History

Population growth in Pakistan has shown continued increase since the 1940s due to reduced mortality and persistent high birth rates. The country's population grew from nearly 33 million in 1947 to about 196.5 million to date–an increase of almost six times since the year of independence. Continued rapid growth in population has ranked Pakistan sixth in world and the third biggest contributor to world population growth. With a very young age structure, and a large number of people about to enter the reproductive years, the population has the potential to grow rapidly in the near future, even though fertility is expected to fall substantially. The Population Welfare Programme is a social development activity aimed at reducing population growth rate which is a necessity for developing countries like Pakistan.

The Seventh Decade (2010- Present)

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In 2010 as a consequence of the 18th amendment in the constitution, the Ministry of Population Welfare ceased to exist and its functions were devolved to the provinces under Population Welfare Departments. The Secretariat of the Provincial Population Welfare Department Punjab is headed by an Administrative Secretary. The Provincial Directorate is headed by the Director General and is implemented in the field through 36 District and 121 Tehsil Population Welfare Offices, which in turn ensure quality service delivery through a network of Family Health Clinics (previously Reproductive Health Services Centers), Family Welfare Centers, Mobile Service Units, and Social Mobilizers. After devolution the first Provincial Population Policy was granted final approval by the Honorable Chief Minister in January 2017. The Policy is broad based and encompasses a vision of a prosperous, healthy and knowledge based society where every family is planned, every member nurtured and all citizens are provided with the opportunity and choice to attain improvement in the quality of their lives.
Post devolution the Population Welfare Department is all geared up to address rapid population growth within a development framework, while emphasizing the importance of inter-sectoral collaboration for a multidimensional focus. It is this vision, in the backdrop of International and National Commitments on reproductive health for all, including family planning, that is steering the activities of the Population Welfare Department Punjab. Some of the initiatives taken post devolution include provision of contraceptives free of cost to clients, expansion of Family Welfare Centers down to union council level, refurbishment and reactivation of Mobile Service Units to reach out with family planning and reproductive health services to target population in rural and hard to reach settlements, aggressive and targetted media campaigns individually and in collaboration with Health Department, development of joint referral system for family planning clients through outreach workers in collaboration with Health Department, provision of missing facilities at Family Health Clinics and Family Welfare Centers, construction of 11 Family Health Clinics, establishment of 17 Adolescent Health Centers, procurement of contraceptives for its service delivery outlets, establishment of its own supply chain management down to grass root level, development of web-based contraceptive Logistic Management Information System cLMIS, strengthening of Population Welfare Training Institute and Regional Training Institutes Lahore and Multan in respect of capacity and quality of trainings, and research work, upgradation of 09 Family Health Clinics attached with teaching hospitals to Training Centers, IT revolution through official e-mail accounts and web-based communication and reporting, establishment of toll free number and help line for family planning counselling, facility for consultation on family planning matters via e-mail and communication with general public through social media facebook page.

The Sixth Decade (2000-2009)

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On July 25, 2001 an Ordinance on “Transfer of Population Welfare Program (Field Activities) (Amendment) Ordinance, 2001″ was promulgated, inter-alia, declaring all Population Program employees as civil servants of the respective Provincial Governments.

The Population Policy of Pakistan was launched in July 2002 with the vision to achieve population stabilization by 2020 through the expeditious completion of the demographic transition that entails decline both in fertility and mortality rates.

During 2004, the Standing Committee of the National Assembly desired that service delivery points of the Population Welfare Program have ISO Certification so that their QOC would be recognized as per international standards and protocols. The programs countrywide network of outlets is mandated to deliver FP services, keeping special focus on QOC. The MOPW is the first ever public sector organization to have (ISO) 9001:2000 Certification for its service delivery outlets, through the United Registrars of Systems (URS), UK.

The Fifth Decade (1990-1999)

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With the end of the Zia regime in 1989, the population program saw strong political support from the highest levels and during the 1990s, the governments strong and explicit support to family planning program gave it a turning point. On 27th of June 1990 the Ministry of Population Welfare was created to look after the affairs of Population Welfare. The Federal Government was responsible for the overall execution and entire funding of the Population Welfare Program through this Ministry. An Inter-Ministerial Committee consisting of Ministers for Planning and Development, Education, Health, Information and Population Welfare was set up for effective implementation of Population Welfare Programme. Pakistan became a signatory to the ICPD plan of action and therefore the Reproductive Health Package was introduced to target population through the department. For expanding coverage a new infrastructure of village based family planning workers was created to take the services to the door steps of the people.

