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Gallup Pakistan Analysis of Pakistan Bureau of Statistics

Mortality (2018-2020)
Pakistan Demographic Survey 2020
 PRESS RELEASE
Gallup Pakistan Analysis of Pakistan Bureau of Statistics Data
Cardiovascular diseases contributed to 15% of the deaths between 2018-2020 – Mortality
(2018-2020) – Pakistan Demographic Survey 2020
Islamabad, July 17, 2023
Gallup Pakistan, as part of its Big Data Analysis initiative, is looking at Mortality (2018-20). This
data is part of a publication by the Pakistan Bureau of Statistics called the ‘Pakistan Demographic
Survey 2020’.
The complete Pakistan Demographic Survey 2020 is available HERE.

What is the Big Data Analysis Series by Gallup:

Gallup Pakistan’s Big Data series was started by Bilal I Gilani, Executive Director of Gallup
Pakistan. Bilal explains the rationale of the series: “The usual complaint from academics and
policy makers is that Pakistan does not have data availability. Our experience negates that.
Pakistan has lots of data, but it is not available in a usable form and not widely accessible. At
Gallup we plan to bridge this gap in terms of accessibility and use of data. The Gallup Big Data
series has earlier worked with data sets such as PSLM, Labor Force Survey, and Economic Survey
reports as well as National Census Reports and Election Commission Data sets. The current series
is using the Pakistan Demographic Survey, an annual compilation which seldom has data points
not covered in many other reports. We hope that these series are useful, and we welcome both
feedback as well as possible collaborations as we create a public good in the form of useful data
sets in Pakistan.

What data points this current edition covers:

This series aims to present the important learnings from the Pakistan Demographic Survey 2020
for policy makers, the public, as well as for marketers in an easy and understandable way. In
particular, this edition looks at Mortality statistics from 2018 to 2020. The total number of deaths
over a period of time can have implications for state of healthcare across the urban-rural divide,
and between provinces, and the age stratification can tell us what the leading causes of mortality
are. The series’ main aim is to provide data. Implications of these data points for development
sector as well as wider socio-political ramifications is something we would like to trigger in
relevant circles.
Today’s topic is “Mortality (2018-20)”

Key Findings:
1) Number of deaths by age group: During 2018-20, total deaths recorded across all ages
were 4,359,166. Children under the age of 1 made up 972,555 of
these deaths, comprising 22% or 1 in 5 of all deaths.
2) Number of deaths by province: The number of deaths during 2018-20 was the greatest
in Punjab, with the province accounting for 61% of the total deaths.
3) Cause of death: 15% of deaths in Pakistan during 2018-20 were caused by
cardiovascular disease, 9% by fever, and 7% by stroke-induced paralysis. The causes of
nearly 1 in 5 deaths (21%) in that time were unknown.
1) Number of deaths by age group:

During 2018-20, total deaths recorded across all ages were 4,359,166. Children under the
age of 1 made up 972,555 of these deaths, comprising 22% or 1 in 5 of all deaths.

Among the children under the age of 1, those aged under 1 month comprised 747,300 or
75% of the total deaths. They were followed by the 1-month-olds (50,630 or 5%). A
general trend of number of deaths per age group decreasing as the age increases can be
observed for infants under 1-year-old.

Figure 1: Infant Death (2018-2020) by Age

747,300

50,630 46,950 39,127 26,117 16,561 22,051 15,203 8,209 12,938 5,739
1,500

Under 1 1 2 3 4 5 6 7 8 9 10 11
month month months months months months months months months months months months

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

After infants, the most deaths were recorded for elders aged 60-69 who made up 17% of
the total with 752,704 recorded deaths. More deaths occurred in rural regions than urban
regions for all age groups, the 1-9 age group being the only exception. Overall, 64%, or
2,781,466, of the total deaths during 2018-20 were recorded in rural Pakistan, compared
to 36% (1,577,701) in urban areas.

