Impact of education, poverty, and demographic background on maternal mortality, fertility, and family planning in Pakistan

Abstract

In recent decades, maternal mortality has significantly reduced on a global scale. However, persistent inequities have undermined these advances in middle- and low-income countries. Therefore, there has been a shift toward more inclusive approaches, such as human capital formation. This perspective article analyzes maternal mortality, fertility, and family planning outcomes in Pakistan, comparing them with educational attainment, socioeconomic status, and demographics. Pakistan’s maternal mortality rate among those with a rural background is 21% higher than those with an urban background in the country. Historically, the country’s total fertility rate (TFR) has been gradually declining, from 4.9 in 1990 – 1991 to 4.1 in 2006 – 2007, to 3.8 in 2012 – 2013, and to 3.6 in 2017 – 2018. However, there are stark disparities in TFR based on demographic background, education, and poverty. Meanwhile, the contraceptive prevalence rate (CPR) has remained stagnant for the past two decades, largely due to inadequate initiatives in poverty reduction, education, and rural development. Pakistan has committed to reducing maternal mortality and fertility and increasing CPR under the International Conference on Population Development, Family Planning 2030, and the recommendations of Pakistan’s Council of Common Interest. Along with these goals, infrastructure development, in (interprovincial roads connecting rural and urban areas and alternative energy initiatives) presents promising prospects for economic growth, poverty reduction, and increased employment opportunities. The paper concludes that health service delivery measures cannot sustain improvements in maternal health, fertility, and family planning indicators alone. Rather, a multipronged strategy focused on poverty reduction, education, and reductions in rural–urban disparities is essential for sustained progress.