Biosocial Science Article 282 Revise 1st proof 24.2.

98

J. biosoc. Sci. (1998) 30, 261–275

 1998 Cambridge University Press Printed in the United Kingdom

THE PREVALENCE AND DEMOGRAPHIC

CHARACTERISTICS OF CONSANGUINEOUS
MARRIAGES IN PAKISTAN

R. HUSSAIN*  A. H. BITTLES†

*Aga Khan University, Karachi, Pakistan, and Australian National University, Canberra,
and †Edith Cowan University, Perth, Australia

Summary. Consanguineous marriages are strongly preferred in much of West

and South Asia. This paper examines the prevalence and sociodemographic
correlates of consanguineous unions in Pakistan using local and national data.
Information from 1011 ever-married women living in four multi-ethnic and
multi-lingual squatter settlements of Karachi, the main commercial centre of
the country, are compared with data from the national 1990/91 Pakistan
Demographic and Health Survey (PDHS), based on information provided by
6611 women. Both sets of results indicate that approximately 60% of marriages
were consanguineous, over 80% of which were between first cousins. The mean
coefficients of inbreeding (F) in the present generation were 0·0316 and 0·0331
for the Karachi and PDHS data respectively. In both surveys the prevalence
of consanguineous unions appeared to be unchanged over the past three to
four decades. Consanguineous unions were more common among women who
were illiterate or had only primary level education, were first or second
generation migrants from rural areas of Pakistan or, in the PDHS, lived in
rural areas, and whose parents were also consanguineously married.

Introduction
During the 20th century the incidence of consanguineous marriage has declined
markedly in economically more developed countries (Coleman, 1980; Lebel, 1983;
Imaizumi, 1986). However, within many regions of the developing world, and
particularly in West and South Asia, marriages between close biological kin remain
common (Al-Awadi et al., 1985; Saedi-Wong, Al-Frayh & Wong, 1989; Bittles et al.,
1991; Jaber et al., 1992; Al-Salem & Rwashdeh, 1993; Bittles, Grant & Shami, 1993b;
Bittles, Coble & Appaji Rao, 1993a). The specific types of consanguineous union vary
widely, from patrilateral parallel cousin marriages through most of the Middle East to
uncle–niece marriages in parts of South India (Bittles, 1994).
Apart from the recent Pakistan Demographic and Health Survey (PDHS),
published information on consanguineous marriage in Pakistan has been limited to a
few studies conducted in urban and rural areas of the province of Punjab (Shami,

261
Biosocial Science Article 282

262 R. Hussain and A. H. Bittles

Schmitt & Bittles, 1989, 1990; Yaqoob et al., 1993), Balochistan (Mian & Mushtaq,
1994), and the North West Frontier Province (Wahab & Ahmad, 1996). The overall
prevalence figures reported in these studies for marriages between second cousins or
closer kin (Fv0·0156) ranges from 31·1% to 58·9%. The present paper presents the
results of a study conducted in the urban slums of Karachi, which in many ways are
a microcosm of urban and rural Pakistan, and the findings are compared with national
data obtained from an analysis of the PDHS.

Subjects and methods

The setting
Karachi is the main port and commercial centre of Pakistan and the capital of
Sindh province. At the time of the last census of Pakistan, in 1981, the city had a
recorded population of 5·2 million. Despite growing civil unrest in the intervening
years, the population has rapidly increased to the present estimated total of 10 million.
The Karachi study was conducted in four squatter settlements: Essa Nagri, Chanesar
Goth, Grax and Orangi. These settlements are mainly inhabited by first or second
generation migrants from other regions of Pakistan who came to the city primarily in
search of a livelihood. Grax and Chanesar Goth, are over 100 years old and initially
they were established as fishing villages, but during recent years population and
housing pressures have led to marked changes in their demographic profiles. Orangi
has a concentration of Urdu-speaking Muhajirs who migrated from North India to
East Pakistan, in particular from the state of Bihar, following partition of the Indian
subcontinent in 1947, and later to Karachi following creation of Bangladesh in 1971.
Collectively, all of the major ethnic groups of Pakistan are represented in these
settlements.
Since the mid- to late-1980s the settlements have been served by Primary Health
Care (PHC) programmes provided by the Aga Khan University. The programmes have
provided a range of curative and outreach preventive services, the efficacy of which is
monitored through a comprehensive information management system (for details, see
Bryant et al., 1993). The main reason for adopting the settlements as study centres for
the present investigation was ready access to the ongoing surveillance data collected as
part of the PHC programmes, which could be used as a standard for validation of the
demographic and reproductive information obtained in the sample survey. By
comparison, the PDHS, conducted between December 1990 and May 1991, covered all
four provinces of the country and included all major urban and rural areas. To date,
it is the only nationally representative study in which information on consanguinity has
been collected.