The overall number of deaths was lowest for age groups 10-19 (113,328 deaths), 20-29
(148,515 deaths) and 30-39 (135,279 deaths).
 Figure 2: Deaths (2018-20) by age group - All Pakistan
972,555 Total Urban Rural

752,704
697,665
651,983
623,821

487,834
464,096
392,116 394,821

274,890 290,851 280,742 288,608

244,495 257,162
228,655 231,705
207,093
148,515 135,279 145,992
118,610 113,328 87,866 84,125 98,503
74,504 60,649
38,825 51,154

<1 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 >80
Age in years

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

Figure 3: Urban-Rural split - All Pakistan

36%

64%

Urban Rural

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

A gendered analysis shows that there have been more male deaths reported than female deaths
overall in the country during 2018-20. Male deaths outnumber female deaths across the urban-
rural regional divide as well. Overall, men made up 53% of the total death count with 2,324,530
recorded deaths, while 47% recorded deaths were those of females, numbering 2,034,637 deaths.
There is a similar 53-47% split for rural area populations, with 1,470,369 male deaths and
1,311,096 female deaths. In urban areas, men also made up 54% of total deaths with 854,161
recorded deaths, while females, numbered at 723,540, accounted for 46% of total urban deaths.
 Figure 4: Deaths (2018-20) by gender - rural urban split
Both Male Female

4,359,166

2,781,466
2,324,530
2,034,637
1,470,369 1,577,701
1,311,096
854,161 723,540

Pakistan Rural Urban

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

2) Number of deaths by province:

The number of deaths during 2018-20 was the greatest in Punjab across all the provinces,
with the province accounting for 61% or 2,655,338 of the total deaths. A total of 926,900
deaths were recorded in Sindh, making up 21% of the total death count in this time. Khyber
Pakhtunkhwa was the province with the third highest death count at 507,249 deaths (12% of
the total), followed by Balochistan, where the total number of deaths was 269,679, 6% of
Pakistan’s total recorded death count in 2018-20. These numbers follow the overall
population distribution among the provinces (as tabulated in Table 1 of the Pakistan
Demographic Survey 2022), with Punjab being the most populated and Balochistan being the
least.
 Figure 5: Deaths (2018-20) by province and gender
Total Male Female

2,655,338

1,408,953
1,246,385
926,900

501,639 507,249
425,261 268,200 269,679
239,049 145,738
123,941

Punjab Sindh Khyber Pakhtunkhwa Balochistan

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

The gender distribution between the four provinces was very similar. For all of them, male
deaths outnumbered female deaths by small margins. In Punjab, male deaths, at 1,408,953, made
up 53% of the total. In Sindh, the number was 501,639 (54%), followed by 268,200 (53%) in
Khyber Pakhtunkhwa and 145,738 (54%) in Balochistan.
The number of deaths recorded in each age group by province follow the same proportions as the
provincial breakdown, except the 10-19, 20-29, 30-39-years old; number of deaths in these age
groups was greater in Balochistan than Khyber Pakhtunkhwa.
The age-group with the highest number of deaths in Punjab was the less than 1-year-old group
with 502,691 deaths, making up 19% of the total deaths. This was followed by those in the 80
and above group (479,886 deaths) and the 60-69-year-olds, who made up 462,777 deaths in
Punjab.
Similarly, children younger than one made up the bulk of deaths in Sindh (248,935 or 27% of
total deaths), Khyber Pakhtunkhwa (156,894 or 31%) and Balochistan (64,035 or 24%).
Consequently, Khyber Pakhtunkhwa had the highest relative infant deaths.
 Figure 6: Deaths (2018-20) by age group - by Province
Punjab Sindh Khyber Pakhtunkhwa Balochistan
502,691

