The National Institute of Population Studies analyzed data on 6364 currently married women from the 1990-1991 Pakistan Demographic and Health Survey (PDHS) to confirm the hypothesis (developed after analysis of the 1984-1985 Contraceptive Prevalence Survey) that contraceptive use was underreported, more so than births, due to shyness. The reported contraceptive prevalence rate (CPR) was 11.8%. Further analysis suggested that 11.9% (759) of currently married women were indeed shy/silent users, defined as women who had not given birth in the last 5-7 years, had not experienced menopause, reported to not be using any contraceptives, had at least 1 child, were less than 45 years old, and did not have secondary infertility. They comprised 44.1% of all nonpregnant nonusers. If one adds the shy/silent users to the contraceptive prevalence rate, it becomes 23.7% (11.8 + 11.9%). The expected total fertility rate (TFR) for a CPR of 11.8% was 6.1. Using the Bongaarts regression intercept of 6.83 and the CPR that includes the shy/silent users resulted in better consistency between the reported PDHS TFR (5.2-5.4) and the adjusted CPR (23.7%). The shy/silent users were more likely to be older (37.1 years vs. 34.8 years), married longer (e.g., married for 20 years, 50.3% vs. 33.4%), and illiterate (83.5% vs. 52%) and to depend more on Allah when expressing a desire for more births (16.8% vs. 2.1%) than the reported current users. They were less likely to believe their husbands approved on contraception (21.1% vs. 57.4%), to talk to them about family planning (16.2% vs. 44.4%), and to be able to go to health facilities and family planning clinics alone (25.4% vs. 50.4%). These findings suggested that the shy/silent users were doing something to prevent pregnancy. They may not have been using modern contraception, but probably used traditional methods and induced abortion. Additional research should examine what methods these women do indeed use to prevent births.
"The hypothesis of the inverse relationship of socio-economic status of the parents and child infant mortality rates has been retested by introducing 'personal illness control' as an intervening variable. The data obtained in the 1984/1985 Pakistan Contraceptive Prevalence Survey have been used. The infant and child mortality rates have been estimated by using indirect techniques." The author finds that infant and child mortality rates are lower among upper socioeconomic groups, with mother's educational status being particularly important.
The study aim was to determine the pattern of demand for children and to suggest ways to introduce the idea of a small-family norm and reduce the unmet need for contraception in Pakistan. The concept of demand for children included the wantedness of the last birth and the timing of the next birth and changed with stage in reproductive life cycle. Data were obtained from the Pakistan Contraception Prevalence Survey of 1984/85. Pakistan's strong patriarchal system emphasized rapid achievement of first pregnancy in order to assure the perpetuation of the lineage. Female status, even with advanced education, emphasized fecundity and producing a male heir. The birthing pattern among rural and urban lower-class women is to bear 3-4 children early in marriage. Evidence from prior surveys showed that educated women plan for a delay in second birth. Of the 6655 ever pregnant and nonsterilized women, about 48% of currently married women desired discontinuation of childbearing. 18% desired a delay of childbearing by 2 years and 10% desired no more children after a last undesired pregnancy. Unmet need was estimated at 17% of all women in the sample. Women desiring no more children were primarily older with 6-8 prior births. Indirect fertility estimates were generated by using Arriaga's techniques for stages of family formation. The resulting estimates showed that higher-parity women desiring no more children still had 2 more children, which was evidence of unmet need. Those desiring more children had higher fertility than those not desiring more children. These women also showed different patterns in their total demand for children, ideal family size, currently living children, and desire for their next birth. Ideal size tended to rise over the length of a marriage, which may mean that women with growing families may justify unwanted fertility. Duration of marriage was viewed as a reasonable indicator of need for fertility control and the concomitant need for outreach, counseling, and family planning services. Increased birth spacing occurred only after 3-4 births. There was a decline in the proportion desiring an additional child with increased birth interval and parity. Results indicated a high prevalence of intended pregnancy, rationalization of high parity in terms of demand for children, and demand for contraception for spacing or limiting births.
Pakistan has a current population of 123 million which is projected to grow to 150 million by the year 2000. Concern for population policy, however, has existed in the context of development in Pakistan since the first 5-year Plan of 1955-1960. The family planning program in Pakistan was then included in the second 5-year plan of 1960-65 and has since been a large program. Family planning efforts and population policy are described for Pakistan from the first 5-year plan through 1993. Review reveals that political support and strategies have changed frequently and have adversely affected the family planning program. Funds allocated for the program increased from one plan period to another, but the program has failed to make an impact commensurate with its size and expenditure. Major factors have been the inadequate coverage of population and lack of a systematic approach. Suffering setbacks in the late 1970s and early 1980s, the program did, however, regain momentum through stronger leadership at the political and administrative levels. Efforts are currently being made to improve the coverage and implementation of the Population Welfare Program along with others in the social sector to get the desired annual population growth rate of 2.5% by the year 2000.
The authors explore reasons for the observed increases in marriage age in Pakistan. "Using anecdotal data from urban Pakistan, an attempt is made in this paper to analyse the perceived reasons that cause delay in marriage as well as some suggestions made by the respondents of this study to overcome the delay if necessary. In [pursuing] this objective, regional and gender variations with regard to reasons and suggestions are discussed."