Data and methods

For the Karachi survey, the sample consisted of ever-married women in the
reproductive age group (15–49 years). The sampling frame was based on an earlier
investigation of the same population that had examined pregnancy outcome and child
survival (Fikree et al., 1994). A structured, close-ended questionnaire was administered
which comprised four subsections: sociodemographic status; consanguinity, lineage and
Biosocial Science Article 282

Consanguineous marriage in Pakistan 263

Fig. 1. Trends in consanguineous marriages in Pakistan, 1956–91.

marital distance; reproductive history and contraception; and presence of disability. Of

the 1021 women initially questioned, 1011 provided complete information, one woman
provided incomplete information, and nine women (0·9%) refused to participate in the
study.
The PDHS contains information on 6910 ever-married women between 15 and 49
years of age. It was based on cluster sampling, with some remote and/or
less populated clusters over-sampled to ensure an adequate number of available
respondents. In order to make the results representative in national terms, sampling
weights were used by the organisers of the PDHS in the primary phase of the analysis
to approximate the population distribution estimated at the last census in 1981. The
results presented are based on the 6611 weighted cases on whom complete information
was available.

Results
Prevalence of consanguineous unions
Both the Karachi survey and the PDHS indicate that consanguineous marriages
continue to be very common among most of the population sub-groups in Pakistan,
with reported rates of 58·7% and 62·7% in the two studies respectively (Table 1).
Furthermore, there appears to have been no appreciable change in the prevalence of
consanguineous marriage in Pakistan over the past four decades (Fig. 1).
An overwhelming majority of the consanguineous marriages were first cousin
unions (83·6% in Karachi and 80·4% in the PDHS). Within these first cousin unions,
whether matrilateral or patrilateral, there appeared to be no strong preference for
either parallel or cross cousin marriages in the Karachi study. Despite the strongly
patrivirilocal pattern of marriage in Pakistan, and the perceived dominance of
patriarchal traditions and customs, this lack of preference for patrilateral marriages in
the Karachi study was surprising. The nationally based PDHS did record some
preference for patrilateral marriages, 29·8% patrilateral versus 20·6% matrilateral, and
the difference between the two types of marriages was more marked in rural than urban
areas. Unfortunately, it was not possible to assess any precise differentials in preference
Biosocial Science Article 282

264 R. Hussain and A. H. Bittles

Table 1. Prevalence of type of consanguineous marriages in
urban Karachi and Pakistan DHS

Karachi PDHS
Relationship % %

First cousin (parallel matrilateral) 10·5 20·6

First cousin (cross matrilateral) 12·7
First cousin (parallel patrilateral) 12·4 29·8
First cousin (cross patrilateral) 13·5
First cousin once removed 2·2
Second cousin 1·2 10·9
Distant cousin 6·2 1·4
Non-consanguineous 41·3 37·3
No. of cases 1011· 6611·

for parallel versus cross cousin marriages from the PDHS data, as detailed information
on all four types of first cousin marriages was not separately collected.
By comparison with earlier studies in urban Punjab (Bittles et al., 1993b; Yaqoob
et al., 1993), the prevalence of first cousin once removed (F:0·0313) and second cousin
marriage (F:0·0156) was much lower in the Karachi survey. It is difficult to say
whether this finding applies only to this particular study population. A more probable
explanation could be that, in collection of the data, respondents who were unsure of
the exact nature of their consanguineous relationship were categorised as ‘distant
cousin’ to eliminate the possibility of any over-estimation of the coefficient of
inbreeding. In the PDHS a reverse trend may have been in operation, with partition of
consanguineous unions into the categories of first or second cousins.
Familial preference for consanguineous unions became apparent when the data
were analysed for consanguinity patterns at parental level (Table 2). For example,
54·3% of women married to a first cousin reported that their parents also were first
cousin progeny, by comparison with 30·6% of women married to a
non-consanguineous partner. A similar pattern also emerged for the prevalence of
consanguineous marriage in the respondents’ parents-in-law, with 62·2% of women in
first cousin unions reporting that their in-laws were first cousins compared with 25·5%
in the non-consanguineous category.

