Who Gets Counted: A Decomposition Analysis of Provincial Disparities in Birth Registration in Pakistan

Abstract

According to UNICEF, one in four children under the age of five has had their birth unregistered worldwide, exposing them to the risks of statelessness, abuse, and discrimination. Despite the integrated global efforts, South Asia, particularly Pakistan, faces significant provincial disparities in birth registration. This study examines cross-sectional data from the 2017-2018 Pakistan Demographic and Health Survey (PDHS) on a sample of 8,638 children under age five. Only 42.54% of these children have their births officially registered. Using Fairlie decomposition as the core method of analysis, our study aims to investigate whether birth registration inequalities in Punjab-Sindh, Punjab-KPK, and Punjab-Balochistan groups stem primarily from compositional or behavioural differences. Additionally, it bifurcates the relative contribution of individual factors driving the observed disparities across all three inter-provincial groups. Fairlie decomposition results reveal that the differences in household characteristics are the primary driver that explains birth registration disparity in the Punjab-Sindh group. Wealth status and mother’s education contribute 95.23% to the explained inequality. In contrast, the birth registration gap is mainly attributable to the differences in behavioural profiles in the Punjab-KPK group. Equalizing all selected characteristics would only eliminate 46.31% of the birth registration gap. On the other hand, all inequality in the Punjab-Balochistan group entirely results from differences in compositional factors. Here, variations in birth registration behaviour play no role in determining the observed disparity, distinguishing it from the previous two groups. Addressing provincial birth registration disparities requires situation-specific interventions to promote equitable birth registration and achieve the SDG target of 16.9 by 2030.