Background and Objectives:
Suicide is a leading cause of death among women in Himalayan villages of Pakistan, So this study aimed to determine the prevalence of suicidal ideation and associate factors among married women in the Himalayan Mountain villages of Gilgit Baltistan (GB) in Pakistan.

Methods:
We used a cross-sectional study design to recruit a random sample (N=830) of married women aged 18-49 years. Trained nurses obtained sociodemographic information, self-reported suicidal behavior using the WHO suicidal ideation module. Multivariable logistic regression analyses were used to estimate significant correlates of suicidal ideation.

Results:
The mean age of study participants was 38.3 years (SD: ±12.8). The 12-month prevalence of suicidal ideation, plans, and attempts is 18.8% (95% CI `6.2-21.7), 4.1% (95% CI 2.9-5.7), and 3.4% (95% CI 2.2-5.3). Significant risk factors for suicidal ideation included lack of cash income (adjusted odds ratio (aOR)=2.78 (95% CI 1.09-7.09), poor relationship with the mother-in-law (aOR=1.63 (95% CI 1.09-2.14), self-perceived poor quality of health (aOR=2.15; 95% CI 1.47-3.13), poor quality of life (aOR=2.79; 95% CI 1.46-5.34), positive history of intimate partner violence (aOR=2.58 (95% CI 1.75-3.82) and positive symptoms of depression (aOR=7.24; 95% CI 4.83-10.82). College or higher levels of education had a protective effect (aOR=0.44; 95% CI 0.23-0.83). Among those reporting suicidal ideation, 13.5% (95% CI 8.8-20.1) attempted suicide, by hanging (47%), jumping into a river (18%), use of pesticide (18%), an overdose of sleeping pills (12%), and use of sharp instruments (5%).

Conclusions:
Suicidal behavior is a serious public health problem in the study population. Prevention efforts should focus on upstream risk factors.