Pakistan’s devolved family planning services : poor governance may be the main issue

Regardless of the declining rates of fertility in the late twentieth century, the population growth rate in Pakistan is the highest in the region and only surpassed by sub-Saharan Africa across the globe. The main reasons are access for poor women in villages due to shortage of outlets and outreach programs and poor service provision due to lack of equipment, inefficiency to retain staff and overload of other responsibilities like polio campaign. A fear of side effects, health concerns, low female literacy rate, weak women autonomy and high mortality rates are important deterrents from usage of family planning services. Researchers have summed up the difficulties of Pakistan in this matter as, “a reluctance or inability to translate reproductive preferences into appropriate behaviour.” The government and ministries mutual cooperation in articulating policies helps in role clarification with respect to population planning. Advocacy at the district, provincial and federal levels is required counselled by medical research along with social objectives by liaising with states with experience of tackling the same issue to analyze performances based on accomplishment of specific FP indicators.