Consanguinity refers to unions between individuals sharing a close common ancestor, most often first cousins. The coefficient of consanguinity, used by geneticists to quantify this phenomenon, varies significantly from country to country. Several factors explain these disparities: matrimonial traditions, tribal structures, geographical isolation, or religious frameworks.
This ranking of the most consanguineous countries is based on documented data on the frequency of consanguineous marriages found in scientific literature, notably the works of Alan Bittles and the databases compiled by World Population Review.
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1. Pakistan
Pakistan has the highest frequency of consanguineous marriages in the world. The majority of unions there are contracted between first cousins, a practice deeply rooted in tribal structures and family traditions.
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This frequency has measurable health consequences: the prevalence of recessive genetic diseases is significantly higher than the global average. Awareness programs remain limited in rural areas, where arranged marriages within the extended family remain the norm.
2. Sudan
Sudan ranks among the countries with the highest rates of consanguinity, with a very high proportion of marriages between cousins. Clan structures and low geographical mobility in certain regions contribute to maintaining this practice.
The available data do not allow for a conclusion about a recent downward trend, unlike other countries in the region. Limited access to medical genetics services complicates the monitoring of pathologies related to these unions.
3. South Sudan
A neighboring country and recently independent, South Sudan shares comparable levels of consanguinity with Sudan. Endogamous marital practices are reinforced by the tribal organization of society and decades of conflict that have reduced population mobility.
The lack of reliable epidemiological data makes it difficult to accurately assess the health impact in this country.
4. Qatar
Despite its wealth and rapid urbanization, Qatar maintains one of the highest rates of consanguineous marriages. Unions between first cousins remain valued in many Qatari families, often to preserve heritage or strengthen family alliances.
Qatar has implemented a premarital genetic screening program to identify couples at risk of transmitting recessive diseases. Recent evaluations show that these programs have helped reduce the number of marriages concluded when both partners are carriers of the same genetic condition.
5. Kuwait
Kuwait presents a situation similar to Qatar. The frequency of consanguineous marriages remains high, driven by tribal traditions that still significantly influence marital choices.
Health authorities have developed genetic counseling campaigns, but social pressure in favor of intrafamilial marriage remains a major obstacle to changing practices. In contrast, younger generations, who are more educated and urban, show signs of change.
6. United Arab Emirates
The United Arab Emirates is among the Gulf countries where consanguinity remains significant. Like in Qatar and Bahrain, a premarital genetic screening program has been deployed to limit health risks.
Massive urbanization and the influx of expatriate populations are slowly changing the demographic composition, but within the national population, marriages between cousins remain common. Field reports vary on the actual effectiveness of these preventive measures.
7. Saudi Arabia
Saudi Arabia has long reported some of the highest rates of consanguinity in the Arabian Peninsula. Premarital genetic screening has been mandatory for several years, a pioneering measure in the region.
The results of this program are documented: the proportion of marriages concluded between healthy carriers of the same recessive disease has decreased. The size of the country and the diversity of its populations complicate the generalization of these results, with rural areas remaining less covered.
8. Iran
Iran illustrates a downward trend in consanguinity since the early 2000s. The rise in women’s education levels, rapid urbanization, and increased access for women to the labor market are the main factors associated with this decline.
However, rates remain higher in rural and border provinces, where tribal structures still exert a strong influence on marital choices. Iran’s demographic transition is one of the fastest in the region.
9. Turkey
Turkey is also experiencing a gradual decrease in consanguineous marriages, particularly in the large cities of the western part of the country. Data show a marked gap between urban areas, where the practice is declining sharply, and rural areas of eastern Anatolia.
Improved access to education and geographical mobility among younger generations are accelerating this evolution. However, Turkey remains among the countries where the overall frequency is still above the European average.
10. Tunisia
Tunisia stands out in North Africa for a documented decrease in consanguinity, driven by the education of women and urbanization. Rates remain higher in interior regions and in communities with strong tribal cohesion.
Genetic studies conducted on the Tunisian population have identified several recessive diseases specific to certain regions, which has facilitated the development of targeted genetic counseling programs.
This overview shows that consanguinity, far from being static, evolves under the combined effects of education, urbanization, and public health policies. The premarital screening programs deployed in the Gulf represent a concrete response, with results varying according to local contexts. The ongoing demographic transition in several of these countries suggests a continued decline, without the disappearance of matrimonial traditions in the most isolated regions.