““Slowly, I will convince the people,” she said.

“Shahid keeps her message basic. In one colorful illustration she shows on home visits, grimy children wail in a tattered house. In another, a mother shakes a rattle at a baby, a father frolics with a toddler and a child reads a book in a tidy dwelling. Intrauterine devices can help make the second picture a reality, she says. “You can live tension-free,” she said to a roomful of women in Mirwah. “Your husband will be happy. Your mother-in-law will be happy. You can pay attention to the children you already have. If you continue having children year after year, you will get sick.”

Contraception “Avon Ladies” Go Door to Door in Pakistan

Sabrina Toppa and Allah Bachayo Khaskheli wrote in The Guardian: From 8:00am to 4:00pm, 25-year-old Samina Khaskheli travels door-to-door in rural Pakistan handing out free samples of condoms, birth control pills, and intrauterine devices. “I was told ‘This is sinful’,” Samina says about the initial opposition to her selling birth control. She took the job warily. Her off-the-map village, Allah Bachayo Khaskheli, is home to roughly 1,500 people in the country’s south-eastern Sindh province. The flatlands are covered by livestock, and economic desperation leaves women toiling alongside men as farmhands, livestock breeders and cotton pickers. [Source: Sabrina Toppa and Allah Bachayo Khaskheli, The Guardian, June 1 2016]

“Samina is a worker for the Marginalised Area Reproductive Health Viable Initiative – Marvi – once a popular emblem of female independence in Sindhi folklore. Today, Marvi refers to a network of literate or semi-literate village women aged 18 to 40 who travel door-to-door selling contraceptives. “In our village, there was no information about family planning. Many women died during childbirth,” says Samina about what inspired her to join.

“Trained by the Karachi-based Health and Nutrition Development Society (Hands), roughly 1,600 Marvis are dispersed throughout Pakistan’s remotest villages, where government healthcare facilities are scant or nonexistent. In the Sanghar district where Samina’s village is located, at least 400 Marvis fill a gap left by a lack of government funded lady health workers (LHWs). Marvi workers receive a six-day initial training by Hands and have their sessions in the field supervised by LHWs. Marvis emerge from the underserved populations they work with, so understand how family planning is best presented to the women they target.

“I wish I had learned about birth control 15 years ago,” says Azima Khaskheli, a 45-year-old livestock breeder in Allah Bachayo Khaskheli village, her black bangles clinking together as goats bleat nearby. When a Marvi worker visited her household to teach about birth control pills, Azima’s husband agreed that limiting future births would be a good choice. Not only would it save the family another trip to a hospital – the last one charged Azima 2,500 rupees (£16) per visit and was located more than half a day away by road – but it might increase Azima’s productivity in the field, which was already flagging thanks to the weight of childcare. She hefts her youngest child on her back while tending to a pack of cows and goats each morning.

“I tell the women ‘If you have a large family, how will you manage the family’s needs and food expenses?’,” says Marvi worker Bhagbhari Babar, who is required to make 50 home visits a month and usually visits a home five or six times before a couple agrees to buy any contraception. “Now [the women] have knowledge about the procedures, and they pursue contraception out of their own choice,” says Ambreen Khaskheli, a LHW.

In addition to birth control options, Marvi workers also teach women about birth spacing, or providing a gap between pregnancies to protect the health of a mother. “We are not trying to limit the number of children – a woman or a family has a right to choose as many number of children as they want, but they must keep in mind the pregnancy period is important for a woman’s health,” says Anjum Fatima, the general manager for health at Hands.

Opposition to birth control in Pakistan often takes on a religious hue, so Marvis are trained to sensitise local religious leaders on the health benefits of family planning. The Marvi programme relies on community mobilisers – ranging from religious leaders to influential landlords – to communicate the benefits of contraceptives. In 2014, approximately 40 Islamic religious leaders approved birth spacing for women in Pakistan. Samina adds that she enjoys the support of the village’s maulvis, or religious authorities, who endorse her door-to-door campaign, and never issue anti-contraceptive messaging over the mosque’s loudspeakers.

“Before the culture was rigid, but now they’ve gradually accepted family planning,” says Samina, the Marvi worker, motioning to the group huddled around her. “I am proud I can teach women about both the Qur’an and birth control.”

Abortion In Pakistan: One of the World's Highest Rates

Abortion rate (abortions per 1,000 women): 50 in 2012 (compared to 53.7 in Russia in 2004 and 13.5 in the United States in 2017) [Source: 2012 study by the New York-based Population Council, a nonprofit that advocates family planning. The rate is for abortions for every 1,000 women aged 15 to 44. — roughly four times higher than in the U.S. [Source: Diaa Hadid, Morning Edition, NPR,, November 28, 2018]

Diaa Hadid reported on Morning Edition of NPR: “According to family planning researchers, abortion provisions in the country's penal code are vague. The procedure is "legal only in very limited circumstances," notes the Guttmacher Institute. The circumstances include a pregnancy that is dangerous to a woman's health — or if there is a "need" for abortion, according to Zeba Sathar, the Pakistan director of Population Council, and Xaher Gul, a Karachi-based public health policy expert and lecturer who advises nonprofits. But what constitutes a "need" is not defined, they say.

“What's more, hospitals generally refuse to perform an abortion because most doctors believe it is illegal, Sathar and Gul say. Even when doctors know abortion is allowed in certain circumstances, they cite their own cultural beliefs to not undertake abortions except in urgent cases — for example, if a woman walks in with "an incomplete abortion," Gul says. That has left Pakistani women at the mercy of back-alley abortion providers.

