Population has long been considered a simple denominator: a way to calculate per capita resources and economic status. But behind the numbers lies a more urgent reality: Pakistan’s 251 million people, with an income of $1,484 per capita and a growth rate of 2.5 percent, are on track to increase to 386 million by 2050.
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This rapid increase will require much more than the headline numbers may reflect: more clean water per capita, more doctors and hospital beds per capita, more police per capita, and more schools, teachers, electricity, gas and essential services across the board.
Development policy and governance frameworks treat population as a central management indicator to assess various deprivations and project future needs for economic growth and social development. In doing so, the population studies and policy literature draws heavily on other fields of knowledge, including cultural studies, economics, public health, and theories of institutional coordination.
One of the central arguments of this literature is that effective population policies and governance structures necessary to support better population management arise from at least three conditions. First, they require a broad consensus within state governance and policymaking systems that population growth is a central policy priority.
Second, they depend on significant investments in health infrastructure to ensure the delivery of family planning and counseling services.
Third, they require sustained and long-term improvements in inclusive growth, particularly in education, mobility and employment opportunities for women.
At this scale of population governance, Pakistan offers an interesting story of the rise and fall of governance policies. It was one of the first countries, back in 1958, where civil society, and then the government in 1965, began to talk about population management policies and the need to make population a central point of economic planning.
The years between 1965 and 1975 are called the early push years. However, the years 1972-1981 witnessed accelerated population growth, while there was a progressive decline in public policies around demographic management until the late 1980s.
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Population policy specialists call the era from 1977 to 1988 “the lost decade.” The fertility rate began to decline ten years later than the rest of South Asia (in the 1990s), although it remained at a higher level (4.1 percent) and the contraceptive prevalence rate stabilized at around 30 percent.
However, during 1989-98, Pakistan’s population welfare policy community witnessed a resurgence of emphasis on population under various initiatives such as the Social Action Programme, the Women Health Workers Programme, and the Planning Commission’s Vision 2030, among many others.
After the 18th Amendment in 2010, the welfare of the population was taken over by provincial governments along with health, education and women’s issues.
During a recent meeting at the Planning Commission, the provincial and federal governments discussed the “fragmentation” of population planning mechanisms, while Prime Minister Shehbaz Sharif emphasized the need for a unified national policy for stabilization and welfare of the population.
Interestingly, during this period (and continuing today) South Asian states such as Bangladesh and India, as well as countries such as Iran, achieved much stronger results in slowing population growth. Its performance in building consensus around demographic measures, strengthening reproductive health care, and improving women’s socioeconomic status has consistently surpassed that of Pakistan.
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However, Pakistan’s development paradigms could not find any substantial use of the population argument in the five-year plans despite international donors and local non-governmental organizations emphasizing the need to do so.
At the institutional level, the Ministry of Population Welfare and the Ministry of Health could not find common ground, distancing themselves from the turf war they continue to wage on various issues, healthy aging being one of the latest.
Even donors were not persistent in providing financial clout to population services, and the emphasis shifted to HIV/AIDS and polio eradication and other development priorities, leading to short-termism in addressing the broader issue of population management.
Fragmentation and inconsistency in policy and planning have led to patchy and/or near-absent institutional support to increase contraceptive prevalence, meet unmet demand for birth spacing services, and provide improved reproductive health and maternal and child health services at the local level, especially in underserved areas.
It is sobering to note that Pakistan ranks 137 out of 166 countries on the Sustainable Development Goals (SDG) Index, with worrying indicators in maternal and child health, education and access to clean water.
The UNDP’s Human Development Report 2025 places Pakistan in the “low” human development category, assigning it an HDI score of 0.544 and ranking it 168th out of 193 countries.
The last factor in population stabilization and well-being is very important and forms the positive feedback loop for social and economic change, which is associated with reduced fertility rates. This factor is the social and economic change of society.
Development economists argue that with changes in social and economic conditions, such as better education and an increase in employable skills among women, an improvement in the conditions of women’s physical mobility, and job creation, marriages may be delayed and the opportunity cost of raising children may increase.
Therefore, investing in girls’ education, mobility, and better business and working conditions can help improve population management prospects and reduce the fertility rate to around two levels or replacement levels. Pakistan needs to make a huge effort to formulate and implement public policies and investment frameworks in this direction.
While it is encouraging to see that all three major political parties have incorporated various dimensions of population welfare and management into their 2024 manifestos, and that there is a Parliamentary Forum on Population, there is still a need to improve parliamentary oversight.
The federal and provincial commissions on the status of women and the office of the women’s ombudsman should be an active part of these parliamentary forums and a whole-of-government approach should be developed with the active participation of civil society organizations. Last but not least, the Pakistan Demographic and Health Survey should become a mandatory exercise to provide the necessary evidence base for demographic policies and governance.
The author is executive director of IMPACT Research International and development policy advisor.
Header image: A general view shows road traffic during monsoon rain in Karachi, Pakistan, on July 5, 2022. – Reuters /Akhtar Soomro/File