479,886
462,777

400,634
306,020
248,935

157,337
156,894

155,321

119,107
116,288

96,812

94,067
89,967
84,256

76,805

75,183
68,645
64,035

61,328
60,216

53,395

44,637
44,460
40,544
39,944

35,173
30,010

28,896
23,930

22,458
22,141

16,704
16,006
13,597

11,818
11,483

11,305
8,311
7,156

<1 1-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 >80
Age in years

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

During 2018-20, a significantly larger amount of deaths occurred in rural regions than urban
regions of Punjab (66%), Khyber Pakhtunkhwa (81%) and Balochistan (69%), while the urban-
rural split between number of deaths recorded in Sindh was almost even (49% rural deaths).
Khyber Pakhtunkhwa recorded the largest discrepancy, with 81%, or 408,376, deaths occurring
in rural areas and the urban region accounting for only 19%, or 98,873, out of the total 507,249
deaths. This may be attributed to the proportion of population split between rural and urban
regions, the former housing more people than the latter.
Figure 7: Rural-Urban split - by Province

Punjab Sindh

35%

51% 49%

66%

Rural Urban Rural Urban

 Khyber Pakhtunkhwa Balochistan

19%
31%

69%
81%

Rural Urban Rural Urban

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

3) Cause of death by age:

The causes of nearly 1 in 5 deaths (21%) in Pakistan during 2018-20 were unknown. 15% of
deaths in this time were caused by cardiovascular disease, 9% by fever, and 7% by stroke-
induced paralysis.

Figure 8: Top 10 causes of death (2018-20) - All Pakistan

3%
3%
Unknown
3%
Cardiovascular disease
4% 21%
Fever
5% Paralysis (stroke)
Cancer
Diabetes
6%
Respiratory diseases
Asthma
7% 15% Kidney disorders
Gastroenteritis
9%

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

Of the top 10 causes of death, 72% are non-communicable diseases such as viruses or water-
borne infections, while 28% are communicable diseases. The former category includes
cardiovascular diseases, stroke induced paralysis, cancer, diabetes, asthma and kidney disorders,
while the latter includes fever, gastroenteritis and respiratory diseases.
 Figure 9: Top 10 causes of death (2018-20) by type of disease

28%

72%

Non-Communicable diseases Communicable diseases/Viral & water-bourne

The age groups can be categorized into ‘Children’, (0-9 years), ‘Teenagers’, (15-19 years),
‘Adults’, (20-49 years), and ‘Elders’, (50+ years) for further analysis.
Narrowing down on the top four leading causes of death (unknown causes, cardiovascular
disease, fever and stoke-induced paralysis) and looking at them by age group reveals that. 41%
of infants in 2018-20 (<1 year) died due to unknown causes, numbering 397,904. For younger
ages, from 1 to 9-years-olds, unknown causes were being cited as the cause for 449,575 or 34%
of the total 1,201,208 deaths in this age category. They were also majorly the cause for the
oldest age group - 142,330 out of 651,982 deaths, making up almost 22% of total death count for
80+ years age group. Fever seems to be a more prevalent cause for children aged 15 to 19 years
(29,606, or 26%, of the total 113,328 deaths), while cardiovascular disease was a prime reason of
death for most adults aged 20 to 49 years. 87,440 deaths in such adults were attributed to
cardiovascular disease, which make up 17% of the total death count for this group (528,288 total
deaths).
 Figure 10: Comparing national causes of death by age group - All Pakisan
397,904

Unknown Cardiovascular Fever Paralysis (stroke)

156,518

142,330
131,809

118,919
112,396

99,864
99,525

96,094
88,148
86,616
66,635
65,122
60,110
52,256
51,971

47,425
45,607

43,036

40,616

37,677

36,812
31,477

29,606
22,116

21,406
19,303

19,201
15,881
13,023

12,082
11,234
10,102
10,010
9,941

27.066
9,139
8,935

8,666

8,618
8,549
8,394
7,854
7,490
7,273

6,818

6,180
4,988

4,882

3,784
3,132
3,082

3,048
2,156
1,830

581
<1 1-4 5-9 1-9 10-14 15-19 10-19 20-29 30-39 40-49 50-59 60-69 70-79 >80
Age in years

