Rafiullah Mandokhel
QUETTA: Poverty, gender inequality and limited access to education and healthcare continue to undermine women’s rights in poverty-hit Balochistan. In the province, child marriage and gender-based violence leave many girls and women vulnerable to problems ranging from disrupted education to physical and psychological torture and health complications.
Palwasha, a housewife living with her extended family on the outskirts of Quetta, was barely 15 when she married and now has four daughters and three sons. She recalls the consequences of early marriage, repeated pregnancies, poverty and family pressures that have exacerbated her hardships manifold.
For the past two years, she has also been suffering from cutaneous leishmaniasis, a parasitic skin disease. She began treatment after being diagnosed but had to interrupt it during another pregnancy. After giving birth, the lesion on her face worsened considerably.
She later sought treatment at a Médecins Sans Frontières facility in Quetta, but financial constraints made her access difficult. Moreover misconceptions about the disease added to her distress. Her family and in-laws feared the wound might be a sign of ‘cancer’, while some other relatives even avoided sitting with her because they wrongly believed the infection could spread through close contact.
“My in-laws, whose two children also suffered from the same ailment, blamed me for bringing the disease into the family. Ultimately, the illness also exposed me to violence and mental and physical torture at home,” she says adding, “If I were a male member of the family, they might have taken me to a private hospital for treatment, but the family left me at the mercy of Allah and free treatment,” she laments.
Palwasha’s ordeal reveals how early marriage, poverty, patriarchal attitudes and social stigma can intersect, limiting women’s choices and making it harder for them to access healthcare and seek support.
Child marriage remains a major concern in Balochistan. The Multiple Indicator Cluster Survey (MICS) 2019 – 20 reveals that 21.9 per cent of women aged 20 – 24 had married before turning 18, while 7.2 per cent had married before the age of 15. Save the Children’s 2024 baseline study offers additional evidence. In a statement published in November 2025, the organization reported that its survey found nearly two-thirds of marriages in Balochistan occurred before age 18, with 40 per cent before age 16. It also reported that one in four girls surveyed had their first child before age 16. The findings highlight the continuing challenge of protecting girls from early marriage, particularly in communities where poverty and limited educational opportunities constrain their choices.
Last year in November 2025, Balochistan enacted the ‘Child Marriages Restraint Act’, setting 18 as the minimum age for marriage. However, the law’s effectiveness depends on enforcement, public awareness, reliable age registration and accessible mechanisms for reporting violations.
Experts believe that early marriage can interrupt girls’ education, limit their economic independence and expose them to pregnancy at a young age. These risks are higher in remote and rural areas, where long distances to healthcare facilities and shortages of trained medical staff can restrict access to essential maternal and reproductive services.
The province’s maternal health indicators underline these challenges. The Pakistan Maternal Mortality Survey 2019 estimated Balochistan’s maternal mortality ratio at 298 deaths per 100,000 live births, compared with 186 nationally. Balochistan has Pakistan’s highest estimated maternal mortality ratio. Early marriage and teenage pregnancy increases health risks for girls, while limited access to skilled birth attendants, healthcare facilities and reproductive health services adds to the challenges facing mothers and infants.
Moreover, gender-based violence further threatens women’s safety and well-being. The Pakistan Demographic and Health Survey 2017–18 found that 28 per cent of women aged 15 – 49 across Pakistan had experienced physical violence since the age of 15, while 6 per cent had experienced sexual violence. Balochistan presents an even grimmer picture of gender-based and domestic violence.
“In many communities, social stigma, fear of retaliation, financial dependence and limited access to justice can prevent women from reporting physical torture. For those living in remote and mountainous areas, seeking help may require long journeys to reach healthcare facilities, legal assistance or protection services,” reveals Watanyar, an activist working for women’s rights in Quetta.
Child marriage, GBV and sexual and reproductive health and rights are closely connected. Girls who lack education and knowledge of their rights may struggle to make decisions, access healthcare and seek help when facing such circumstances. Addressing these challenges requires more than legislation, awareness campaigns. Girls need a safer environment, access to quality education, affordable healthcare and awareness of their rights.
In a province as geographically vast and socially diverse as Balochistan, responses must reflect local realities. Every girl should be able to complete her education, access healthcare, live in an environment free from violence and participate in decision making about her future.__ This story is part of the Provincial Media Fellowship on Early Marriage, GBV and SRHR, in partnership with UNFPA Pakistan and supported by the Embassy of the Netherlands.
