The “New Beginning” in Pakistan’s Family Planning Programme

Family planning in Pakistan has a long, interesting, expensive and generally unsuccessful history. Recently, after a pause of several years, vigorous public-sector efforts to control population growth have been resumed. This has been called “the new beginning” by Pakistan officials. This note will relate the details and also the genesis of this recent renewal of family-planning activity. The first “beginning” was the programme launched in 1965 [4]. This programme grew rapidly and attracted considerable attention internationally. By the mid-Seventies it was clear that the programme’s impact had been overrated and that it was on the verge of stagnation. Under the strong urging of USAID, the major donor group, a last desperate effort was made using a strongly supply-oriented approach. This so-called “inundation scheme” also proved a failure and by 1977 the programme had virtually come to a halt [5]. The Fifth Five Year Plan (1978- 1983) endorsed population control but called for an integrated health- and family planning approach. A new programme of training, mass education and improved service-delivery was laid out in the Plan, but, in fact, little seems to have been accomplished or even attempted in the’ early part of this period. The programme had been discredited and had been all but shut down. But the need remained. Pakistan’s fertility was shown by the World Fertility Survey results for 1975-76 to be essentially unchanged in 20 years – a total fertility rate of some 7 births per female over her reproductive career, resulting in an annual growth rate of about 3.0 percent.