Exploding population: choice not destiny - capturing Pakistan’s demographic dividend


This page in:


Blog in Urdu

Family planning in Pakistan
This blog is certainly not about exploding mangoes but about the exploding Pakistani populace. The recent reactions of surprise on results of the census seems bewildering. Pakistan’s population is now over 207 million with a growth rate of 2.4 percent per year since the last census in 1998. The results were predictable and expected, as Pakistan has not implemented any large-scale population related interventions for over a decade. We should not be expecting results because inaction does not usually deliver them.
Pakistan’s efforts to reduce fertility and population growth were transformed during the 1990s. The period between 1990-2006 saw effective policy making under the Social Action Program with multiple interventions e.g. expansion of public sector provision, large scale private sector participation including social marketing innovations, improving access to women through community based providers. All the right things that delivered huge results. Fertility declined from around seven to four children per woman, and contraceptives use increased from 10% to over 30% - a 300% increase. Appropriate actions delivered results and some still can be photocopied and expanded on scale for making progress.

Much more remains to be done in terms of Pakistan's family planning
The actions started to wane after 2006 and was followed by a decade of inaction. Public and private sector interventions stagnated, community based service delivery given a deadly blow, and with no new ideas, resources started to dry up.  Results duly stagnated and the population continued to explode.  Pakistan is on a dangerous trajectory with a stagnant fertility decline and contraceptive use. What is worrying, and to some degree scary that the country has the largest ever cohort of adolescent youth going into active reproductive age. Without decisive action, the population explosion is likely to continue and could easily double by 2047, when Pakistan will be 100 years old, putting enormous strain on the country’s ability to deliver basic services to its population despite economic growth.
Pakistan GDP is growing and is expected to grow further in future. The real GDP per capita (constant US$ in 2007) is projected to grow from $1,000 in 2015 to $2,283 in 2050. At the present trend of fertility decline, it’s estimated that its population will be about 345 million in 2050 (at 2.8 children per woman).
However, Pakistan could grow much faster to a per capita GDP of $3,414 in 2050 if it achieves the South Asian average fertility reduction rate, with a population of 276 million in 2050 (based on 1.84 children per woman), if appropriate actions are effectively implemented. The cost of inaction will be a forgone GDP estimated to be $2.3 trillion between 2020 and 2050, which means a loss of $76 billion per year. This will have serious economic and social implications for the people and the country. 
There is greater realization that Pakistan cannot afford procrastination. There have been positive actions recently, especially at the provincial level both in Punjab, Sindh and KP focusing on girl education, maternal and child health, nutrition, procurement and supply of contraceptives, introduction of new contraceptives, targeting the poor, etc. However, these actions need to be significantly and exponentially enhanced in all provinces. The large youth bulge can be turned into a great opportunity (demographic dividend) but the dividend unfortunately, is not automatic. Policy action is needed now for rapid acceleration of fertility reduction.

Pakistan needs to position its policy and strategic narrative around “family planning plus” as a priority development agenda with an enhanced scope of interventions and innovative “out of the box” thinking. It also needs to have commensurate financing to transform and boost the reproductive market for family planning products and services. This requires sustained political leadership; scale-up evidence-based interventions using multi-sectoral approach and increased investments predominantly targeting the private sector. 
Essential interventions will need to include:

  1. Resolving the fragmentation of reproductive health service delivery and using branding/social marketing for public sector services;
  2. Continue to prioritize girl’s education increasing female enrolment, retention and quality in secondary schools with economic empowerment women/youth by scaling-up skills development, entrepreneurship and financial inclusion initiatives;
  3. Scaling-up public financing for private sector market shaping programs including subsidizing local manufacturing of family planning products to lower prices benefiting all providers and consumers;
  4. Financing an intensive behavior change communications campaign besides introducing life skills education in all higher secondary schools; and
  5. Leveraging social protection system to target the poor.
Pakistan's destiny is in its own hands, the time for decisive action is now. 


Inaam Ul Haq

Dr Inaam Ul Haq, Public Health Physician

Join the Conversation

Mahedi Hasan
November 28, 2017

Thanks for sharing the marvelous info. It is an excellent article which helps me a lot. I expect we will get this type of informative article more and more.

Inaam Ul Haq
December 05, 2017

Dear Hasan thank you for sharing your comments.  We do plan to share similar articles.

Steven Earl Salmony
March 10, 2018

If the human species is indeed responsible for recognizable, scientifically established global threats to future human well being and environmental health, then common sense tells us that each and every human being is implicated in the mess we have produced. That said, we cannot broadly assign individuals with equal culpability for the colossal ecological wreckage human beings everywhere are in the act of unleashing upon earth. Without doubt some individuals are more responsible than others for the serious existential situation humankind has evidently precipitated. Perhaps starting now here because there is nothing to be gained from delay, individuals as well as corporations (that have been misguidedly accorded "personhood") who actually bear responsibility need to be held to account for the explosion of distinctly human, synergistically occurring overproduction, overconsumption and overpopulation activities overspreading the surface of the earth on our watch.

