- Pakistan has a very high population growth rate that is straining its resources and environment. The government created its first population policy in 2002 to try and lower fertility rates and slow population growth. - The policy aimed to reduce fertility rates to replacement level by 2020 through expanding access to family planning services and education programs. It also sought to mainstream population issues into overall development planning. - Key strategies included increasing awareness campaigns, decentralizing services to districts, expanding the role of the private sector, and ensuring quality and choice in family planning service provision. The goal was to transition to lower population growth and stabilize the population by 2020.

1. Population Policies And
Programme In Pakistan
RP:Yasir Arfat Butt

2. INTRODUCTION
Pakistan currently is the 6th most populous country in the world with out of
the highest rate in Asia and among developing countries. High fertility is the
major contributor to the growth rate as mortality rates have been low since
last three decades. Employment opportunities have been unable to keep
pace with labour force growth in recent years. Natural resources and the
environment are suffering from overuse and the degradation respectively.
The government of Pakistan recognizes the serious implications of high
fertility and population growth and is seeking to accelerate the pace of
fertility decline, lower current rates of population growth, reduce infant,
child and material mortality.

3. OBJECTIVES
After having studied the unit, the students are desired to be able to:
1. Describe government efforts on the population problem of Pakistan
2. Analyze elements of Population policy
3. Describe the strategies suggested in the policy
4. Identify areas of focus in population policy
5. Highlight the importance of interaction between public and private
sector in the area of population planning.

4. POPULATION POLICIES/ PROGRAMS/PLAN
Foreseeing the long terms consequence of high Population Growth
Rate, the Family Planning Association of Pakistan. an NGO. initiated
efforts to contain population growth in the year 1952.
Three years later. the government began to fund the association and
noted the need to reduce population growth in its First Five Year Plan
(1955-60). The government soon combined its population planning
efforts in hospitals and clinics into a single program.

5. In the mid-1960s. the Ministry of Health initiated a program. Through this
program the government was able to attract funding from many international
donors, but the program lost support because the targets were overly
ambitious. The population planning program was suspended and
substantively reorganized after the fall of Muhammad Ayub Khan's
government in 1969.
In 1980 the Population Division, formerly under the direction of Minister of
State. was renamed as Population Welfare Division and transferred to the
Ministry of Planning and Economic Development. This agency was charged
with the delivery of both family planning services and maternal and child
health cares.
POPULATION POLICIES/ PROGRAMS/PLAN

6. Population Education Program in the formal education was
introduced in the year, 1983. Focus of this program was on the
revision and development of curriculum and materials for
secondary schools. The second phase (1986-88) and third phase
(1993-98) were focused on the extension of the first phase.
In the year, 2002, the government came with first ever population
policy. This policy is now being reviewed and the final draft of the
revised Population Policy is available.
POPULATION POLICIES/ PROGRAMS/PLAN

7. POPULATION POLICY 2002/PROGRAMME
REVIEW AND ANALYSIS
As per Population Policy 2002, Ministry of Population Welfare committed
itself to bring fertility transition to replacement level fertility of 2.1 births by
2020. This was an ambitious and tough challenge for Pakistan.
The huge unmet need for family planning services. high level of unwanted
pregnancies and large number of induced abortions reflect the situation.
Although family planning service delivery points have increased and the
price of contraceptives have remained unchanged over the last few years,
access to service remains a problem area.

8. The Programme has for the last many years focused on promoting small family
forms through awareness and motivational campaigns. This strategy has been
partially successful raising the level of awareness about population issues, but it
has not been able to bring about the desired change in attitudes and behavior.
The programme was de-federalized in 2002 with the financial. administrative
and operational authority transferred to the Provincial Population Welfare
Depanments PWDs).
POPULATION POLICIES/ PROGRAMS/PLAN

9. REVITALIZING THE IMPERATIVE
A- Population and Development
Rapid urbanization, technological advancement, increasing female literacy and
better job prospects for women, proliferation of information through the media, and
competitive market forces have set in the process of transformation in social values
and lifestyles. With additional burden being put on educational and employment
opportunities for the youth, resulting an increase of youth entering the labour force.
The increase in population density, mushrooming urban slums, rapid depletion of
water resources, deforestation and loss of arable land due to urban development are
some of the manifestations of rapid population growth

10. REPRODUCTIVE HEALTH AND FAMILY
PLANNING
The Population policy of Pakistan 2002 aimed at accelerating fertility
transition to attain replacement level fertility by 2020 and the Population
Perspective Plan (2002-12) envisioned CPR of 57%. Pakistan currently
recognizes, more than ever before, the need to be consistent with its
development and welfare priorities. It also realizes that this requires strong
political support; improvement in literacy rate, particularly of women and
reduction in poverty. On a positive note, a major shift has been the growing
public realization that reproductive health is a broader concept and family
planning.

