Gilgit: The findings of the Gilgit-Baltistan Multiple Indicator Cluster Survey 2024–25 were launched at a dissemination ceremony in Gilgit on Tuesday, presenting one of the most comprehensive assessments of the situation of children, women, young people and households across the region.
Conducted by the Statistical Cell of the Planning and Development Department, Government of Gilgit-Baltistan, with technical assistance from UNICEF and the Pakistan Bureau of Statistics, the survey covers more than 180 indicators, including 35 linked to the Sustainable Development Goals.
The findings reveal substantial disparities among districts. Hunza records comparatively strong results across child survival, maternal healthcare, nutrition, early childhood development, education and youth engagement, while Diamer faces some of the most severe and overlapping challenges.
The survey also highlights a major regional concern related to young people: 23.6% of youth aged 15–24 are not in education, employment or training. The rate reaches 41.2% in Astore and 36.7% in Kharmang, while young women and those aged 20–24 are disproportionately affected.
A Region Divided by Unequal Development Outcomes
Province-wide averages conceal major inequalities among the 10 districts of Gilgit-Baltistan.
The under-five mortality rate ranges from 13 deaths per 1,000 live births in Hunza to 66 in Diamer. Similarly, secondary-school completion ranges from 83.5% in Hunza to only 11.9% in Diamer.
Nearly 95% of women in Hunza received at least four antenatal care visits, compared with only 10% in Diamer. Childhood stunting ranges from 9.5% in Hunza to 57.8% in Diamer.
The figures show that Gilgit-Baltistan cannot be treated as a single, uniformly progressing region. Each district faces a different combination of health, education, nutrition, employment and social-development challenges.
Survey Covered More Than 7,000 Households
The survey covered urban and rural areas of all 10 districts through a two-stage stratified sampling design based on the 2023 census sampling frame provided by the Pakistan Bureau of Statistics.
The sample included 357 clusters and 7,140 households. Gilgit had a sample of 800 households, Ghanche 740 and each of the remaining districts approximately 700 households.
Of the households found occupied or eligible, the response rate was 97%. The survey also included 10,830 women and 4,204 men aged 15–49, along with information on 6,095 children under five and 5,411 children aged 5–17.
Response rates reached 95.1% among women, 85.5% among men, 96.9% for children under five and 97.8% for children aged 5–17. Separate household and source-water quality tests were also conducted.
Nearly One in Four Young People Not in Education, Employment or Training
Youth disengagement emerges as one of the survey’s most important findings. Across Gilgit-Baltistan, 23.6% of young people aged 15–24 are not in education, employment or training—an indicator commonly described as NEET.
The district-level comparison reveals wide disparities:
- Astore: 41.2%
- Kharmang: 36.7%
- Ghanche: 31.8%
- Ghizer: 24.3%
- Nagar: 23.2%
- Gilgit: 21.5%
- Diamer: 20.8%
- Shigar: 20%
- Skardu: 18.7%
- Hunza: 14.1%
Astore’s rate is nearly three times that of Hunza. Kharmang and Ghanche also record significantly higher proportions than the Gilgit-Baltistan average.
The findings reveal a pronounced gender gap. Around 28.4% of young women are outside education, employment and training, compared with 10.6% of young men.
Youth disengagement is also higher in rural areas, at 24.5%, compared with 20.2% in urban areas. Among ever-married youth, the rate reaches 46.7%, compared with 17.9% among those who have never married.
Age is another defining factor. The rate stands at 15.9% among adolescents aged 15–19 but rises sharply to 50.8% among young people aged 20–24. This indicates that the transition from education into employment or further training represents a critical point of vulnerability.
The findings call for district-specific investment in market-driven skills, apprenticeships, career guidance, entrepreneurship, digital employment and employment services. The particularly high rate among young women also highlights the need to address mobility, care responsibilities, social restrictions and limited access to safe and suitable employment opportunities.
The indicator should not be treated only as a measure of unemployment. It captures young people disconnected simultaneously from education, training and employment and therefore at greater risk of long-term economic and social exclusion.
Child Mortality Remains High
Gilgit-Baltistan’s neonatal mortality rate is estimated at 24 deaths per 1,000 live births, infant mortality at 43 and under-five mortality at 50.
These figures represent an improvement compared with the Pakistan Demographic and Health Survey 2017–18, which reported neonatal mortality at 47, infant mortality at 63 and under-five mortality at 76 per 1,000 live births.
However, district disparities remain substantial. Under-five mortality is highest in Diamer at 66, followed by Astore at 62, Shigar at 58 and Kharmang at 52.
Hunza records the lowest rate at 13, followed by Ghizer at 32, Nagar at 35, Gilgit at 44, Skardu at 45 and Ghanche at 46.
The difference between Hunza and Diamer is more than fivefold, highlighting inequalities in maternal healthcare, newborn care, nutrition, immunisation and access to health facilities.
Adolescent Birth Rate Highest in Diamer
The adolescent birth rate for Gilgit-Baltistan stands at 35 births per 1,000 women aged 15–19.
Diamer records the highest rate at 57, followed by Gilgit at 50, Nagar at 45, Shigar at 40 and Ghanche at 37.
