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Keeping Pakistan’s high fertility in check


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-Photo by Fayyaz Ahmed
-Photo by Fayyaz Ahmed
While contraceptives do help with family planning, what really helps is preventing women from marrying very young.

A survey in Pakistan revealed that women under 19 years of age at marriage were much more likely to give birth to five or more children than those who were at least 19 years old at marriage. The same survey also revealed that visit by family planning staff did not have a significant impact on reducing fertility rates. Instead, women who watched family planning commercials on TV were much less likely to have very large families.

Being the sixth most populous nation in the world, Pakistanis are also exposed to disease, violence, and natural disasters, which increase the odds of losing children to accidents or disease. At the same time, many consider the use of contraceptives to be un-Islamic. In addition, the preference for a male offspring is also widespread. As a result, Pakistani parents are inclined to have several children. The immediate task for the governments in Pakistan is to ensure that the rate of decline in fertility rates observed over the past two decades continues. At the same time, the governments in Pakistan should learn from Bangladesh that has made significant progress in stemming the population tide.

Source: The World Bank (2013) – Graph generated by Murtaza Haider.
Source: The World Bank (2013) – Graph generated by Murtaza Haider.

Getting down to two children per family may seem an elusive target, however, Pakistanis have made huge dents in the alarmingly high fertility rates, despite the widespread opposition to family planning. Since 1988, the fertility rate in Pakistan has declined from 6.2 births per woman to 3.5 in 2009. In a country where the religious and other conservatives oppose all forms of family planning, a decline of 44 per cent in fertility rate is nothing short of a miracle.

A recent paper explores the impact of family planning programs in Pakistan. The paper uses data from the 2006-07 Pakistan Demographic and Health Survey, which interviewed 10, 023 ever-married women between the ages of 15 and 49 years. The survey revealed that only 30 per cent women used contraceptives in Pakistan. Though the paper in its current draft has several shortcomings, yet it still offers several insights into what contributes to high fertility and what the effective strategies are to check high fertility rates in Pakistan.

The survey revealed that the use of contraceptives did not have any significant impact for women who had given birth to six or more children. While 24 per cent women who were not using any contraceptives reported six or more births, 37 per cent of those who used contraceptives reported six or more births. At the same time, 27 per cent of women who were not visited by the family planning staff reported six or more births compared with 22 per cent of women who had a visit with the family planning staff.

Meanwhile, demographic and socio-economic factors reported strong correlation with the fertility outcomes. Women who were at least 19 years old at marriage were much less likely to have four or more births than those who were younger at the time of marriage. Similarly, those who gave birth before they turned 19 were much more likely to have four or more births.

Education also reported strong correlation with fertility outcomes. Consider that 58 per cent of illiterate women reported four or more births compared to 21 per cent of those who were highly educated. Similarly, 60 per cent of the women married to illiterate men reported four or more births compared to 39 per cent of the women married to highly educated men. The survey revealed that literacy among women mattered more for reducing fertility rates than literacy among their husbands.

The underlying variable that defines literacy and the prevalence of contraceptives in Pakistan is the economic status of the households. The survey revealed that 32 per cent of women from poor households reported six or more births compared to 21 per cent of those who were from affluent households.

The above results suggest that family planning efforts in Pakistan are likely to succeed if the focus is on educating young women. Educated young women are likely to get married later and will have fewer children. This is also supported by a comprehensive study by the World Bank in which Andaleeb Alam and others observed that cash transfer programs in Punjab to support female education resulted in a nine percentage point increase in female enrollment. At the same time, the authors found that those girls who participated in the program delayed their marriage and had fewer births by the time they turned 19.

“In fact, women in Punjab with middle and high school education have around 1.8 fewer children than those with lower than middle school education by the end of their reproductive life. Simple extrapolations also indicate that the 1.4 year delay in marriage of beneficiaries associated with the program could lead to 0.4 fewer births by the end of their childbearing years.”

The religious fundamentalists in Pakistan will continue to oppose family planning programs. They cannot, however, oppose the education of young women. The results presented here suggest that high fertility rates could be checked effectively by improving young women’s access to education. At the same time, educated mothers are the best resource for raising an educated nation.

Author Image

Murtaza Haider is a Toronto-based academic and the director of

He tweets @regionomics

The views expressed by this writer and commenters below do not necessarily reflect the views and policies of the Dawn Media Group.

Comments (63) Closed

cameo Aug 28, 2013 05:58pm

This is a more serious issue than terrorism in Pakistan. Some policies that can help: - child labor laws and implementation - compulsory education

saad Aug 28, 2013 06:12pm

good one

Pakistani Aug 28, 2013 06:36pm

How many kids you got from your marriage MH? just a question....if less then 3 then the reason is the planning which you suggesting to have effect in Pakistan or some of your medical reasons :-).

