Cousin marriage in Pakistan and India: universal across every Pakistani province, concentrated in pockets in India and very marginal as compared to Pakistan. Why is this so?

Gallup Pakistan Digital Analytics team pulled DHS microdata from Pakistan and India — specifically isolating Muslim vs. Hindu populations across seven North Indian states, where South India’s separate Dravidian cousin-marriage tradition doesn’t apply — to understand how prevalent this practice really is in Pakistan, and how it compares regionally and religiously.

Every single Pakistani province exceeds 50%: → Sindh: 70.5% → Balochistan: 67.1% → Azad Kashmir: 65.0% → Khyber Pakhtunkhwa: 62.0% → Punjab: 61.6% → FATA: 57.8% → Islamabad: 54.9% → Gilgit-Baltistan: 51.3% (Pakistan’s lowest region)

North India’s Muslim populations, for comparison: → Rajasthan: 17.7% (the highest state-level Muslim rate we found) → Uttar Pradesh: 15.2% → Bihar: 15.1%

Key findings:

Pakistan’s lowest province still beats India’s highest Muslim-state rate by roughly 3x. Gilgit-Baltistan’s 51.3% dwarfs Rajasthan’s 17.7% — and Gilgit-Baltistan is the floor for Pakistan, not the ceiling.

Muslims consistently out-marry cousins relative to Hindus in every single North Indian state we checked — a real, consistent religious pattern, ranging from 1.8x higher in Punjab to 5.7x higher in Rajasthan.

The structural difference matters more than the numbers alone. In India, consanguineous marriage concentrates in specific pockets — South Indian Hindus with their Dravidian tradition, North Indian Muslims with a distinct but far more moderate pattern. In Pakistan, it’s diffuse and near-universal, cutting across province, ethnicity, and urban/rural lines alike. That points to something more deeply embedded than religion or region alone — a nationwide social and marriage custom that predates and cuts across Pakistan’s internal divisions.

This has real public health relevance too — consanguineous marriage is linked in the literature to elevated risk of certain recessive genetic conditions. Understanding just how deeply and evenly this practice runs across the country is a first step toward any informed conversation about genetic counseling access or public health messaging.

Data: Pakistan DHS 2017-18 (NIPS), India NFHS-5 2019-21.
Analysis by Gallup Pakistan Digital Analytics.