Coefficient of inbreeding
The mean coefficient of inbreeding was calculated for both study groups according
to the formula a:Rp F , where p is the proportion of couples in each category of
consanguineous union and F is the coefficient of inbreeding for that category. For the
Karachi data, the mean coefficient of inbreeding in the progeny of the present
generation (a) was 0·0316. The equivalent mean coefficient of inbreeding for the PDHS,
0·0331, was similar to that obtained for the index generation in the Karachi study, and
earlier urban Punjab surveys (Bittles et al., 1993b).
Biosocial Science Article 282

Consanguineous marriage in Pakistan 265

Table 2. Prevalence of parental inbreeding in urban Karachi

Consanguineous Non-consanguineous All

marriage (%) marriage (%) cases

Respondents’ parents related

No 25·5 56·0 385
Yes 72·3 38·5 590
Don’t know 2·2 5·5 36
Respondents’ in-laws related
No 22·3 45·9 324
Yes 71·3 39·0 586
Don’t know 6·4 15·1 101
No. of cases 593· 418· 1011

The coefficients of inbreeding calculated over a single generation should be regarded

as underestimates, as multiple pathways of consanguineous union could not readily be
traced and all marriages beyond second cousin (F:0·0156) were classified as
non-consanguineous when values of a were computed for both populations.
Additionally, in Karachi more than two-thirds of respondents were unable to provide
information on the precise consanguinity status of either their own grandparents or
those of their husband (i.e. the great-grandparental generation for the progeny). Given
the familial pattern of consanguinity seen over two generations, there must be a strong
possibility that a similar pattern of close kin marriage would have existed in preceding
generations. Finally, the clans to which the respondents variously belong, i.e. their
zat/quom/braderi, vary in size and composition. Strict endogamy over successive
generations would lead to the possibility of significant random inbreeding effects,
especially in some of the smaller clans, which again would result in underestimation of
the coefficient of inbreeding. In summary, the actual levels of homozygosity in both
populations are probably much higher than indicated by the calculated coefficients of
inbreeding.

Demographic profile
Most of the women in the Karachi study population were in the 20–35
year age group, with few respondents at the extremes of the age range (Fig. 2).
Although the age distribution in the PDHS was similar, given the much larger sample
size there were sizeable numbers of women at both ends of the age spectrum. Except
for the youngest age group (15–19 years), there was no appreciable difference in the
proportion of consanguineous marriages in the remaining age groups for either the
Karachi study or the PDHS.
As over 80% of the consanguineous marriages reported in both the Karachi study
and the PDHS were first cousin unions, for the examination of associations between
consanguinity and education, occupational status, and other demographic and
socioeconomic variables, the data were sub-divided into two categories,
Biosocial Science Article 282

266 R. Hussain and A. H. Bittles

Fig. 2. Age distribution of consanguineously married women in Pakistan.

consanguineous and non-consanguineous. In terms of education, 69·9% of women in

the Karachi study and 79·2% of women in the PDHS had received no formal schooling
(Table 3). However, in both surveys, there were significantly more women in the
consanguineously married group who were illiterate. Of the women who had some
schooling, the proportion of those who were consanguineously married was greater
among those with primary education only. The data on husbands’ educational status
suggest that selectivity in the choice of a suitably educated bride only became important
when the groom had a college education.
Both the Karachi study and the PDHS indicated that very few women are employed
in either the formal or the informal sector. Of the small minority of women in the
Karachi survey who were currently employed, most had menial jobs in service
industries, or were involved in manual labour. The PDHS showed more women in the
production/manufacturing sector, followed closely by women working for cash or
credit in agricultural work. There was however no significant difference in female
occupational status by consanguinity in either study. Other than for men employed in
the professional or service categories, in Karachi consanguinity status appeared not to
be correlated with the husband’s type of employment (Table 3). In the PDHS there
were some differences between husband’s occupation and consanguinity, notably in the
sales and animal husbandry categories, but overall current occupational status did not
correlate well with marriage preference.
Consanguineous marriage was practised to varying degrees by all three religious
groups in Karachi (Table 4). The reported prevalence was lowest among Hindu
couples, many of whom trace their lineage to North India, particularly the Indian state
of Rajasthan where consanguineous unions are rigorously proscribed for Hindus. Most
consanguineous marriages in the Hindu community were cross cousin unions, of the
type mother’s brother’s daughter (MBD) and father’s sister’s daughter (FZD), with a
few matrilateral parallel cousin marriages (mother’s sister’s daughter, MZD). Among
Christians, both Roman Catholics and Protestants also contracted consanguineous
marriages, mainly cross cousin unions. There was however a greater proportion of
MZD marriages in the Christian than the Hindu community. Both Christians and
Biosocial Science Article 282

