Islamabad: Pakistan is witnessing a slow but steady decline in fertility rates, with urban areas showing notable leadership in family planning efforts, according to Gallup Pakistan’s analysis of the Household Integrated Economic Survey (HIES) 2024-25. The national Total Fertility Rate (TFR) has dropped from 4.0 in 201-19 to 3.6 in 2024-25, although the rate remains higher in rural areas. The Contraceptive Prevalence Rate (CPR) has increased to 3% nationally, with urban regions reaching 44%, reflecting a gradual shift in the country’s demographic landscape.
According to Gallup Pakistan, the driving forces behind these trends include women’s education and autonomy, which are significantly influencing family planning practices. Educated women are more inclined to use contraceptive methods, contributing to the decline in fertility rates. However, challenges persist, particularly in rural areas where spousal opposition and cultural barriers continue to hinder progress. The report suggests a need for policies that not only improve access to family planning services but also address cultural attitudes that limit women’s reproductive choices.
The analysis further highlights regional disparities, with urban areas benefiting from better access to family planning resources and higher female education levels, leading to a sharper decline in fertility. Conversely, rural communities face limited healthcare access and lingering cultural resistance to contraceptive use. The desire for larger families remains a prominent reason for not using family planning, with 36% of women citing this, alongside spousal opposition and religious beliefs.
The findings underscore the importance of integrating educational initiatives with family planning programs, particularly in rural and socio-economically disadvantaged regions. Women’s decision-making power, or lack thereof, also emerged as a critical factor influencing family planning adoption. The report calls for empowering women through education and increased autonomy in household decisions to further accelerate the fertility decline and promote better health outcomes across Pakistan.