THE dramatic fall in global fertility rates — from 4.8 births per woman in 1970 to 2.2 in 2024 — represents one of history’s great demographic shifts. Yet some nations remain stuck in transition. Pakistan, South Asia’s second-most-populous country, exemplifies both progress and challenges in bringing birth rates to sustainable levels. The country’s fertility rate has tumbled from six births per woman in 1994 to 3.6 today, according to the UN’s latest World Fertility Report. But this masks stark disparities. Urban women average far fewer children than their rural counterparts. The adolescent birth rate, at 40 per 1,000 women aged 15-19, remains stubbornly high. At current trends, Pakistan will not reach replacement-level fertility of 2.1 children until 2079 — decades behind its neighbours. Bangladesh’s fertility rate has fallen to 2.14 and is projected to reach replacement level by 2026. India achieved replacement-level fertility in 2020.

This matters enormously for Pakistan’s development prospects. High fertility strains public services and household resources. Yet managed properly, a falling birth rate could yield a ‘demographic dividend’ of working-age adults unburdened by dependents, powering economic growth as it did in East Asia. Achieving this requires a more muscular approach from policymakers. Access to family planning remains patchy, particularly in rural areas. Many women lack the autonomy to make reproductive choices. Child marriage, though illegal, persists. Meanwhile, female labour force participation remains among the world’s lowest. The government should integrate family planning into primary healthcare while expanding girls’ education and women’s employment. Religious leaders could be enlisted to challenge cultural resistance to contraception. Better data collection would help target interventions. None of this is rocket science. Bangladesh shows what determined policy can achieve. But our lacklustre governance limits implementation, while conservative social attitudes run deep. Without sustained political will to complete the fertility transition, we risks squandering our demographic moment. The next decade could prove decisive.

Published in Dawn, February 4th, 2025