11. NATIONAL POPULATION POLICY 2002
Though Pakistan was one of the first few courtiers to realize the need for family
planning in 50’s and adopted a population policy as early as 1960, yet it has only
made a marginal dent on fertility due to a number of factors. These include
fluctuating political commitment, frequent changes in structure of the program,
lack of multi-sectoral programme, to narrow a focus on married women as the main
target, limited coverage of the programme and absence of a conductive
environment for fertility reduction such a low status of women, high infant and child
mortality, low educational levels and inadequate investment in social sectors.

12. Keeping in view these factors, Pakistan’s first ever National population policy
was formulated in the year 2002. Based on demographic realities to be
effective, the policy addressed the following objectives:-
• Reduction in rate and incidence of unwanted fertility
• Reduction in demand for large family size
• Greater investment in the youthful population
• Focus of male involvement
It was to achieve stabilization by 2020 through swift completion of
demographic transitions that entails declines both in fertility and mortality
rates.
POPULATION POLICIES/ PROGRAMS/PLAN

13. GOALS
The Population policy sought to:-
• Attain a balance between resources and population with the broad
parameters of the ICPD paradigm.
• Address various dimensions of the population issue within national laws,
development priorities while remaining within our national, social and cultural
norms.
• Increase awareness of the adverse consequences of rapid population growth
both at the national, provincial, district and community levels.
• Promote family planning as an entitlement based on informed and voluntary
choice.
• Attain a reduction in fertility through improvement in access and quality of
reproductive health services.

14. OBJECTIVES
Short Term:
Reduce population growth to 1.9% per annum by 2004
Reduce fertility through enhanced voluntary contraception to 4 births per
women by the year 2004.
Long Term:
Reduce population growth rate from 1.9% per annum in 2004 to 1.3% by 2020.
Universal access to safe family planning methods by 2010.
Reduce fertility through enhanced voluntary contraception to 2.1 births per
women

15. STRATEGIES
• Develop and launch support campaigns to address special groups as, policy makers,
opinion leaders, youth and adolescents.
• Increase ownership of population issues by the stakeholders and strengthen their
participation in the processes of service delivery and program design.
• Adopt a shift from target oriented to people-oriented needs and services.
• Coordinate and monitor a broad network of family planning and RH services.
• Expand the role of private sector by making contracepts cheap and reachable.
• Strengthen contribution to population activities by NGOs and media.
• Decentralize program management and service delivery to districts level.
• Harness support, cooperation and involvement of men in strengthening the family as the
basic unit of society and in small family size decision making.
• Ensure Population and Family Life Education for school and college students

16. AREAS OF POLICY FOCUS
1- Population Mainstreaming in National Planning and Development Program
Population mainstreaming entails incorporation of the population factor in
development plans to promote social justice and address poverty through socio-
economic development in the context of migration, urbanization, environment and
sustainable growth. This Policy is developed and coordinated through a multi-
sectoral strategy towards population issues in which there is a synergy between
population dynamics, economic revival and poverty alleviation programmes. The
connectivity of population with poverty, status of women and sustainable
development will be established because they are basically related and progress in
any component can catalyze improvements in others.

17. SERVICE DELIVERY EXPANSION AND IMPROVEMENT OF QUALITY
Ensuring quality in a wide range of family planning services will be the
major short-term goal of this policy. In the longer run whilst the public
sector will not relinquish its responsibility as service provider, recognizing
the magnitude of the task it will fully engage the non-governmental and
private sector partners to cope with future needs of service delivery.
Contraceptive choice is to be widened by providing training to service
provider in latest techniques. Quality service provision will be ensured
through regular monitoring.