Consanguineous marriage in Pakistan 267

Hindus strongly disapproved of patrilateral parallel cousin marriages (father’s
brother’s daughter, FBD), because the lineage was perceived as being transmitted
through the father and thus the union was considered as analogous to a brother–sister
marriage. By comparison, in an MBD marriage the fathers of the bride and groom
have different lineages and so the match is considered acceptable. The PDHS provided
no information on religion, probably reflecting the constraints of its sampling frame
rather than the absence of minority, non-Muslim religious groups who would have
been resident in the areas covered by the survey.
A strong correlation was observed between the native language and ethnicity of
respondents in the Karachi study, and so language was adopted as a proxy for ethnicity
in all further analyses. The Karachi study showed that Punjabis had the lowest
prevalence of consanguineous marriages among the major ethnic groups (Table 4). This
was mainly due to the fact that almost all of the Christian population were Punjabis,
whereas other ethnic groups such as Pathans and Balochis were totally Muslim. The
lowest prevalence of consanguineous marriage among Muslims was found in the
Muhajirs, both in the Karachi survey and the PDHS (Table 4). The Urdu-speaking
Muhajirs were mainly first or second generation migrants from the state of Bihar in
North India, where levels of Muslim consanguineous marriage generally are lower than
in Pakistan (Ansari & Sinha, 1978). The absence of a strong clan culture and their
relatively higher levels of literacy also might be responsible for a less traditional
outlook on marriage within the community. The two data sets showed markedly
different results for Pathans (Pushto/Hindko-speakers), with 86·2% consanguineous
marriages reported for Pathans in Karachi as opposed to the 51·3% and 52·8%
consanguineous unions among urban and rural Pathans in the PDHS. It is possible
that the high level of consanguineous marriage among this particular sub-group in the
Karachi study principally reflected the dynamics of migration and family formation.
Most of the Pathan households started as bachelor households, with young single
males moving to the city in search of employment, and the majority of these men later
contracted marriage with relatives from their native village. For this reason, the results
of the PDHS may more accurately reflect the cultural norms of the Pathan community
in their home villages. This impression is supported by the findings of a study
conducted in the Swat District of northern Pakistan (a predominantly Pushto/Hindko
language area), where the prevalence of consanguineous unions at the level of second
cousin or closer was 31·1% and 37·1% for urban and rural areas respectively (Wahab
& Ahmad, 1996).
It has been reported that consanguineous marriages are more common in extended
households. The Karachi data support this in general, but there were a large number
of nuclear households within the consanguineously married group. This finding
perhaps reflects two factors: (1) most of the residents are first or second generation
migrants to the city, a move which may have disrupted the extended family system
within their native village; (2) space limitations within the urban squatter settlements.
The extreme lack of space often necessitates married sons vacating the family home,
especially when their own families begin to increase in number. The data show little
difference in the mean number of family members by consanguinity status (Table 4).
However, there were major differences in family type by ethnicity. For example, most
of the Balochi and Sindhi respondents had extended family households, especially in
 268

Biosocial Science Article 282

R. Hussain and A. H. Bittles
Table 3. Educational and occupational status by consanguinity in urban Karachi and the PDHS

Karachi PDHS

Non- Non-
Consanguineous consanguineous All cases Consanguineous consanguineous All cases
n:593 n:418 n:1011 n:4152 n:2459 n:6611
(%) (%) (%) p value* (%) (%) (%) p value*

