Dr. Luay Shabaneh, UNFPA Representative
Last week, I participated in a meeting convened by the Minister of Planning to initiate a national dialogue on population management. The meeting was attended by the Ministers of Health and Information along with numerous key stakeholders in Pakistan. Population growth – and the resulting anxiety surrounding it – has become more pressing issues in Pakistan than ever before. Key concerns include a high fertility rate, rapid population increase, rising unemployment, inadequate education, skills development, stunting, and climate change. However, according to Dr. Natalia Kanem, the Executive Director of UNFPA, the real fertility crisis lies in the lack of a reproductive agency. it is often assumed or implied that fertility rates reflect free choices. However, in reality it is rarely the case. Poor health services, lack of education, lack of awareness and backlash against women’s rights are the primary drivers of fertility rates in Pakistan.
Misguided beliefs and misperceptions around national narratives on population growth have led many countries to adopt policies that often worsen the problems they aim to solve. In Pakistan, for example, the taxation of contraceptives, the lack of progressive measures against child marriage, barriers to girls’ education, limited access to reproductive health services and supplies, and the limitation of women’s reproductive rights have all contributed to a rise in unintended pregnancies amplify the challenges associated with population growth. Viewing population growth narrowly – as solely a matter of family planning – while overlooking its broader complex aspects, has resulted in inadequate and ineffective progress on critical population indicators including maternal mortality, unmet family planning needs, contraceptive prevalence, and, most importantly, development of human capital.
World Population Day, commemorated every year on July 11, is an important occasion to reasses the approach to population management. It is a moment to genuinely listen to what women and young generations want and need to create conditions that empower them to exercise their rights, make informed choices and enjoy a hopeful future. This is the only path that can make transformative change in the population and development architecture and normalize fertility behavior that support balanced development agenda. Family-friendly policies – such as affordable, accessible maternal and childcare services, and the active engagement of men in promoting sexual and reproductive health – can help prospective parents balance their career and family goals. Equally important is investment in comprehensive sexuality education equips young people with the knowledge they need to make informed choices. As Dr. Natalia Kanem aptly stated that ’only shared solutions, grounded in human rights, will meet the demands of a demographically diverse world’. Ensuring universal access to sexual and reproductive health and rights remains a cornerstone of sustainable and inclusive societies.
Pakistan’s population agenda faces structural and multi-dimensional challenges – requiring equally comprehensive solutions. At the policy level, it is crucial for Pakistan to secure sustained political commitment and leadership for the population agenda by activating the population federal task force chaired by the Prime Minister and including Chief Ministers and other relevant leaders. This body can serve as a high-level mechanism to align national and provincial efforts.
Revising the National Finance Commission (NFC) formula – from a burden-driven model to a target-focused approach – is essential to garner political commitment at the provincial level. To meet its financial obligations, the government must also increase public expenditure on contraceptives from the current 1 USD to 3.5 USD per capita, as recommended by Council of Common Interests (CCI). An immediate allocation of 10 billion PKR to the Population Fund is necessary to mobilize matching funds from international donors and accelerate progress on the population management agenda. Providing tax exemptions on family planning commodities would further enhance affordability and access. Moreover, it is vital to improve and diversify the allocation and utilization of domestic resources for reproductive health and family planning services and commodities.
At the institutional level, Pakistan needs to strengthen governance and address structural deficiencies to guarantee the effective delivery of sexual and reproductive health services. It is recommended to integrate population concerns into sectoral plans and approach the population agenda from a multi-sectoral viewpoint, ideally led by a cross-sectoral coordination ministry. Enhancing data collection and analysis systems is vital for efficient monitoring and tracking progress. In terms of delivery service, community levels should be enhanced through targeted outreach initiatives. Bridging gaps in family planning programmes and expanding coverage requires increasing both the number and geographical distribution of Lady Health Workers. The government should also prioritize the efficiency of reproductive health commodity security and supply chain management, while encouraging public-private partnerships. Improved coordination is another crucial element. Stronger collaboration among development partners and stakeholders is essential to ensure a unified approach to the population agenda. Additionally, aligning efforts of provincial and federal governments on a common platform is critical to realizing the shared vision of Pakistan’s development agenda.