Jens Andersen
November 29, 2017

Population Pakistan 2017: 197,164,669
Population Bangladesh 2017: 164,669,751
Total 2017: 362 millions
India 1951: 359 millions
As we can see Bangladesh and Pakistan together to day have the same populatione as India in 1951. It is a catastrophe

Inaam Ul Haq
December 05, 2017

Thanks Andersen - completly agree that this is a huge challenge - but it can be managed and there are solutions by focusing on the youth educating skilling them and by increasing access to finance and the large population can be made productive members of the economy. 

November 29, 2017

Isn’t the Karachi population underestimated by around 6-10million. What are the implications on health and education financing for the city/division? And what role is WB played to validate the population data it will use in programs?

Inaam Ul Haq
December 05, 2017

Dear Mariam
The truth is that there is a disagreement on Karachi's numbers however as of now there is no evidence that it has been underestimated.  It is difficult to agree to statements that it has been nderstement.  There needs to be some evidence which one can rely on.  We need to wait for the results of reassessment as agreed by the government. 
Under estimation does have implication for good planning for provision of services.  We usually dont validate the data but for programs we undertake assessment definign size of popualtions.  As I said we will all need to wait for the result of reassessment. 
thanks and regards

March 02, 2018

Every household in Karachi including mine kept on waiting for census people. They came and noted the name of the guardian of the family and nothing else. They recorded only one resident while there are 5 residents in my household. For people like us, we know that articles like this are not enough until the real and bigger picture is shown.

Shah Fahad Baigal
December 01, 2017

Just think of the situation when women stopped having kids due to these birth control policies. Increasing or the exploding population can be handled because there are adequate resources but think of when women face the plague of infertility, is there any policy to control infertility just like policies of birth control? No. Some demographers predicted that in 2080 women will be infertile, babies per women will be very small and hence children will be rarities. This seems utopian now but it's happening and we don't set any policy when women will be biologically incapable of producing children.
2.1 babies per women is standard for maintaining population in industrialization countries. It is astonishing that in America it is below the standard which is 1.8 babies per women. The rate is also lower in Europe which is 1.6 babies per women and meanwhile in Japan, it is 1.4 babies per women.
So in the race of birth control and saving resources, population of world is getting smaller and smaller which is bigger threat than overpopulation. These abrupt policies may be very dangerous for human race as well. We need to keenly study these demographic transitions.

Inaam Ul Haq
December 05, 2017

Dear Baigal thanks for your comments.  I would only like to point out that the population of the world is 7.6 billion and is still increasing and is estimate to increase to 11.2 billion by 2100. Therefor eI have to disagree that the proposed solutions are dangerous for human race.  It is quite contrary to that

December 02, 2017

This article is so immature in its content and substance. The writer has failed to provide the solution how to control the increasing populations. Instead he uses the 'could be, would be, should be and intervention needs' to be etc. etc. It is a serious issue for the country. Mangoes do not explode rather rot but still smell great. Where has all the money millions of dollars WB loan gone.

Inaam Ul Haq
December 06, 2017

Thanks for your comment - unfrotunately it did not come to your expectation.  Just would like to comment on one aspect - Pakistan has various options which the country needs to choose from - that is why terms like could be or would be used.

December 03, 2017

Really its a good Program

Inaam Ul Haq
December 05, 2017

thank you

December 05, 2017

I enjoyed your blog a lot. Your insight shows how much love you have for your country.

Mohammad Nadeem
December 07, 2017

Many thanks for sharing this piece of information which indeed is an excellent reading. As you have proposed, so many choices are available and can be implemented especially girls education as a priority across the country. This needs however some attention and ownership at different levels including the stakeholders.

December 08, 2017


Mishaal joseph
December 08, 2017

It's really good

December 21, 2017

Thanks Inaam - indeed an excellent blog addressing a real challenges - requiring serious public action. As has been clearly articulated, the inaction will be too costly. Unfortunately the same is true for many other countries including Afghanistan.

Parvez Iftikhar
January 28, 2018

Thanks for this article. We are sitting on a ticking time bomb. How can we make our current/future leaders realize? Perhaps this being election time we should all ask the political parties what they intend to do about it if they come to power. World Bank should also focus a little more in creating awareness about the gravity of the issue, and also the benefits of dealing with it (more prosperity). Focus should be on Media people, opinion makers, celebrities, Social activists etc. An ordinary Pakistani citizen does not even think it’s an issue - at least not for the time being. They need to be made aware that decisions today will have Consequences tomorrow.