Pakistan, the world's fifth most populous country, is characterized by a rich tapestry of ethno-linguistic groups, varied topography and distinct socioeconomic landscapes. Yet, the country faces significant development challenges, including unequal resource distribution, disparities in basic service delivery and related socioeconomic deprivation. This has been stated in the District Vulnerability Index for Pakistan (DVIP), launched by the Population Council on November 17.
The report is based on six distinct domains of housing, communication, transport, livelihoods, access to health services, access to education and demographics. The index, developed by the Pakistan Population Council, measures the exposure of districts across Pakistan to social, economic and environmental risks.
Even better-performing districts, the report notes, reveal systemic weaknesses nationwide. Nearly 10 million, or 11.3%, Pakistanis live in the 20 most vulnerable districts. About 2 million of them are women of reproductive age and similar numbers are children under the age of 5. More than half of the most vulnerable population resides in Balochistan – more than 40% of the province's population.
The deep study is aimed at addressing the gaps by developing an index that incorporates domains of vulnerability typically underreported in the analysis in Pakistan. The Index is built on the established social vulnerability indices, adapting their frameworks to Pakistan's district-level context.
Key Highlights
Nearly 10 million Pakistanis live in the 20 most vulnerable districts—about two million are women of reproductive age, and a similar number are children under-five.
o More than half of this population resides in Balochistan, making up over 40 percent of the province's total population.
Among the 20 least vulnerable districts, 13 are in Punjab, four in Sindh, two in Khyber Pakhtunkhwa (KP) and none in Balochistan.
o The five least vulnerable districts in the country are the four urban districts of Karachi in Sindh, followed by Lahore in Punjab.
The most vulnerable category includes two districts in KP, only one in Sindh, none in Punjab and an alarming 17 in Balochistan.
o The most vulnerable districts include Washuk, Khuzdar, Zhob, Kohlu, Musakhel, Dera Bugti, Killa Saifullah, Kalat, Seerani, Jhal Magsi, Nasirabad, Chagai, Barkhan, Harani, Awaran, Kharan and Panjgur from Balochistan. North Waziristan and Kohistan from KP and Tharparkar from Sindh.
In the 20 worst-performing districts in the housing domain, over 65 percent of households live in temporary or makeshift structures; half lack toilet facilities; and 40 percent have no access to improved water facilities.
o In districts like Sohbatpur (Balochistan), 75 percent of households live in one-room dwellings.
o In Jhal Magsi, also in Balochistan, an extraordinary 97 percent of households reside in kacha or semi-pakka homes.
The communication and transportation domain also highlights widespread disconnection in Balochistan.
o Many contiguous districts severely lack adequate access to roads, transport or telephone services within reachable distances.
In contrast, much of Punjab, particularly its northern and central regions, has relatively strong infrastructure in this domain.
In the livelihoods domain, 15 of the 20 lowest-ranked districts are in Balochistan.
o KP and Balochistan also exhibit the highest unemployment rates and the largest proportions of unpaid family workers, reflecting fragile and precarious livelihoods.
o Both KP and Balochistan also stand out as more vulnerable in the access to health domain, with lower accessibility of health facilities and limited doorstep community health outreach, and also wide disparities in health access between districts within the province.
In the most vulnerable districts, the average distance to the nearest health facility exceeds 30 kilometers.
o When coupled with poor transportation and communication infrastructure, this severely hinders access to essential services to meet basic health needs, especially maternal and child healthcare.
In terms of access to public education facilities, Karachi stands out with the highest density of primary and high/higher secondary schools, though this may be due in part to its high population density.
In Balochistan low school density and long travel distances are likely exacerbated by vulnerability in the transportation domain.
Notably, across all provinces, except Punjab, girls tend to face greater distances to high/ higher secondary schools than boys.
Many districts in Balochistan and KP score poorly in the demographics domain, although Tharparkar (Sindh) ranks as the most vulnerable.
While high fertility pervades across Pakistan, some districts lag far behind in the fertility transition, contributing to unusually large families.
o This pattern likely intersects vulnerability in other domains, such as access to education and health services.