18. SERVICE DELIVERY WILL SPECIFICALLY INCLUDE
• Strengthening Community-Based Services
• Linkages with Institutional Service Delivery System
• Strengthening and upgrading the existing Family Welfare
Centers
• Public-Private Partnerships
• Male involvement
• Improve and Ensure Quality of Services

19. ADVOCACY
This Policy addresses those who being illiterate lack knowledge or have inhibitions to
practice family planning. This will be done through a carefully designed program of
advocacy and promotional campaign, which addresses all stakeholders. An Advocacy
Campaign will be devised to build sustain adoption of the small family norm. It will raise
awareness about population and development issues by engaging change agents to
communicate the impact of runaway population.
• Advocacy programmes will utilize all channels of communication particularly the media.
• Public Representations
• Policy/Decision Makers
• Opinion leaders
• Men, Youth and Adolescents
• Medical Profession
• Organized Sectors
• Intelligentsia/Influential Groups

20. TRAINING AND CAPACITY BUILDING
The following training programme and human resource development
would be key features of the strategy:
• Family Planning Training: They are equipped not only to provide pre-
service and in-service training to all population welfare training
personnel but also on an organized basis respond to the training
needs of nation building departments.
• Human Resource Development (HRD): A HRD plan will be prepared for
programme personnel. Thus has assumed added importance because
of the need for re-training in new skills and management approaches.

21. DECENTRALIZATION AND COORDINATION
The program which to date has been federal will be distribute with
administrative, financial and programme transfers to the provinces. It will further
distribute the program to the District level in line with governments devolution plan.
The population is a crosscutting issue, which cannot be addressed in isolation and
warrants an existing organizing mechanism. Coordination is required at all levels
within the government and outside and with all stakeholders.

22. MIS, LOGISTIC MANAGEMENT & MAPPING
A review of Management Information System (MIS) based on a District
monitoring of socio-economic demographic indicators and incorporates
quantitative and qualitative data on programme result based performance.
Since the policy envisages active involvement of all public and private sector
agencies in the dispensation of Reproductive health services. This required a
strong and established Logistic Management Information System (LMIS).
A proper Mapping in each District of health, population welfare, NGO &
private sector family planning facilities is visualized this would reduce
duplication of resources, increase coverage especially of un-served and
under-served regions by relocating facilities.

23. RESEARCH IN POPULATION AND DEVELOPMENT & FUNDING
Strong research areas, which include family planning, fertility, mortality,
evaluation for the population programme components etc. The mandate also
makes the institute responsible for imparting training in the field of population and
development.
A total of Rs.49.5 billion requirements are estimated for the next 19 years for
achieving the fertility replacement perceived under the Population Policy by the
year 2020. Major part of the financial inputs will cover the provision of subsidized
contraceptives to the clients, service delivery, training, advocacy and research and
to cover human resource and infrastructure gaps essential for achieving goals.

24. PROPOSED PAKISTAN POPULATION POLICY 2010
The Policy 2010 places the ‘population factor’ at the centre stage of
national development planning. It recognizes reproductive health as a critical
component of sustainable socioeconomic development having string linkages
with the government’s poverty reduction strategies. The Policy 2010 repositions
family planning as a health initiative, with a focus on maternal health and child
survival, by making family planning services a vital component of the essential
services package. Within this holistic perspective and in the wake of emerging
demographic realities, the Policy 2010 re-emphasizes timely completion of
fertility transition for stabilizing the population and reaping the demographic
dividend.

25. STRATEGIES
• Mainstreaming Population in Development Planning
• Advocacy and Demand Generation
• Enhancing Access to and Improving Quality of FP/RH Services
• Contraceptive Commodity Security
• Training and Human Resource Development
• Research and Evaluation
• Public-Private Partnership
• Monitoring

26. IMPLEMENTATION PLAN
In the wake of recent constitutional amendment (18th amendment), though the
population welfare program would be transferred to the provincial governments, policy making
and its execution, in view to ensure continuity and consistency of national development priority,
would continue at the federal level through an apex body. In addition, necessary mechanisms
and institutional arrangements would be put in place to seek the support of elected
representatives and local leaders, opinion makers, religious scholars and organized
communities for efficient and effective implementation of the Policy 2010.
Legal framework
In 2001, after an extensive review, the Population Welfare Programme was defederalized
through an ordinance ‘Population Welfare Programme (2001), the funding however, was to
continue through Federal PSDP up to 2003; thereafter the funding was to provided through
N.F.C. award. The administrative and financial control over the service delivery infrastructure
was transferred to the Provincial Population Welfare Departments along with the staff,
equipment and funds.

27. INTERNATIONAL COOPERATION
The Policy 2010, therefore, encompasses not only national development
priorities but also international obligations. The MoPW envisages expanding the scope
of its activities in accordance with the recommendations of the ICPD. Precisely against
this backdrop, the Policy 2010 focuses on developing bi-lateral relations, especially with
other Muslim and South Asian countries, and forging linkages with international
development agencies, particularly for sharing best practices and seeking technical
support. The Policy 2010 seeks enhanced financial and technical cooperation from the
international community, anticipating that it would understand and appreciate the
population and reproductive health situation of Pakistan and its implications within and
beyond boundaries.