A new study by the Population Council delivers a sobering verdict on Pakistan’s demographic trajectory: the country’s long-delayed fertility transition has stalled since 2006. After a brief decline, birthrates have remained stubbornly fixed at around 3.6 children per woman — more than one and a half times the global replacement level. If this trend continues, Pakistan’s population is projected to approach 400 million by 2050, placing immense strain on already fragile systems of governance, service delivery and natural resources.
The reasons for this impasse are hardly a mystery. Yet familiarity has bred complacency rather than reform. Large families remain common in environments marked by economic insecurity, poor educational outcomes and inconsistent access to health services. These structural conditions have not improved enough to meaningfully alter family-size preferences. As a result, Pakistan now finds itself among the few countries in the world where fertility has remained stalled for nearly two decades — an alarming distinction in a region where others have moved decisively forward.
Social and cultural barriers further reinforce this stagnation. Family planning programmes, once promoted as a national priority, still fail to reach millions of couples. The use of modern contraceptives has plateaued at roughly one-third of married women, a figure unchanged for years. Deep-rooted religious and traditional taboos continue to make discussions around birth control uncomfortable, and in some settings even risky, particularly for women. Without sustained community engagement, these barriers remain firmly intact.
Policy incoherence has compounded the problem. The population-based formula used to distribute federal funds under the National Finance Commission (NFC) Award continues to reward provinces with larger populations, creating little incentive for leaders to encourage smaller family norms. For many local politicians, promoting family planning is seen as politically costly — risking votes, funding, or influence. At the same time, Pakistan’s public health system remains chronically underfunded. Lady Health Workers, the backbone of reproductive healthcare in rural areas, are too few in number, while clinics frequently lack reliable contraceptives and even basic medical supplies.
The costs of inaction are already painfully visible. Nearly 40 per cent of Pakistani children suffer from malnutrition, and an estimated 26 million remain out of school. Rapid population growth magnifies each of these crises. With every year that fertility remains high, public spending on education, health and housing is stretched thinner. The devastating floods of 2022, which affected more than 33 million people, underscored how demographic pressures amplify vulnerability to climate shocks. More people inevitably mean greater pressure on land, water, jobs and social cohesion.
Global experience offers a clear lesson. From Bangladesh to East Asia, countries that successfully reduced fertility unlocked periods of accelerated economic growth. Lower dependency ratios allowed them to invest more per child, expand their workforces and reap a demographic dividend. Pakistan, too, has this potential — but only if population policy is treated as a long-term development priority rather than a political inconvenience.
Experts and advocates are clear that no single intervention will suffice. A holistic approach is essential. Chief among all priorities is expanding girls’ access to secondary education. Evidence consistently shows that each additional year of schooling delays marriage, postpones childbearing and reduces total fertility. Yet fewer than half of Pakistani girls complete secondary school. Improving enrolment, retention and safety at this level must be central to any serious demographic strategy.
The stakes are simply too high for half-measures. Without meaningful progress on education, healthcare and gender equity, fertility decline will remain sluggish, and development gains will continue to erode. Policymakers must recognise that demographic pressures will shape every sector in the decades ahead — from labour markets and urban planning to climate resilience and food security. It is time for blunt, honest questions to be asked in drawing rooms and corridors of power alike: How many more children will grow up malnourished or uneducated? How many more women will risk their lives in childbirth? And how much longer can Pakistan afford to avoid an honest debate about its population future?
Shafaqna Pakistan
pakistan.shafaqna.com
Note: Shafaqna do not endorse the views expressed in the article
