The Much-Awaited Fertility Decline In Pakistan: Wishful Thinking or Reality?

Abstract

The Pakistan Demographic and Health Survey (PDHS) from 1990-1991 showed a decline in the total fertility rate (TFR) from 6.3 lifetime births per woman in 1975 to 5.5 births during the 6 years before the survey. A similar decline in fertility was claimed more than a decade earlier and then refuted as it seemed to have been based on a data artifact. According to various surveys the TFR for the 1980s ranged from 6.0 to 6.9 and there is no consensus on fertility levels in Pakistan. Fertility did not change much before the late 1980s when a decline may have begun. The final year of the PDS yielded a TFR of 6.5 in 1988. In contrast the PDHS indicated a TFR of 5.5 for 1985-1991 and a TFR of 5.2 for 1990-1991. If the TFR from the Pakistan Contraceptive Prevalence Survey (PCPS) is considered representative for 1984-1985 the TFR in Pakistan had fallen by about 0.5 in 6 years. The PDHS report attributes this decline mainly to the rising female age at marriage. The comparison of age-specific fertility rates for 1970-1975 with those for 1985-1991 as reported in the 1975 PFS and the 1991 PDHS respectively indicated that fertility had declined most among 15-19 year olds. The ratio of age-specific fertility rates for the 15-19 year age group during 1985-1991 was 1/3 lower than that of the same age group for 1970-1975. At the same time fertility levels among all other age-groups except women 45-49 years old seem to have fallen 4-15% since 1975. Data from the 1990-1991 PDHS like those of the 1975 PFS have presented evidence of a change in fertility that seems unlikely unless contraceptive use has been severely underreported in this survey. Fertility could be lowered quite rapidly from a TFR of 5-6 to a TFR of about 4 children per woman if the means to control fertility were made more attractive accessible and effective.