Size of wallet determines delivery room for Pakistani mothers

In Pakistan your bank account largely dictates where your baby is born, with 22.1% of Pakistani mothers still giving birth outside of any health facility entirely.

A sweeping new study published in Institute for Health Metrics and Evaluation based on 130 low- and middle-income countries has revealed exactly where the world's babies are taking their first breaths—and for Pakistan, the delivery room a mother ends up in is heavily dictated by her wallet.

According to the 2023 data, childbirth in Pakistan is split exactly evenly between public and private hospitals, with each handling 38.8% of the country's deliveries. Meanwhile, lower-level clinics handle almost no births (0.2%), and a significant 22.1% of Pakistani mothers still give birth outside of any health facility entirely.

This perfectly balanced split between public and private hospitals makes Pakistan stand out from the global crowd.

Worldwide, public hospitals do the heaviest lifting, handling nearly half (47.5%) of all deliveries in developing nations.

The researchers highlight that the boom in Pakistan’s private hospital deliveries has been driven primarily by the country's upper-wealth groups.

Because private health insurance or government reimbursement for private care is rare in most developing nations, choosing a private hospital usually means paying steep out-of-pocket costs. As a result, poorer women in Pakistan are largely left relying on the public sector for their care.

This creates a stark dividing line in maternal care based on income. While the private sector continues to grow for those who can afford it, experts warn that systems relying heavily on private care need to be carefully examined, as they can severely worsen health inequities and lock out vulnerable populations.