The World Happiness Report 2015 ranks Pakistan at 81, well ahead of India ranked at 117 among 158 countries surveyed. Not surprisingly, Switzerland is home to the happiest people in the world. The top 10 on the list are rich industrialized countries of the world.
Pakistan happiness index score has declined by 0.312 since 2008, the year Pakistan became a "democracy" after 8 years of "military rule" by President Pervez Musharraf.
The World Happiness Report bases each country’s ranking on six variables: GDP per capita, social support, healthy life expectancy, freedom to make life choices, generosity, and freedom from corruption.
The prevalence of depression is among the key factors determining a country's happiness. The report notes that Pakistan has made significant efforts in treating rural women's depression. Here's an excerpt from the report:
"Community health workers (Lady Health Workers) were trained to identify and treat maternal depression, using a CBT-based ( intervention (the Thinking Healthy Program). The initiative used 16 home-based individual sessions and included active listening, collaboration with the family, guided discovery and homework (Cognitive Behavioral Therapists) is, trying things out between sessions, practicing what was learned). Forty local areas were assigned to either intervention or routine care, with about 450 mothers in each group. At follow-up sessions (after six months) the experimental group included 23% still depressed, compared with 53% in the control group. In another study, psychoeducation is being offered to all mothers."
A Lancet paper describes the mental health intervention as follows:
"Lady Health Workers (LHWs) were trained to deliver a Cognitive Behavior Therapy (CBT) based intervention to depressed women, beginning in the last trimester of pregnancy and ending at 10 months postpartum. The intervention is based in a psychosocial model and not presented as a ‘treatment’ for a ‘mental health problem’ but rather as way to improve positive and healthy thinking around the mother and the baby. The actual delivery of the intervention was integrated into the routine work of the existing community health worker – called Lady Health Worker (LHW) and delivered at the women’s’ home. LHWs are mainly responsible for maternal and child health care".
The Lady Health Workers (LHW) program in Pakistan has been described as “one of the best community-based health systems in the world” by Dr. Donald Thea, a Boston University researcher and one of the authors of a recent Lancet study on child pneumonia treatment in Pakistan. He talked with the New York Times about the study.
Pakistan's relatively lower levels of depression and suicides (less than 3 per 100,000) in South Asia are reflected in the region's suicide statistics. A 2013 scientific paper titled "Mental Depression of Indian Women" published in "Anthropology" described the situation in India as follows: "Suicidal rate in India is higher comparing to other countries in the world. In each year over a half million people put their own lives down globally, of them 20% are Indians (17% of world population). However, during last two decades the rate of suicide has increased from 7.9 to 10.3 per 100,000".
India's youth suicide rate of 30-40 per 100,000 is among the highest in the world, according to a Lancet study. In addition, Indian farmers' suicides are continuing unabated at a rate of one every 30 minutes for the last two decades.
The problem of suicides appears to be at least in part due to the fact that India's value added agriculture continues be among the lowest in the world. Unlike India, Pakistan managed to significantly raise agriculture productivity and rural incomes in 1980s through a livestock revolution. Economic activity in dairy, meat and poultry sectors now accounts for just over 50% of the nation's total agricultural output. The result is that per capita value added to agriculture in Pakistan is almost twice as much as that in Bangladesh and India.
The key to improving happiness in developing countries like India and Pakistan is to focus on meeting basic needs such as education, nutrition and hygiene, in addition to addressing issues of health, including mental health.