Page 89 - GHES-3-1

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

Robinson’s landmark review of Pakistan’s family planning of the provinces have been established. The Country
program from 1955 to 1977 is particularly insightful. Engagement Working Group, which includes federal and
“Modern theories of fertility predict that contraceptive provincial ministries and department partners, reviews
usage rises with income and education. There is a progress every quarter. These reforms have attracted
configuration of factors – income, female employment, investments from bilateral and multilateral donors in
literacy, and infant mortality – which are clearly linked to areas such as family planning; reproductive maternal,
fertility through contraception. Where these variables are newborn, and child health; UHC; and social protection.
If these multisectoral reforms, bolstered by institutional
negative, the results of any program will be uncertain…. mechanisms, are successful, Pakistan is likely to meet its
One might say that the Family Planning Scheme in national and international commitments to a large extent.
Pakistan represents a good test of whether family planning
can take hold in a situation in which the setting is basically 5. Conclusion
adverse” (Robinson, 1978).
This paper highlights that poor educational background,
In this context, Pakistan requires a holistic development low socioeconomic status, and rural underdevelopment
approach that integrates the health and population contribute to negative outcomes in maternal mortality,
sectors while implementing structural reforms to reduce fertility, and family planning uptake. While Pakistan has
poverty, enhance education – particularly for girls – and made progress in maternal, neonatal, and child health, as well
mitigate rural–urban inequality. In addition, women’s as in measures to improve education, poverty reduction, and
empowerment through the transformation of social and infrastructure development, more sustained and cohesive
gender norms should be prioritized. reforms are needed. In this context, recent reforms under CCI
There is substantial evidence of the interlinkages recommendations, FP2030, and UHC provide a glimmer of
between socioeconomic factors and outcomes related to hope. Broader initiatives in infrastructure development and
maternal, neonatal, child, and adolescent health; family alternate energy may help further reduce the rural–urban
planning; and TFR. In recent years, there has been a divide and improve economic opportunities.
renewed focus on these issues, alongside universal health In conclusion, a multipronged strategy that focuses on
coverage (UHC) and multisectoral interventions, that is, poverty reduction, improving education, and reducing
life skills-based education and infrastructure development, rural–urban disparities is essential for achieving sustained
in Pakistan. Sindh implemented its FP2020 roadmap, the progress in health and population outcomes. Such an
Costed Implementation Plan (CIP), which this author approach is particularly important in light of Pakistan’s
developed in the context of the 2012 London Summit. The broader policy objectives, including the SDGs, FP2030,
CIP received national and international acclaim (Folsom and the goals set by the International Conference on
& Tamar, 2022; CIP, 2015), prompting other provinces to Population Development in 2019.
replicate some of the best practices. Moreover, there was
a renewed focus on family planning and reproductive Acknowledgments
health, significantly influenced by the 2017 Population Laraib Lashari supported enlisting the references in the
Census, which revealed rapid population growth. This led paper.
the Supreme Court of Pakistan to take a suo moto action
in 2018. The Supreme Court’s recommendations were Funding
forwarded to the CCI and endorsed in the same year.
These initiatives are expected to positively impact fertility, None.
contraception, and maternal health. Conflict of interest
The CCI recommendations include multifaceted The author declares no conflicts of interest.
policy commitments and institutional mechanisms to
ensure accountability. The policies cover family planning, Author contributions
reproductive health, FP2030 commitments, UHC, and
poverty reduction measures, such as social protection This is a single-authored article.
programs and health insurance. The BISP, which provides Ethics approval and consent to participate
financial support to the poorest women in society, is
also expected to have a positive impact. To ensure the Not applicable.
implementation of the CCI recommendations and FP2030 Consent for publication
commitments, a federal task force led by the prime minister
and provincial task forces led by the chief ministers Not applicable.

Volume 3 Issue 1 (2025) 81 https://doi.org/10.36922/ghes.2531