The lowest rates are reported in Hunza at 12 and Skardu at 13, followed by Astore at 17, Ghizer at 23 and Kharmang at 26.
The findings highlight the importance of girls’ education, adolescent reproductive-health information, delayed marriage and access to appropriate health and family-planning services.
Fertility and Family Planning
The total fertility rate in Gilgit-Baltistan is estimated at 4.2 children per woman.
Contraceptive prevalence using any method has increased from 39% in the 2017–18 demographic and health survey to 45.2% in MICS 2024–25. Modern contraceptive methods are used by 33.9% of women, while 11.1% rely on traditional methods.
Gilgit records the highest contraceptive prevalence rate at 60%, followed by Nagar at 58.8%, Skardu at 54.8%, Hunza at 54.1%, Shigar at 53% and Ghizer at 52.6%.
Diamer records by far the lowest rate at 12.6%. Astore stands at 36.4%, Ghanche at 42.7% and Kharmang at 45.7%.
Across the region, 49.7% of women have their need for family planning satisfied through modern contraceptive methods, leaving a considerable proportion without adequate access.
Only Half of Women Report Decision-Making Power on Reproductive Health
The survey presentation reports that 53.4% of women aged 15–49 participate in or exercise decision-making on their reproductive health.
This means that almost half of women do not meet the survey’s indicator for reproductive-health decision-making. The finding adds an important dimension to the figures on contraceptive use, maternal healthcare and adolescent births, demonstrating that access to services must be accompanied by women’s ability to make informed decisions about their health.
Major Gaps in Antenatal Care
Around 83.4% of women with a live birth during the preceding two years received antenatal care from a skilled professional at least once.
However, only 37.4% completed four or more antenatal visits, revealing a considerable gap between initial contact and continued care throughout pregnancy.
Coverage of four or more visits is highest in Hunza at 94.7%, followed by Ghizer at 66.7%, Gilgit at 60.9%, Skardu at 54.9% and Nagar at 52.3%.
It falls to 32.1% in Ghanche, 23% in Kharmang, 22.9% in Shigar and 13.4% in Astore. Diamer records the lowest coverage at only 10%.
The difference between Hunza and Diamer is nearly 85 percentage points.
One-Third of Deliveries Lack Skilled Assistance
Across Gilgit-Baltistan, 66.8% of births are assisted by skilled health personnel, including doctors, nurses, midwives, lady health visitors and community midwives.
Hunza reports 100% skilled attendance, followed by Gilgit at 92.4%, Nagar at 91.2% and Ghizer at 86.7%.
The rate stands at 75.5% in Skardu, 73.9% in Astore, 71.7% in Ghanche, 68.5% in Shigar and 56.8% in Kharmang.
Diamer records the lowest coverage at 32.4%, indicating that approximately two out of every three births in the district take place without skilled assistance.
Mental-Health Findings Require Careful Attention
The survey found that 6.9% of respondents reported symptoms of depression or anxiety during the preceding two weeks, while 2.5% reported suicidal thoughts.
Ghizer reports the highest prevalence of depression or anxiety symptoms at 19%, followed by Gilgit at 9%, Astore at 8.5% and Nagar at 7%.
The reported prevalence is 5.5% in Ghanche, 5.3% in Kharmang, 4.2% in Skardu, 3.4% in Shigar and 2% in Hunza. Diamer reports only 0.2%.
The survey also exposes a major treatment gap. Only 0.9% sought help from a professional, while 43% approached relatives, friends, teachers or other non-professional sources.
More Than One-Third of the Population Faces Food Insecurity
The survey found that 37% of the population experiences moderate or severe food insecurity.
This includes 32.7% experiencing moderate food insecurity, involving compromises in food quality and quantity, and 4.3% experiencing severe food insecurity, including hunger, running out of food or going without food.
The finding is particularly concerning for a mountainous region affected by high transportation costs, limited agricultural land, seasonal isolation and climate-related disasters.
Child Food Poverty Reaches an Alarming Level
Child food poverty affects 69.4% of children under two in Gilgit-Baltistan.
The survey defines child food poverty as receiving food from four or fewer food groups during the previous day. Around 43.8% of children experience moderate food poverty, while 25.6% experience severe food poverty, receiving food from no more than two food groups.
Exclusive breastfeeding among infants under six months is also extremely low at 17.6%.
Stunting Affects More Than Four in Every Ten Children
Around 42.3% of children under five are stunted, reflecting chronic undernutrition. Underweight prevalence stands at 14.2%, wasting at 2.4% and overweight at 3.2%.
Stunting is highest in Diamer at 57.8%, followed by Kharmang at 54%, Ghanche at 47.9% and Shigar at 47.2%.
Skardu records 39.9%, Ghizer 37.4%, Astore 31.9%, Gilgit 27.8% and Nagar 25.6%. Hunza has the lowest prevalence at 9.5%.
The 48.3-percentage-point difference between Hunza and Diamer demonstrates the scale of nutritional inequality across the region.
Immunisation Coverage Remains Inadequate
Only 58.2% of children aged 12–23 months have received all basic vaccinations.
