Is Pakistan’s fertility transition stalling?

ABSTRACT

This study examines the question as to whether Pakistan’s fertility transition is stalling. The paper reviews the trajectories of fertility and its various determinants and compares Pakistan’s trends with those of India and Bangladesh. Countries in the South Asia region share features such as cultural similarities (e.g. the low status of women and son preference) and high poverty levels. However, while Bangladesh and India are near replacement fertility today with modern contraceptive prevalence rates well above 50 per cent, Pakistan still has one of the highest fertility and lowest contraceptive prevalence levels in Asia. Our main conclusion is that Pakistan’s fertility transition is close to stalling in mid-transition. The key causes of this stall are a high and unchanging desired family size, stalling demand for contraception and relatively low satisfaction of this demand. These are important obstacles to future decline in fertility.

KEYWORDS:

• Fertility
• transition
• stalling
• determinants
• reproductive preferences
• Pakistan
• South Asia

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The gap in fertility between Pakistan and its neighbors is also found in different socio-economic groups. For example, Siow Li Lai (2022) concludes that Pakistani women had more children than Bangladeshi women across all socio-economic variables.

2 Traditional method use also rose during the 1990s and has continued to be about 25 per cent share of all contraceptive use until 2018. The trends for modern, traditional and all contraceptive prevalence therefore are similar.

3 In fact, there is a slight decline in DEM in Pakistan, so the rise in SAT is greater than the rise in the mCPR.

4 The 2017 data for Pakistan are based on responses to the questionnaires for the National Composite Index on Family Planning (NCIFP) which is an expanded version of the standard FPE score. The NCIFP questionnaire includes all FPE questions, so that a comparable FPE index can be calculated. It is important to note that differences between countries and across cycles can occur simply because the experts often must make subjective assessments and the experts change over time. In addition, the questions used to create the index have been refined and changed over time. As a result, differences between FPE scores of countries and trends for individual countries should be interpreted with caution.

5 Estimates are adjusted for the change in the questionnaire made in 1999.

6 We do not discuss the potential role of induced abortion because levels and trends are not readily available. However, abortion rates are relatively high in South Asia. In 2012 Pakistan had the highest rate of 50 abortions per 1000 women aged 15–49 compared to 47 in India 38.9 in Bangladesh. National estimates of abortion rates since 2002 indicate an approximate doubling of the abortion rates between 2002 and 2012 (Sathar et al., 2007, 2014). This upward trend implies a role for abortion in reducing fertility between 2002 and 2012.