On little more serious note, the other way around is to follow your foot prints, the family with more kids should end up in Canada beside you....As that place need more people......then they can get the education without any hurdles from religious peers..... :-)

Rythmscape Aug 28, 2013 06:57pm

Such a well researched article.I hope entire south asia would take family planning programmes on high priority basis.High population density is one of the prominent reason behind backwardness and social evils of the entire region,after all it's all about demand and supply...

Ahsan Aug 28, 2013 07:10pm

In simple words........Population Control program...So the Masters can control you & your nation..They are pushing hard to control population and successed in India China by planning..G-M-O food...etc

Pakistani Aug 28, 2013 07:59pm

Why can not Pakistan take advantage of its human capital? Rather than losing money on so called family planning, Pakistan should invest in human resource development.

Tahir A Aug 28, 2013 08:07pm

During my flood relief work in Pakistan, it was shocking to see fairly old aged white haired men married to very young girls with big families and hardly any age gap between the children. The situation was rampant and it wasn't clear whether the guys were first-time married or had other wives and children from other marriages (relationships).

.But more alarming was the fact when the men and women were asked, the general answer was "It is Allah's will, these kids bring their own bounties and plenty of good fortunes with them.... Alhamdolillah". They looked unfazed and content enough with life and I just moved on rather disturbed, perhaps something is wrong with my own perception of raising a small family.

Mr Anonymous Aug 28, 2013 08:07pm

Maaf kar do bhai........apni piyari suggestions apnay pass rakhain....aur PhD bhee....Toronto main beth kar Pakistan kee problems solve naa karain....shukriya...balke THANK YOU...

Nomansland Aug 28, 2013 09:48pm

The writer did a very fine job by comparing the status of different countries in South Asia. One more country that is doing very fine in terms of health indicators is Nepal. Pakistan needs to learn a lot from its impoverished neighbors.

rana1639 Aug 28, 2013 10:45pm

@cameo: foremost education. Education of the mind set towards culture,social taboos and traditions

Kamran Sikandar Aug 28, 2013 10:50pm

A well researched article that touches on all aspects of fertility in Pakistani women. Education among women is an area that is coming more and more in the limelight not only among the people of Pakistan but also around the globe; especially after the attack on Malala and its fallout. If we can have more and more educated women speaking out for the cause, Pakistan would benefit greatly.

rafe husain Aug 28, 2013 10:57pm

Corrupt Pak regime couldnt handle the country even if the population was reduced by half (70 mill). Education is the requirement and education automatically stabilizes the population.

Shakil Ahmed Aug 28, 2013 11:59pm

The root cause of this is education, general awareness and access to basic health facilities.

Tahir Aug 29, 2013 12:09am

Well, this is interesting. Western countries are trying to increase their birth rates. I thought as Muslims, we believed that sustenance comes from Allah Almighty?

sid Aug 29, 2013 01:33am

In India we have been successful by and large...........Only Dalit and sections of Muslim community have a very high birth rate.Some Maulvi's claim it be un-islamic.....They don't understand that provery is the worst curse............

Shah Aug 29, 2013 02:36am

According to PEW Research Pakistan is the fifth largest nation in terms of population with over 200 million people in 2013. Pakistan pusher Brazil down to a sixth position back in 2011/2012.

H L Aug 29, 2013 03:01am

Take away from this article: "At the same time, educated mothers are the best resource for raising an educated nation."

"Give me educated mothers and I will give you an educated nation."


illawarrior Aug 29, 2013 07:00am

Why do you say "They cannot, however, oppose the education of young women."? They can, and they do! Just ask Malala!

ASB Aug 29, 2013 07:17am

good luck with female education when their schools are destroyed. failed state try building girls school first.

Dixit Aug 29, 2013 09:34am

Excellent article that tells about present & future at the same time.

Jay Aug 29, 2013 10:28am

Why to keep any check on population growth ? Is it not satisfying that the religion and its people are growing skywards second by second. You should be more glad for this.

Sonal Aug 29, 2013 02:00pm

Great article.

Apart from education of women, I think we as a society need to elevate the status of women

cameo Aug 29, 2013 02:37pm

It is not that having a lot children necessarily a bad thing for a country. It is only bad when they are not properly educated and become a burden on the society in long run. Most middle class families can not afford to provide good education/up bringing to more than 2-3 children.

Ravi Ingale from Pune Aug 29, 2013 02:54pm

Even today Pakistan's fertility rate is 4 children per woman. Pakistan only upper part (NWFP and North Punjab) is available for the residential preference and these area are now full fill, out of its capacity, Otherwise after some years Pakistan's population density will be more than Bangladesh. Bangladeshi can migrated to India and Myanmar for food and jobs. But Where Pakistani will go??

Saqib Ali Aug 29, 2013 02:57pm

A very long explanation for something which is rather obvious! If this is what research has come to now a days then God help us all.