Coverage for all recommended antigens among children aged 24–35 months is lower at 48.5%, meaning that more than half have not completed the full recommended vaccination schedule.
Early Childhood Development Shows Wide Inequality
The survey found that 62.1% of children aged 24–59 months are developmentally on track in at least three of four areas: literacy and numeracy, physical development, social and emotional development, and learning.
Hunza records the highest result at 95.9%, followed by Nagar at 79.6%, Ghizer at 73%, Skardu at 69.6%, Gilgit at 66.7% and Astore at 65.5%.
Ghanche and Kharmang stand at approximately 64%, while Shigar records 55.4%. Diamer has the lowest result at 45.7%.
Despite the importance of early learning, only 11.7% of children aged 36–59 months attend an early childhood education programme.
One in Four Primary-School-Age Children Is Out of School
The net attendance rate among children of primary-school age is 47.4%, while 25% are out of school.
Attendance declines further at higher levels. The net attendance rate is 25.3% for children of middle-school age and only 16.1% for those of secondary-school age.
Diamer Records the Lowest Education Completion Rates
The primary completion rate for Gilgit-Baltistan stands at 58.8%, the middle completion rate at 55.1% and the secondary completion rate at 46.2%.
Hunza records the highest completion rates at every level: 96.8% for primary, 92% for middle and 83.5% for secondary education.
Diamer records the lowest rates—18.4% at primary, 18% at middle and 11.9% at secondary level.
At the primary level, Ghanche records 76.9%, Ghizer 72.3%, Gilgit 71.1%, Astore 67.4%, Nagar 67.3%, Shigar 63.4%, Skardu 63% and Kharmang 59.5%.
At secondary level, Gilgit records 61.6%, Ghanche 51.7%, Ghizer 51.6%, Skardu 50.7%, Nagar 48.7%, Astore 38.6%, Shigar 37.5% and Kharmang 31.6%.
Foundational Learning Remains Weak
Only 26.2% of children aged 7–14 demonstrate foundational reading skills, while 25.7% demonstrate foundational numeracy skills.
The findings show that attendance and completion do not necessarily translate into adequate learning outcomes.
Digital Access Expands, but Gender Gaps Persist
Around 49.1% of households have internet access, but only 15.1% own a computer.
Mobile-phone ownership among people aged 15–49 stands at 53.2%, while 76.3% used a mobile phone during the preceding three months. Only 41% used the internet, and 44.5% demonstrated at least one of the listed ICT skills.
Internet use stands at 65.3% among men compared with 32.5% among women. This gender divide limits women’s access to information, digital services, education and emerging employment opportunities.
Only Half of Children Under Five Have Registered Births
Birth registration among children under five stands at 51.3%.
Children without birth registration may face difficulties establishing their legal identity, accessing education and social protection, and proving their age or citizenship.
Child Marriage Continues to Affect Young Women
Around 18.1% of women aged 20–24 were married before reaching the age of 18.
Child marriage is closely associated with interrupted education, adolescent pregnancy, limited economic participation and greater health risks for young mothers and their children.
Safe Drinking Water Remains a Major Challenge
Around 80.1% of households use at least basic drinking-water services. However, only 15.8% have access to safely managed drinking water—an improved source located on the premises, available when needed and free from E. coli contamination.
Around 53.3% of households have a handwashing facility with soap and water, while 83% use basic sanitation services. At the same time, 9.5% of household members practise open defecation.
Dependence on Wood for Heating Remains Almost Universal
Although 99.5% of households use clean fuels or technologies for lighting, only 19.6% use clean fuels for cooking and just 2.4% use clean technologies for heating.
Wood remains the primary heating fuel for 96% of households, with implications for household air pollution, women’s workload, forest resources and public health.
Social Protection Reaches a Majority, but Gaps Remain
Around 70.6% of the population received some form of social transfer or benefit during the three months preceding the survey.
However, coverage alone does not establish whether assistance is sufficient, regular or effectively targeted towards the most vulnerable households.
The survey also found that 15.2% of children aged 2–17 experience some form of functional difficulty, highlighting the importance of inclusive education, accessible services and disability-sensitive social protection.
District-Specific Planning Is Essential
The findings present a mixed picture of progress and persistent deprivation. Gilgit-Baltistan has recorded improvements in child survival and contraceptive use, but major gaps remain in nutrition, immunisation, early childhood education, school attendance, foundational learning, youth engagement, safe drinking water and clean household energy.
Diamer requires an integrated response covering maternal and child health, nutrition, reproductive health and education. Astore needs urgent attention to youth engagement and continuity of maternal care. Kharmang and Ghanche face particularly high youth disengagement, while nutrition and education remain concerns in Kharmang, Ghanche and Shigar.
Ghizer’s reported mental-health burden warrants further examination and stronger support services.
Hunza’s comparatively strong results may offer useful lessons, but differences in geography, population, institutions, social conditions and access to services must be considered before replicating approaches elsewhere.
The survey provides an extensive evidence base for development planning. Its value will ultimately depend on whether the findings are translated into adequately financed, district-specific interventions with measurable targets and regular public monitoring.
