Can Family Planning Succeed in Pakistan?

While Pakistan was one of the first developing countries to support family planning (FP) its growth rate remains at 3% per year fueled by a large mortality decline and a small decline in births from 49.2/1000 in 1901-10 to 42.8/1000 in 1984-86. Much of the decline in the birth rate can be attributed to an increase in the marriage age. While 62% of women know of at least one method of FP only 12% report ever using FP. A look at the history of population activities in the country shows that after an early start population activities went through a period of dormancy with 22 administrators appointed in nearly 30 years. These shifts have been accompanied by unrealistic goals and unreliable benchmark figures. The current plan of the Population Welfare Program (PWP) includes developing multisectoral economic links to the promotion of FP and increasing coverage of FP services in order to achieve a contraceptive prevalence level of 23% by 1993. Accelerated program activity is expected to result in overall coverage of 70% (50% in rural areas) by the year 2000. Other issues include improving utilization of service providing wider outreach coverage enhancing the quality of services creating demand strengthening program management and ensuring continued political support. Factors which contribute to the high birth rate are the perceived low cost of children the low status of women and unmet need. Pakistani women are beginning to understand that smaller families increase prosperity but they need to have easy access to services. If the FP program is improved as outlined above and this effort is augmented by social programs to enhance female literacy and education as well as the status of women and to promote breast feeding then FP can succeed in Pakistan. Until such a time it is premature to conclude that FP will not be accepted by the people of Pakistan.