Pakistan is at a crossroads, and not for the reasons you might think.

Data from the latest Pakistan Demographic and Health Survey (PDHS) show the country has an opportunity to seize an economic boost, but only if they can accelerate fertility decline and women’s empowerment through increased access to voluntary family planning and other strategic investments.

The boost is known as the demographic dividend—the accelerated economic growth that results from changes to a country’s age structure, namely a decrease in the share of young dependents (net consumers), relative to an expanding proportion of working-age adults (net producers). With a relative increase in the working-age population, if educated and productively employed, these changes can usher in better living standards for families, increased production per capita, and higher rates of savings and investment.


With a population exceeding 184 million, Pakistan is slowly progressing through its demographic transition—or the movement from people living short lives and having large families to living long lives and having small families. Historically, high fertility has distorted Pakistan’s age structure. In fact, the average number of children per woman did not fall below six until the 1980s. As a result, the country is characterized by large numbers of children and young adolescents. Last year, 34 percent of the population was below the age of 15, requiring significant government and household investments to fund the health, education and other consumption needs of the youngest age groups. Another 30 percent of the population is between the ages of 15 and 30.

The new 2012-13 PDHS shows that fertility has declined to 3.8 children per woman (see graph). However, this represents an annual decrease of just .05 from the last survey round—a significantly slower pace of decline than that observed in East Asian countries at similar points in their demographic transitions. In order to facilitate a robust dividend, fertility decline must accelerate so that today’s generation of children and young adolescents progress into their working-ages, while successive generations of children decrease in size.

Although fertility decline and the resulting maturation of the age structure are critical for the dividend, this trajectory is anything but guaranteed without increased access to voluntary family planning. Importantly, family planning programs have not only been shown to increase the social acceptability of birth control and smaller families, but they also provide the voluntary, affordable and effective methods to help women have the number of children they desire.

The 2012-13 PDHS reports that 26 percent of married women are using modern contraception, a 17-percentage point increase over two decades. While notable, one in five married women have an unmet need for family planning, putting millions at risk for mistimed and unplanned pregnancies each year. Also contributing to the slower pace of fertility decline is the preference for large families by Pakistani women and men (four children on average), which has remained unchanged since 1990.


Improving access to family planning is not only important for expediting fertility decline and age structure shifts, but it’s also critical for making the most of the prospects the dividend offers. Family planning is important for preventing unintended pregnancy, unsafe abortions and maternal death/disability, thus averting missed opportunities in education, employment and lifetime earnings. Harnessing women’s potential thus also requires empowering women of all ages through the expansion of education and employment opportunities. So far, Pakistan’s record isn’t stellar; according to the PDHS, 57 percent of women have never attended school (compared to 29 percent of men) and just 29 percent of women were employed within a year of the survey (compared to 98 percent of men).

Can the country turn it around in time to reap economic rewards? Is Pakistan making progress towards strengthening access to family planning information, services and supplies? Stay tuned for next month’s Demography Dish to find out.

The Demography Dish is a new monthly blog series featuring trends and analysis about demography and development.