Women’s education
None 74·4 63·6 69·9 0·0001 81·5 75·4 79·2 0·0001
Primary 14·3 11·2 13·1 9·5 8·5 9·1
Middle 7·1 12·0 9·1 3·8 5·3 4·4
Secondary 3·2 10·8 6·3 4·5 9·0 6·2
Post-secondary 1·0 2·4 1·6 0·7 1·8 1·1
Husbands’ education
None 41·8 40·0 40·9 ns 47·7 50·9 49·0 0·0001
Primary 14·9 16·5 15·5 18·2 15·0 17·0
Middle 16·8 12·9 15·1 12·1 9·6 11·1
Secondary 19·7 22·3 20·7 17·9 18·3 18·0
Post-secondary 6·8 8·3 7·8 4·1 6·2 4·9
 Biosocial Science Article 282
Women’s occupation
Professional/clerical/
sales 1·0 2·4 1·6 ns 1·5 1·6 1·5 0·002
Service industry 5·9 7·9 6·7 0·8 0·8 0·8
Agriculture — — — 7·3 4·8 6·4
Production/labour 3·7 2·6 3·3 8·2 7·4 7·8
Housewife 89·4 87·1 88·4 82·2 85·4 83·5
Husbands’ occupation
Professional 2·2 3·6 2·8 0·026 5·3 6·8 5·8 0·0001

Consanguineous marriage in Pakistan

Clerical 9·3 7·7 8·6 4·8 4·1 4·6
Sales 13·5 14·1 13·7 11·6 14·0 12·5
Service 12·8 19·4 15·5 7·1 7·0 7·1
Animal husbandry/
fisheries 3·9 1·6 3·0 33·0 28·7 31·4
Production/labour 55·2 51·0 53·4 31·6 34·2 32·5
Unemployed/not
classifiable 3·1 2·6 3·0 6·6 5·2 6·1

*Based on v statistic; ns:non-significant.

269
 270

Biosocial Science Article 282

Table 4. Other sociodemographic characteristics of respondents by consanguinity in urban Karachi and PDHS

Karachi PDHS

Non- Non-
Consanguineous consanguineous All cases Consanguineous consanguineous All cases
n:593 n:418 n:1011 n:4152 n:2459 n:6611
(%) (%) (%) p value (%) (%) (%) p value

Religion
Muslim 78·5 50·5 67·0 0·0001* — — — 0·0001*

R. Hussain and A. H. Bittles

Christian 19·1 43·0 29·0
Hindu 2·4 6·5 4·0
Residence
Major city — — — — 13·5 23·8 17·4 0·0001*
Small city/town 12·3 14·5 13·1
Village 74·2 61·7 69·5
Native language
Urdu 20·2 23·2 21·4 0·0001* 9·2 16·4 11·9 0·002*
Balochi 13·3 5·3 10·0 1·1 1·5 2·7
Punjab/Seraiki 28·0 51·0 37·5 57·1 49·8 54·4
Sindhi 25·8 12·4 20·3 16·8 11·4 14·8
Pushto/Hindko 9·5 2·1 6·4 12·3 18·7 14·7
Others 3·2 6·0 4·4 3·5 2·2 1·5
Type of family
Nuclear 60·7 66·0 62·9 ns 45·5 50·8 47·4 0·0001*
Joint (Stem/sibling) 2·4 1·4 2·0 — — —
Extended 36·9 32·6 35·1 54·5 49·2 52·6
Mean no. of family
members 8·7 (4·3) 8·7 (4·0) 8·5 (4·2) 0·0001† 8·0 (3·9) 8·1 (4·0) 8·1 (4·0) 0·0001†

*Based on v statistic; †based on F statistic; ns:non-significant.