Rao Aug 29, 2013 04:12pm

@rafe husain: Don't you think it is all in the hands of God who knows best for his people? He will provide and guide his true followers.

Hanif Samoon Aug 29, 2013 04:32pm

What to speak of family planning in this land of pure! In rurual Sindh if you ask a person, how many children do you have, the answer would certainly be, " I may have 7 to 8" I mean most of the people even do not like to remeber the number of the siblings they have!

Rashid Aug 29, 2013 05:43pm

Life and death is in the hands of God. Why humans should interere with his job?

abdulla Aug 29, 2013 05:44pm

Charts are wrong. please check

Unknown Author Aug 29, 2013 07:08pm

@Ravi Ingale from Pune:

India has higher population density than Pakistan

Taha Lateef Aug 30, 2013 02:24am

@Tahir: And perhaps we should sit in tree and wait for the sustenance to come to us. We have been asked to tie the camel first and then to pray and leave it in the hands of God. Control the population first then pray Him for sustenance.

Imran Aug 30, 2013 02:42am


You said," Well, this is interesting. Western countries are trying to increase their birth rates. I thought as Muslims, we believed that sustenance comes from Allah Almighty?".

Wow, this must be sarcasm. Or you can go on believing as 'we the muslims' can just mindlessly multiply and keep the sub standard populace coming. Quantity over quality?

Imran Aug 30, 2013 02:46am

@Mr Anonymous: You wrote,"Maaf kar do bhai........apni piyari suggestions apnay pass rakhain....aur PhD bhee....Toronto main beth kar Pakistan kee problems solve naa karain....shukriya...balke THANK YOU....

You sound like a polite Taliban Mr. Anonymous. The hostility against intelligent and logical thought process.

Imran Aug 30, 2013 02:53am

@Ahsan: You wrote,"In simple words........Population Control program...So the Masters can control you & your nation..They are pushing hard to control population and successed in India China by planning..G-M-O food...etc.

Ahsan, don't be so paranoid about whoever you consider to be the 'Masters'. Once you can take care of all the problems of the over populated in your country, perhaps the population will not be always knocking at the 'Master's door.

Shakil Aug 30, 2013 04:58am

@Tahir: It sure does, provided you have money in your pocket. Stand on the road empty stomach and see how many days God or People will feed you, also try sending your kids to school without money, shoes, proper clothings and you will see the outcome. The concept is totally wrong that Allah Talla will look after you, he certainly will provided you look after yourself first.

AR Aug 30, 2013 05:58am

@Rashid: So you are suggesting not to take any medicine when you will be sick and leave to God?

Nadia Ali Aug 30, 2013 09:58am

Insightful research sir! I wasn't expecting Bangladesh to be doing so much better than us. We really are alone at the deep end then!

Zahid Anwer Aug 30, 2013 10:58am

Give education and every problem of Pakistan will die eventually....

vijaychennai Aug 30, 2013 01:00pm

Birth rate in Bangladesh is below world average? Is it correct?

Gohar Aug 30, 2013 01:20pm

@Hanif Samoon:

I think that it's only you who thinks like that!

Gohar Aug 30, 2013 01:20pm

@Rashid: Last I checked, God gave us a brain to utilize!

Gohar Aug 30, 2013 01:25pm

@Jay: It's not about quantity it's about about quality. You can have 1000 illiterate starving Muslims or you can have 100 well fed, educated and trained ones. I think logically it would be the second group!

Gohar Aug 30, 2013 01:25pm

@rafe husain:

Your comment does nothing in form of addressing the issue here. In fact in the South Asia region, Pakistan is one of the least corrupt countries. Also corruption is a marker of society.

Khanzada Aug 30, 2013 04:09pm

ANd India and Bangladesh economies are booming, they are no longer poor countries. Logic does not make sense?

Manish Rohera Aug 30, 2013 05:05pm

@Tahir A: No my friend unfortunately ignorance is bliss this what the cause of poverty is in subcontinent

imran Aug 30, 2013 05:07pm

A very real and serious issue nicely written by Mr Haider.

Its hard to see the arguments against what the author has discussed. People who object to limiting the number of off springs are the same conspiracy theorists that seem to be semi educated madrassa / masjid sermonized ostriches. We should look at the over populated country we have, with cities that are unable to provide the facilities for this population. It is amazing to see people just standing around the street corner or market all day staring at other passerbys.

There should be an effort to limit family size with two children for next 20 years.

Karachi Bhai Aug 30, 2013 05:19pm

Well there is at least some positives in the progress noted in last 20 years. A comprehensive strategy is needed. Bring religious power holders behind it. They can be convinced or can be incentives can be offered. Make it a subject in schools from senior grades,

Abu Bakar Aug 30, 2013 05:47pm

@Rashid: 100% correct life and death is in the hands of God. But Humans play big role in starting both process of life and death. What happens at the end that is in the hands of God.

osama Aug 30, 2013 06:18pm

@Rashid: If one doesn't copulate life doesn't begin!!!