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

The top 10 causes of death for children and elders are all natural. However, traffic accidents and
causes other than sickness lead to 9% (44,162) of deaths in adults; deaths caused by traffic
accidents and accidental falling or drowning also make up 13% (14,434) of teenager mortalities.
For teenagers (15-19 year olds), death by suicide makes up 5% (3,992) of the total deaths,
significantly higher for this age group than the rest. Fever is another recurring cause of death
across all age groups, making its place in the top 5 causes across each of them.
Kidney disorders and diabetes become greater causes of death in older age groups (adults and
elders), while asthma leads to nearly 1.6% (4,043) deaths in children and 5% (117,567) in the
elderly.
 Top 10 causes of death - Children Top 10 causes of death - Teenagers
2%
1% 3% 3%
2% Fever
3% Unknown causes 4%
4% Fever Unknown causes
Post natal complications 5% Traffic accident
29%
5% Respiratory diseases Accidental fall/drowning
37% 5%
Cardiovascular diseases Cancer
7%
Complications during pregnancy
6% Paralysis (stroke)
7% Other diseases 6% Suicide
Anemia 10% Cardiovascular disease
12% 9%
Asthma Kidney disorder
Other than sickness Complications during delivery

Top 10 causes of death - Adults Top 10 causes of death - Elders

3% 3% 3%
3%
4% Cardiovascular disease Cardiovascular disease
3% 5%
Cancer Unknown causes
17% 20%
Unknown cause Paralysis (stroke)
4%
Fever 7% Fever
5%
Kidney disorder Diabetes
6% 12% 8%
Traffic accident 16% Cancer
Viral Hepatitis 8% Asthma
8%
9% Other than sickness 10% Kidney disoder
Diabetes Hypersensitive diseases
Paralysis (stroke) Viral Hepatitis

Source: Pakistan Demographic Survey 2020; analyzed by Gallup Pakistan

Wish to Contribute to Gallup Big Data Analysis?
Gallup Pakistan is looking for collaboration with researchers to expand both the Big Data Analysis
project as well as this study of Pakistan Demographic Survey 2020. If you have any ideas, please
write to Bilal I Gilani, Project Director, Big Data Analysis at Gallup Pakistan.
Wish to know more about the Pakistan Demographic Survey 2020?
Pakistan Demographic Survey (PDS) is a regular activity of PBS, conducted during inter-censual
period to provide reliable data on Demographic Indicators. These Demographic statistics are
inevitable for policymakers, planners, and administrators for planning of development programs
for the National & Provincial Governments.
Pakistan Demographic Survey (PDS), 2020 is the twentieth round of a series of surveys, initiated
in 1984. After 1984 nineteen rounds of PDS were completed till 2007. Current round of PDS was
started after a gap of 13 years, which provides the detailed information on various demographic
indicators for the year 2018-2020 at National level with Urban-Rural breakdown. These indicators
are Life Expectancy, Crude Birth Rate, Crude Death Rate, General Fertility Rate, Age Specific
Fertility Rates, Age Specific Death Rates, Infant Mortality Rate and Rate of Natural Increase etc.
Results of the survey are compiled at National level with Urban Rural Segregation.
You can find more information on the Pakistan Demographic Survey 2020, and complete tables,
on www.pbs.gov.pk
Or visit:
Pakistan Demographic Survey 2020

Disclaimer: Gallup Pakistan is not related to Gallup Inc. headquartered in Washington D.C. USA. We
require that our surveys be credited fully as Gallup Pakistan (not Gallup or Gallup Poll). We disclaim any
responsibility for surveys pertaining to Pakistani public opinion except those carried out by Gallup Pakistan,
the Pakistani affiliate of Gallup International Association. For details on Gallup International Association
see website: www.gallup-international.com

Disclaimer: The views and inferences expressed in the article are that of the author himself and Gallup
Pakistan does not take any responsibility in this regard. This series, and many such initiatives, are internally
funded by Gallup Pakistan and Gilani Research Foundation. No outside country or local funding has been
received for this current activity.