The Fourth Decade (1980-1989)

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In 1980 the Population Division, formerly under the direction of a minister of state, was renamed the Population Welfare Division and transferred to the Ministry of Planning and Economic Development. This agency was charged with the delivery of both family planning services and maternal and child health care. Community participation had finally become a cornerstone of the governments policy, and it was hoped that contraceptive use would rise dramatically. The population by 1980 had exceeded 84 million.

The process of organizational changes continued and the field activities and provision of services were transferred to the provincial governments, while finance and policy making was left with the federal government. The Pakistan Demographic Survey (PDS) of 1984-87 estimates indicated the crude birth rate at 43.3 per thousand and the total fertility rate (TFR) at 6.9 children per women.

During this period The National Institute of Population Studies (NIPS) was established and the role of nongovernmental organizations (NGOs) was institutionalized through the NGO Coordination Council (NGOCC). However, largely, the programme withered during this time due to reluctance of its leaders to provide strong support.

The Third Decade (1970-1979)

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It was presumed that by 1970, about 18 percent of married women would be practicing contraception and this rate was expected to go up by 34 percent by the end of 1975. In late December 1971, the population was estimated at 65.2 million. The period between 1970 and 1978 was in fact, marked by the non-existence of a plan formulated specifically for Pakistan after the separation of East Pakistan (now Bangladesh) from the country in 1971. In 1977, after the change in political set up in the country, the program met with severe criticism from the political and religious leaders, which led to the suspension of all program activities until 1979. The shutdown of activities effected the functioning of the program adversely. The results of the 1975 Pakistan Survey (PFS) revealed that the CPR was as low as 5.2 percent.

The Second Decade (1960-1969)

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The Second – 5 year Plan (1960-65) was proposed for 20 years, after which sufficient awareness, motivation, and resources were anticipated to ensure continuing family planning without increased government support. It was primarily designed to influence social attitudes and practice in favor of family planning. Because of the limited reach of the Family Planning Association of Pakistan to cover population on a large scale, family planning services were initially provided through the outlets of the Health Department. To oversee these activities, small independent units were established in the Ministry of Health and Provincial Health Departments. The social research projects were initiated through donors as a support activity. At the end of 1964, there were 1589 family planning clinics functioning within the set up of health dispensaries, hospitals and maternal care centers. On the basis of a national cooperative study of the Lippes Loop and the Margulies spirals indicating satisfaction and acceptability by Pakistanis, the government endorsed use of the IUCD for women as a major method for future use in its national program.

In 1964, an evaluation revealed that the services were not reaching the target population through the health outlets as these were overburdened with the existing health needs of the people.

In 1965 an autonomous body — the Family Planning Council — was created under the Ministry of Health and Social Welfare to exclusively launch family planning activities that would have a wider area of coverage and more autonomy in operation. Furthermore, the National Board of Family Planning was formed to Advise Government Policies. The Council was later renamed as the Population Planning Council.

Later in March 1968 a separate Administrative Division was created, mass scale information, education and communication (IEC) activities were launched, and a service delivery network was established with a target of providing family planning services to 20 million couples in the country. In spite of 19 years of organized family planning efforts, supported by 14 years of active official support the results of the 1968-69 National Impact Survey highlighted the dismal performance of the Programme where only 6 percent of eligible couples were reported to be using contraceptives. However, success was noted in the spread of contraceptive knowledge as majority of married women were reported to have the knowledge of at least one method of family planning.

The First Decade (1950-1959)

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The Programme was launched independently in 1953 through an NGO, the Family Planning Association of Pakistan, and focused on advocating and facilitating small family norms. At that time the population of Punjab was 20.54 million with every married woman bearing around 6-7 children. Three years later, as part of the first -5 year plan (1955-60), the government offered a small financial assistance to the Association to establish clinics in selected cities for providing family planning services. In 1958, it was realized that an active family planning program was the need of the moment.