“Pakistani women largely seek abortions because they either don't know about contraception or cannot access reliable contraception — or they've stopped using contraception after suffering complications, Sathar says. According to her research, most of the women who seek abortions are married, poor and already have children. Only 30 percent of fertile-age women use modern contraceptives, according to a 2017 U.N. report. "We found to our surprise that most of the women had more than three children, maybe as many as five," Sathar says. "They were almost all — 90 to 95 percent — married. They were older, so they tended to be poorer, less educated."

High Abortion Rate In Pakistan: Result of Poor Policy

Diaa Hadid reported on Morning Edition of NPR: “Pakistan's high abortion and low contraception rates reflect a family planning policy in shambles, says Abdul Ghaffar Khan, director general of Pakistan's population program wing. His office is meant to set the national family planning agenda, but Khan described the situation as "a bureaucratic mess." Family planning used to be the job of the federal government, but approval for a national policy languished for years. [Source: Diaa Hadid, Morning Edition, NPR,, November 28, 2018]

“In 2011, national authorities passed the matter to provincial governments. But at the provincial level, family planning is not part of the health ministry's portfolio. It is part of a different office and has long been neglected and underfunded, Khan says. That means women aren't advised about contraception or supplied contraceptives when they are most amenable: after childbirth, receiving postnatal care or immunizing their babies, says Sathar of the Population Council. She described it as one of the chief "structural flaws of how we provide family planning."

“But changes may be coming. On July 4, Pakistan's Supreme Court demanded hearings into the country's family planning failures. A national policy may be put into action in the coming months, Khan says.”

Midwives, Abortions and Contraception in Pakistan

Diaa Hadid reported on Morning Edition of NPR: “In a group interview with NPR, about a dozen midwives who also provide abortions said they would only help a woman who already appeared to be miscarrying — like Mehnaz, who induced her own abortion before seeking help. "I don't help with murder," says Mumtaz Begum, a 60-year-old who lives in a slum in the port city of Karachi. She has no medical qualifications but says a midwife taught her how to induce abortions decades ago, using medications freely available in Pakistan. [Source: Diaa Hadid, Morning Edition, NPR,, November 28, 2018]

“On a recent day, Begum showed NPR those pills and injections. They were clustered on a dusty table alongside religious texts and a bag of onions in a dank room with peeling paint. The gurney where she treated women was littered with clothing. "I wipe it down before women come in," she says. Because many providers aren't properly qualified, researchers estimate about a third of all women who undertake abortions in Pakistan suffer complications, ranging from heavy bleeding to a perforated uterus and deadly infections.

“Health workers do reach out to women to provide information about family planning. Some 130,000 women are employed by provincial health ministries to do house visits across the country, teaching about birth control. But Gul says health workers are poorly trained and in short supply. Budgetary shortages, supply problems and corruption mean they often don't have contraceptives, or distribute expired contraceptives — and that there's little follow-up on how to use them.

“Mehnaz was paid a visit by two such workers. She says they gave her an injection meant to prevent conception for three months. She became pregnant again anyway. As before, she tried taking pills to induce an abortion but says they made her sick so she stopped taking them.

Missing Girls and Abortions in Pakistan

There are 96 females for every 100 males in Pakistan. The birth of a girl is often considered bad luck and girls have traditionally been given less care and are more susceptible to disease than boys. South Asia is the only region in the world where there are fewer women than men. In many places, boys are given more food than their sisters. The Jats, a tribe in northern India and Pakistan, reportedly get rid of unwanted baby girls by placing them in buffalo pens to be trampled to death.

Diaa Hadid reported on Morning Edition of NPR: Mehnaz sits inside her home in Abbottabad, northern Pakistan. She has one son and six daughters. She has also had three abortions, fearing she would have more girls.When at 19 Mehnaz became pregnant for the fifth time, she panicked. She already had four daughters, and her husband was threatening to throw her out if she had another. So she did what millions of Pakistani women do every year: She had an abortion. [Source: Diaa Hadid, Morning Edition, NPR,, November 28, 2018]

Like many of those women, her abortion was partly self-administered. "I kept taking tablets — whatever I laid my hands on," she says. "I lifted heavy things" — like the furniture in her tiny living room. She drank brews of boiled dates — many Pakistanis believe the beverage triggers labor. Mehnaz says she felt "a terrible pain in my stomach." Her husband took her to a midwife, who told him the baby was dead. "She gave me injections and it came out," Mehnaz says. That was eight years ago. Since then she has had two more abortions, each time because she feared the baby would be a daughter.

“Mehnaz, whose last name is being shielded to protect her identity, is one of millions of Pakistani women who have abortions each year. Some of these women, like Mehnaz, will abort a fetus if they fear they are carrying a female child, who can be seen as an economic burden.” Mehnaz “was married at 13 to her cousin in their tiny village and had four daughters in quick succession and seven children in all — six girls, one son. And three abortions. She is illiterate and said she didn't know anything about sex or contraception early in her marriage.

“Three years ago she had her seventh child, a girl. She then tried taking the pill, offered by the visiting health workers. She says it made her dizzy and she stopped taking it. She again became pregnant but miscarried — and pleaded with doctors to sterilize her. She says they told her she had to wait until she was 40 — or get a permission slip from her husband. He refused: "He says he can't sign this, it's a sin." She says he also refuses to use condoms or to stop having sex with her. If she has another girl, her husband may well abandon her. If she tries to induce another abortion, her health could deteriorate. "I am stuck," she says.

Image Sources: Wikimedia Commons

Text Sources: New York Times, Washington Post, Los Angeles Times, Lonely Planet Guides, Library of Congress, Pakistan Tourism Development Corporation (tourism.gov.pk), Official Gateway to the Government of Pakistan (pakistan.gov.pk), The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Reuters, Associated Press, AFP, Wikipedia and various books, websites and other publications.

Last updated February 2022


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