Biosocial Science Article 282

Consanguineous marriage in Pakistan 271

Grax village, but the Sindhis in Chanesar Goth had more nuclear households. Similar
results were obtained from the PDHS. In general, there were more extended households
in rural areas, and among consanguineous marriages in particular ( p:0·05).
Although both surveys obtained information on a number of socioeconomic
variables, such as quality of housing and provision of amenities, on stratification by
consanguinity status no appreciable difference was seen for the majority of these
indicators. The only exception in both data sets, was ownership of consumer goods
and, in the Karachi data only, monthly income level (Table 5). For socioeconomic
status as indicated by ownership of consumer goods there was a statistically significant
difference in the PDHS ( p:0·001), perhaps as a result of the large sample size.
Stratification by place of residence in the PDHS revealed that for major cities and small
towns there were no discernible differences in ownership by consanguinity status (data
not shown), whereas in rural areas a much higher proportion of consanguineously
married couples possessed consumer goods ( p:0·05), probably reflecting the greater
relative affluence of consanguineous households.
In the Karachi study, although the difference in family income levels by
consanguinity status appeared to be small, it was statistically highly significant
( p:0·01). This indicates that, despite the apparent homogeneity of the study
population, non-consanguineous households were more prosperous, a finding which
possibly reflects the differences between the two groups in terms of their occupation
categories (Table 3). As the PDHS did not collect information on monthly cash
income, no comparative analysis could be undertaken.

Discussion
During the last two decades, Demographic and Health Surveys (DHS) have become
widely regarded as the source of benchmark information on economically less
developed countries. The DHS offer the considerable advantage of nationally
representative samples. However, with a sample size which comprises approximately
1/15,000 to 1/20,000 of the total population, there may be significant loss of detail. In
the PDHS this is exemplified by the truncated data collected on the specific types of
consanguineous unions contracted, and the total lack of information on minority
religious affiliations.
Nevertheless, the findings obtained with the two study populations were similar in
their overall demographic and household characteristics, and comparable with regard
to the prevalence of consanguineous marriages contracted. The observed level of
comparability provides support for the initial contention that the urban squatter
settlements of Karachi, with their rich ethnic and religious diversity, can justifiably be
considered a microcosm of Pakistan. Overall, the results are consistent with trends
reported in earlier DHS conducted in Egypt, Tunisia and Morocco where
consanguineous unions are strongly favoured (Bittles, 1991), and previous studies from
Pakistan (Bittles et al., 1993b; Yaqoob et al., 1993).
Despite a marked increase in the level of urbanisation and nuclear families in
Pakistan over the last three decades, consanguineous marriages appeared to be equally
common in urban and rural areas, and among nuclear versus extended households.
This finding gives credence to the belief that the motivational force behind marriage
 272

Biosocial Science Article 282

Table 5. Socioeconomic characteristics by consanguinity status in urban Karachi and PDHS

Karachi PDHS

Non- Non-
Consanguineous consanguineous All cases Consanguineous consanguineous All cases
n:593 n:418 n:1011 n:4152 n:2459 n:6611
(%) (%) (%) p value (%) (%) (%) p value

R. Hussain and A. H. Bittles

Mean monthly income
(Rs) 3051 (1787) 3098 (1807) 3071 (1795) 0·0001‡ — — — —
Ownership of consumer
goods†
None 5·9 5·7 5·8 ns 36·5 32·2 34·7 0·0001*
Any one 7·6 8·9 8·2 23·9 20·8 22·6
Any two 44·9 40·9 43·2 14·0 16·7 15·1
Any three 20·0 20·6 20·3 10·0 11·3 10·6
Any four 15·7 15·8 15·7 7·9 9·4 8·5
Any five 5·9 8·1 6·8 5·2 6·4 5·6
Any six — — — 2·5 3·2 2·9
Ownership of transport
None 86·5 86·8 86·5 ns 59·5 56·8 58·5 ns
Bicycle 8·1 8·6 8·3 29·3 31·0 29·9
Motor cycle 3·9 3·1 3·6 3·4 4·0 3·6
Car/van 1·0 0·5 0·8 2·3 2·1 2·2
More than one 0·5 1·0 0·8 5·5 6·1 5·8

†Radio, TV, fridge, washing machine and water pump and room cooler—DHS results are based on 4088 cases.
*Based on v statistic; ‡based on F statistic; ns:non-significant.
Biosocial Science Article 282

