Introduction

Introduction

Family Planning (FP) activities were introduced in Pakistan's First Five Year Plan (1955– 60) through the Family Planning Association of Pakistan (FPAP) and other voluntary organizations. In the second Five Year Plan (1960–65), Family Planning services were extended through the health infrastructure; however, in the third Five Year Plan (1965–70), an independent Family Planning set-up was created, mass- scale information, education, and communication (IEC) activities were launched, and a service delivery network was established. In the next plan (1970– 75), the “Continuous Motivation Approach” was introduced by employing male-female teams of workers at the Union Council level. During 1975–80, the program operated at a low key due to re-organization, political unrest, and suspension of IEC activities.

In 1981, an administrative re-organization was undertaken and a broad-based, multi-sectoral, and multi-dimensional strategy was conceived, developed, and introduced. In the sixth Plan period (1983–88), field activities were provincialized through a 1983 ordinance, the role of nongovernmental organizations (NGOs) was institutionalized through the NGO Coordination Council (NGO CC), social marketing of contraceptives (SMC) was introduced, and the National Institute of Population Studies (NIPS) was established. The strategies of the sixth Plan were pursued in the seventh Five Year Plan (1988–93), with emphasis on lowering the fertility level and a focus on a motivational campaign and widening the range of contraceptive methods for voluntary choice. Also, a special IEC program and quality FP service delivery facilities were developed for the country's large cities, with a view to set trends for rural areas. The role of the District Office was expanded, and Divisional and Tehsil tiers were created. In fact, a breakthrough in the program occurred during the later part (1990–93) of the seventh Plan.

Between 1993 to 1998, Pakistan ran a successful Family Planning program which was instrumental in reducing fertility rates and increasing contraceptive prevalence. The key element of the program was the recruitment of trained Lady Health Workers (LHW) to provide primary health care and Family Planning services to women at community level. In 2010, devolution of power to provinces through 18th amendment in the constitution resulted in dissolution of Ministry of Population Welfare and transfer of the subject to the provinces. Thus, the Population Welfare Departments in provinces took a lead role in population policy, plans, programs and projects and their implementation.

Family Planning is now again getting space on the government's policy agenda. The Federal Government has constituted a Task Force on Population and Family Planning to develop a strategy for controlling population growth and guiding its implementation. The Task Force, headed by the President, which includes all provincial Chief Ministers as members, is working towards three key targets; increasing contraceptive prevalence rate to 55 percent, reducing fertility rate from 3.6 births per woman to 2.1, and decreasing population growth rate to 1.5 percent. Given the devolved governance structure in Pakistan, the inclusion of Chief Ministers in the Task Force is key to implementing a coordinated and comprehensive Family Planning program.
 

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