The results of the DVIP point to the strong need for addressing the root causes of vulnerability with political priorities focused on tackling poverty, improving access to education and healthcare (including family planning), and ensuring equal economic opportunities for marginalised populations.
The dual burden
The impacts of high population growth were reflected in persistent human development challenges, including child stunting, learning poverty and a workforce insufficiently equipped for the future.
Climate change continues to expose communities to extreme temperatures, floods, droughts and environmental degradation, with the most severe effects falling on districts already struggling with poverty, weak infrastructure and limited access to essential services.
Pakistan's long-term economic prospects depend on effectively confronting the dual national challenges of rapid population growth and climate vulnerability. While the country continues its trajectory toward macroeconomic stabilization and growth, Pakistan cannot realize its full potential without addressing the pressures created by population momentum and escalating climate risks.
Why Balochistan is the hardest hit?
The report lays bare the widespread disconnection in Balochistan which stands out as more vulnerable in access to health, with limited availability of health facilities, poor doorstep community outreach and wide disparities within districts. Education, too, shows a grim picture: the most vulnerable districts have low school density and long travel distances, a condition worsened by poor transport links.
While the federation has attempted to address grievances through the Aghaz-e-Haqooq-e-Balochistan package, the 18th Amendment and the NFC Award, much more remains undone. Current speculation about a possible cut in the NFC Award – and the resulting reduction in provincial revenues – does not bode well for a province already battling chronic underdevelopment, worsening poverty and a renewed wave of terrorism from the BLA and affiliated networks. Pakistan's decision-makers must rethink their Balochistan strategy. Why, despite increased provincial resources through the NFC, has there been so little tangible development? One uncomfortable but widely acknowledged answer is that much of the provincial ruling elite has simply not spent development funds where they were intended.
Some argue that Balochistan's sparse population makes development costlier and, therefore, slower. But this cannot justify the near-total neglect reflected in the DVIP. Development can and must happen.
Analysis
The DVIP is an “eye-opening” report, as it reveals that human development is mostly centred on Punjab, which has no districts classified as most vulnerable, in contrast to Balochistan and KP, the provinces facing the highest levels of vulnerability and unemployment. The findings put a question mark on the use of the trillions of rupees in additional financial resources that were given to the provinces under the Seventh NFC Award. All the provinces are cash-rich and investing their surplus cash in the federal government debt instead of spending it on their people.
The report's findings underscore that there is an urgent need to transfer the financial resources directly to the districts, as the current arrangement of strong control of the provincial capitals on the resources is increasing the share of the vulnerable population. The report should serve as a basic document for government and policymakers as they go on to plan their priorities, and at the same time, sit in introspection as to how and why they have failed so miserably.
It is a pity that 11.3% of people live in the 20 most vulnerable districts, and a majority is denied even clean drinking water and sanitation services. Education, safe housing and other amenities such as electricity and gas are mostly privileged stuff that most of the people in KP and Balochistan can only dream of.
That is tantamount to a denial of fundamental rights guaranteed in the Constitution, and is a crime, per se. One of the basic policy recommendations – transfer of funds directly to the districts – is worth implementing. This substantiates the argument of empowered local governments, an aspect that is widely lacking countrywide despite explicit constitutional directives. The report rightly goes on to question the implementation of the NFC Award, and the ill will through which finances are manoeuvred.
A UNDP 2025 study had painted a similar picture of Pakistan by placing it in the "low" human development category, with a ranking of 168th out of 193 countries. The worrisome aspect is that the value of HDI was 0.544, which is declining with each passing year. With a population growth rate of 2.55%, Pakistan is in dire need of an astutely choreographed developmental plan, one that is free from parochialism.
There is also a pressing need to recognize the interdependence between population dynamics and climate impacts. Policymakers need to integrate vulnerability metrics into future frameworks for resource allocation. Incorporating these insights into national planning will be critical for ensuring equity, strengthening resilience and directing support to the districts that need it most.
The writer is a lecturer at a
private sector university.