Consanguineous marriage in Pakistan 273

with a close biological relative is deeply embedded in the cultural mores of Pakistani
society. The lack of any clear preference for patrilateral cousin marriages further
indicates that, in the case of a son, it is not always the economic rationale that
primarily drives the preference for a consanguineous union. From the family
perspective, social concerns such as a knowledge of and familiarity with the positive
and/or negative aspects of the proposed partner’s family, regard for the offspring of
siblings, or simply some form of perceived old age insurance against eventual
mistreatment from the daughter-in-law, are perhaps more central to marriage
decision-making. For daughters, the primary concern is the provision of a safeguard
against possible maltreatment by her future husband and/or in-laws.
Admittedly, in some rural areas the economic rationale of keeping the property
intact does play a role in the preference for consanguineous unions, as evidenced by
the difference in economic status based on possession of consumer goods (Table 5). In
other instances, maintaining the purity of descent also may be an important
contributory factor; however in such situations the marriage is not always restricted to
a consanguineous union but more generally is within the clan (zat). This is evident from
the study of Shami, Grant & Bittles (1994) conducted in major cities and towns of
Punjab; besides the 46·5% of consanguineous marriages which were consanguineous at
Fv0·0156, an additional 37·7% of marriages had been contracted within clan
groupings.
The coefficient of inbreeding computed for the present study was based on the
consanguinity status of one generation only, and the estimates are more conservative
than the actual level of inbreeding in the community. This is further supported by the
finding that more than one-third of those with non-consanguineous marriages had
parents who had close consanguineous marriages. Despite a strong cultural heritage of
endogamous marriages, most of the Pakistani populace, unlike their North Indian
counterparts, do not maintain a record of lineage which could be passed on to the next
generation. Consequently, very few people possess factual knowledge of consanguineous
marriages in their grandparental (great-grandparental for the progeny) generation.
The overall prevalence of consanguineous marriages amongst Hindus in the
Karachi study was closer to the reported prevalence from studies conducted in the
Dravidian states of South India (Dronamraju & Meera Khan, 1963; Rao & Inbaraj,
1979; Bittles et al., 1991) than in North India (Mukherjee, 1992). However, unlike their
South Indian counterparts, there were no uncle–niece marriages amongst the Hindus
in Karachi, which may reflect sensitivity to the Koranic prohibititon applied to such
unions in the majority Muslim population. The prevalence of consanguineous
marriages amongst Christians was much higher than that reported for their
co-religionists in other regions where inbreeding is favoured, such as South India (Rao
& Inbaraj, 1977; Bittles et al., 1991) and the Middle East (Khlat & Khudr, 1986;
Khoury & Massad, 1992). Despite the disapproval of the Roman Catholic Church
towards close kin marriage, in Karachi there was no appreciable difference in the
prevalence of consanguineous unions within the Roman Catholic and Protestant
sub-groups. With the exception of individuals with origins in South India, most of the
present day Christian population of Pakistan were converted by missionaries during
the period of the British Raj. The relatively recent timing of these conversions, and the
fact that the majority of Christians have strong roots in rural Pakistan, is perhaps
Biosocial Science Article 282

274 R. Hussain and A. H. Bittles

another reflection of the strong influence of the region’s culture that transcends
religious and ethnic identity in Pakistani society.
The present study shows very high levels of consanguineous marriages among the
major ethnic and religious groups in Pakistan. However, to provide a more complete
picture of this practice in the country as a whole, further studies are needed to examine
the specific marriage patterns contracted within the many small and highly
endogamous groups, including the Bohra and Memon communities in Karachi, the
Ismaili population of Northern Pakistan and the Zikree Baloch and Zoroastrians in
Balochistan.

Acknowledgments
This paper is based on original research undertaken by R.H. as part of her doctoral
dissertation. The generous financial assistance provided by the Wellcome Trust to
AHB, grant number 037709/Z/93, is gratefully acknowledged. The authors wish to
thank Gigi Santow, John Caldwell and S. K. Jain for their valuable comments on an
earlier version of this manuscript.

