Page 88 - GHES-3-1

Global Health Economics and
Sustainability
Impact of socio-demographics on MMR, TFR, & FP in Pakistan

not been complemented by interventions in education, low participation rates highlight the need for macro-
rural development, and poverty reduction. level policy changes to include women in the country’s
economic development.
3. Differentials based on residential
background, education, and poverty 4. Future prospects of improvement

Secondary data revealed consistency in high maternal in maternal health, fertility, and
mortality and fertility rates and low CPR when compared contraception
across educational attainment, rural background, and The data demonstrate close associations between
wealth quintiles. maternal mortality, fertility, and contraception with three
fundamental factors: Educational level, socioeconomic
3.1. Residential background
status, and demographic background. Due to the poor
Pakistan’s population reached 241.4 million in the 2023 status of these factors, interventions in Pakistan have failed
digital census (Pakistan Bureau of Statistics, 2023), with an to sustain gains in reducing maternal mortality and fertility
alarming annual growth rate of 2.55%. The rural population and improving contraceptive use. Progress in education,
constitutes 147.7 million (61%) whereas the urban poverty reduction, and rural development remains slow,
population is 93.7 million (39%). On comparing across reflected in sluggish improvements in indicators for
provinces, 84.9%, 59.2%, 46%, and 69% of the population maternal health, fertility, and contraception.
in KP, Punjab, Sindh, and Balochistan, respectively, reside As a signatory to the United Nations’ Sustainable
in rural areas. As noted previously, a rural background Development Goals (SDGs), Pakistan has committed to
– characterized by limited infrastructure and services – reducing maternal mortality to <70/100,000 live births
contributes to high maternal mortality and fertility and and eradicating extreme poverty (defined as earning <1.25
low family planning uptake. US$ a day) whereas halving multidimensional poverty by
3.2. Educational background 2030 (Federal SDGs Support Unit, n.d.). Regarding family
planning, commitments were made under the FP2020
In Pakistan, 74 million young people aged 5 – 24 have London Summit of 2012, the Family Planning 2030
never been to school. A total of 23, 17, 8, and only 5 million (FP2030) initiative, and through the Council of Common
young people have completed primary, matriculation, Interests (CCI) – a constitutional forum in Pakistan. Based
intermediate, and graduate education, respectively (World on these commitments, Pakistan has resolved to achieve a
Bank, n.d.). Pakistan’s literacy rate is 60%, with urban and CPR of 60%, a fertility rate of 2.2, and a population growth
rural literacy at 78% and 59%, respectively. Girls’ education rate of 1.1% by 2030.
is an important driver of social progress and directly
impacts maternal mortality, fertility, and family planning It is important to assess the achievability of these
uptake. In 2019 – 2020, before the onset of the COVID- goals. In this regard, a UN report offers valuable insights.
19 pandemic, 37% of girls in Pakistan had never attended The report analyzed low, medium, and high population
school (World Bank, n.d.). The data consistently show growth trajectories in relation to CPR and TFR. This
that lower levels of education are associated with higher analysis can be compared with Pakistan’s commitments
maternal mortality and fertility and lower contraceptive for 2030, benchmarked against averages for developing
use. countries and regional countries (Asia and the Near
East). For developing countries, the report predicts that
3.3. Poverty by 2030, the CPR for low, medium, and high population
Pakistan experienced a decline in poverty during the growth will be 69%, 59%, and 49%, respectively. In other
1970s and 1980s, but this trend was not sustained due words, low population growth is associated with higher
to policy instability. Recently, significant reductions in CPR and vice versa. Likewise, the projected TFR for low,
poverty have occurred through initiatives such as the medium, and high population growth in 2030 is 1.8, 2.4,
Benazir Income Support Program (BISP). According and 2.8, respectively (Moreland et al., 2010). According
to the Ministry of Planning and Development, 24.3% to Pakistan’s 2023 Census, the population growth rate is
of the population (55 million people) live below the 2.55%, which is rather high and makes the country the
poverty line. Women’s economic empowerment is an fifth most populous country in the world. Consequently,
important determiner of poverty levels in a society. Pakistan may struggle to achieve its CPR and TFR goals for
In Pakistan, women’s labor force participation is only 2030 unless population growth slows.
23%, meaning that three out of every four women are Further reflecting on the relationship between
not part of the labor force (World Bank, n.d.). Such socioeconomic factors, CPR, TFR, and mortality, Warren C.

Volume 3 Issue 1 (2025) 80 https://doi.org/10.36922/ghes.2531