Zimbo_Indian Aug 30, 2013 06:51pm

@Shah: At this rate you will soon overtake India and ultimately China. Good show.

Khan Aug 30, 2013 08:06pm

It is no wonder that people with PHD tend to lose some of their sense (may be because they are too much focused in one direction but think they are HAR FUN MAULA's)

Early age marriage is not an issue but illiteracy is......An educated family make better decision (even if married young) than uneducated (married older). There are old people that like to have more kids because thats what they like to have and there are younger families that only have 1 or two kids because thats what they plan to have.

Thinking that early age marriage is a factor behind rapid PAKISTANI POPULATION GROWTH is naive and certainly not representative of PHD STATUS.

Awais Aug 30, 2013 09:34pm

What will we achieve by population control? To me its the attitude of the power holders in Pakistan that is the issue here not the population growth or poverty. We could brainstorm better policies to achieve better economic growth by putting people to work, working on changing people mindset to not feel ashamed of getting hands dirty by any kind of work to get the wheels rolling.

Instead we are working on "reducing the mouths to feed" kinda attitude. The way economy taking the downfall, this logic is illogical. The poverty is going to increase even we skip a whole generation worth of reproduction.

At one point, we are trying to bring people back home to stop brain drain, on the other hand we want less people to avoid poverty. This confused notion of population control needs to be refined. We should be working out energies off to train people for them to work and increase production to increase resources rather than reducing people to match the ever decreasing resources!

Darks Aug 30, 2013 10:27pm

@Unknown Author: Statistics hide truth at times. While India has more density, pakistan lacks hospitable land as 40% is arid inhospitable Balochistan and both sides of Indus River system is covered by arid region. But it is equally right that India is over crowded.

Mr Singh Aug 30, 2013 10:34pm

@Unknown Author: because large number of Muslims stayed in India in 1947. even more than combined population of east Pak and west pak of that days. if all Indian Muslims will move to pak and all Pakistani Hindus to India. Pak can't survive. but India will easily survive with lower population. even if Indian Muslims stay in India and paki Hindus move to India. India can give food to them

Pankaj Patel Aug 30, 2013 11:07pm

The title should be "Keeping Pakistan's high fertility in tact" That is most people in Pakistan are worried about.They oppose polio vaccine because they think Polio vaccine reduces fertility.People who read Down do not matter and those who matter need more children to wedge Jihad.Remember what Ayatollah Khomeini said "Economy is donkey"

Berk Aug 30, 2013 11:28pm

Pakistan would not suffer from poverty if there was no overpopulation and illiteracy. Illiterate girls are not able to educate their children, so these children remain poor and ignorant, as well as their future children. So, educate your people, especially girls! We do not live in the middle ages anymore.

pashtunyar Aug 30, 2013 11:42pm

@Rashid: Imagine if the doctor at the emergency were to make such a statement?

Imran Aug 31, 2013 05:24am

@Saqib Ali: You wrote,"A very long explanation for something which is rather obvious! If this is what research has come to now a days then God help us all."

What kind of research would interest you, if not this? Or is that you think that all facts are already right there in the holy book. Why bother!


Anoop Aug 31, 2013 09:07am

Its actually disturbing how the same story fits the Indian Muslims to perfectly.

Now, the things might be changing, but you often hear of Muslim Families with more than 4 to 5 children. This will cut into the education funds for all the children, most of whom will be sent to Madrassahs, as they don't charge and give accommodation too.

The cycle repeats.

Madressahs churn out Radicals, the same way Madressahs in Pakistan.

From around 10% of the population, Indian Muslims have increased to about 15%, even higher, some say.

The funds from Arab lands, fund these Madressahs and Mullahs and they inturn teach their followers to shun contraceptives.

India has managed to break the shackles with its free society and active pro-women organisations. Similar fears had crept in for Polio vaccinations, but India overcame that. Hopefully we can see the Muslim population stabilise and even go down in the next decade or so. For India's sake..

Omer Khalid Khan Aug 31, 2013 09:13am

Excellent Research, I am wonder what regression would like for this data. Wud luv look at that.

Also a few positives for our nation

Masud Khan Aug 31, 2013 12:08pm

@Ravi Ingale from Pune:

Why would someone go to India when India hosts more hungry people than the rest of the world does together? And while 50%-60% of the Indians response to nature's calls in the open air, only 8% of the Bangladeshis fall in that category.

Masud Khan Aug 31, 2013 12:13pm


Yes, indeed!

Shahzad Aug 31, 2013 01:36pm

A more alarming fact is that those who struggle to even make ends meet have huge families and vice versa.