References
A-A, A. S., M, M. A., N, K. K., F, T. I., T, A. S., E-K, M.
& E-D, L. (1985) Consanguinity among the Kuwaiti population. Clin. Genet. 27,
483–486.
A-S, M. & R, N. (1993) Consanguinity in North Jordan. J. biosoc. Sci. 25,
553–556.
A, N. A. & S, S. P. (1978) Survey on the effects of inbreeding in two populations of
Bihar. Ind. J. med. Res. 68, 295–299.
B, A. H. (1991) Consanguinity: a major variable in studies of North African reproductive
behavior, morbidity and mortality? In: Proceedings of the Demographic and Health Surveys
World Conference, Vol. 1, pp. 321–341. IRD/Macro International, Columbia, Maryland.
B, A. H. (1994) The role and significance of consanguinity as a demographic variable.
Popul. Dev. Rev. 20, 561–584.
B, A. H., C, J. M. & A R, N. (1993a) Trends in consanguineous marriage in
Karnataka, South India, 1980–89. J. biosoc. Sci. 25, 111–116.
B, A. H., G, J. C. & S, S. A. (1993b) Consanguinity as a determinant of
reproductive behaviour and mortality in Pakistan. Int. J. Epidemiol. 22, 463–467.
B, A. H., M, W. M., G, J. & A R, N. (1991) Reproductive behavior and
health in consanguineous marriages. Science, 252, 789–794.
B, J. H., M, D. R., K, K. S., D’S, R., H, K., A, A., Q, A.
F.,  W, V. & H, R. (1993) A developing country’s university oriented toward
strengthening health systems: challenges and results. Am. J. publ. Hlth, 83, 1537–1543.
C, D. A. (1980) A note on the frequency of cousin marriages in Reading, England in
1972/73. Hum. Hered. 30, 278–285.
D, K. R. & M K, P. (1963) The frequency and effects of consanguineous
marriages in Andhra Pradesh. J. Genet. 58, 387–401.
F, F. F., B, H. W., M, F., D’S, R. & H, R. (1994) Risk factors
for intrauterine growth retardation: results of a community-based study from Karachi. J. Pak.
med. Ass. 44, 29–34.
Biosocial Science Article 282

Consanguineous marriage in Pakistan 275

I, Y. (1986) A recent survey of consanguineous marriages in Japan. Clin. Genet. 30,
230–233.
J, L., M, P., B, X., R, J. I. & S, M. (1992) Marked parental
consanguinity as a cause for increased major malformations in an Israeli Arab community.
Am. J. med. Genet. 44, 1–6.
K, M. & K, A. (1986) Religious endogamy and consanguinity in marriage patterns in
Beirut, Lebanon. Social Biol. 33, 138–145.
K, S. A. & M, D. (1992) Consanguineous marriage in Jordan. Am. J. med. Genet.
43, 769–775.
L, R. R. (1983) Consanguinity studies in Wisconsin. I: Secular trends in consanguineous
marriage, 1843–1981. Am. J. med. Genet. 15, 543–560.
M, A. & M, R. (1994) Consanguinity in population of Quetta (Pakistan): a
preliminary study. J. hum. Ecol. 5, 49–53.
M, D. P. (1992) Consanguineous marriages and their genetical consequences in some
Indian populations. In: Isolation, Migration and Health, pp. 63–74. Edited by D. F. Roberts,
N. Fujiki & K. Torizuka. Cambridge University Press, Cambridge.
R, P. S. & I, S. G. (1977) Inbreeding in Tamil Nadu, South India. Social Biol. 24,
281–288.
R, P. S. & I, S. G. (1979) Trends in human reproductive wastage in relation to
long-term practice of inbreeding. Ann. hum. Genet. 42, 401–413.
S-W, S., A-F, A. H. & W, H. Y. H. (1989) Socio-economic epidemiology of
consanguineous matings in the Saudi Arabian population. J. Asian Afr. Stud. 24, 247–252.
S, S. A., G, J. C. & B, A. H. (1994) Consanguineous marriages within
social/occupational class boundaries in Pakistan. J. biosoc. Sci. 26, 91–96.
S, S. A., S, L. H. & B, A. H. (1989) Consanguinity related prenatal and
postnatal mortality of the populations of seven Pakistani Punjab cities. J. med. Genet. 26,
267–271.
S, S. A., S, L. H. & B, A. H. (1990) Consanguinity, spousal age at marriage
and fertility in seven Pakistani Punjab cities. Am. hum. Biol. 17, 97–105.
W, A. & A, M. (1996) Biosocial perspective of consanguineous marriages in rural and
urban Swat, Pakistan. J. biosoc. Sci. 28, 305–313.
Y, M., G, K-H., J, F., K, J. & I, L. (1993) Early child health
in Lahore, Pakistan. II. Inbreeding. Acta Paediatr. Suppl. 90, 17–26.