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Pakistan has a highly patriarchal society. Consequently, the desire for sons is a dominant and widely prevalent cultural value that is reinforced by feudal kinship systems that permeate many parts of the country. While reliance on sons is stronger in rural areas because of agricultural work and the tying of land ownership with male inheritance, even in other areas boys are seen to be important in carrying on the family name and taking care of parents in old age. On the other hand, daughters are seen as an expense and an economic burden in both rural and urban areas. A mere 22 percent of women participate in the labor force, and the role of women as productive agents is largely confined to urban areas. The majority of women remain economically dependent on male household members and are unlikely to be contributing to household income. Preference for sons can translate into sex-selective abortions and uneven sex ratios at birth. This report forms part of a research project to explore the issue of gender-biased sex selection and to make evidence-based recommendations for responding to adverse sex ratios at birth.