Is fertility behaviour changing in Pakistan? Evidence from rural Punjab and the North-West Frontier Province 1997 and 2004.

In a panel study of fertility behaviour conducted between 1997 and 2004 in rural Punjab and the North-West Frontier Province (NWFP) of Pakistan data collected from 12 communities showed a modest increase in contraceptive use over a six-year period. A majority of women had expressed a desire to limit family size in both years but despite that two thirds had a birth over the six years between the two surveys. This suggests a disassociation between stated fertility preferences and fertility behaviour and a persistent unmet need for contraception. The modest rise in contraceptive use occurred at the same time as village-based family planning services became more widely available. Although there was a weak correlation between the occurrence of births from 1997 to 2004 and contraceptive use in 2004 as some changes in the family planning service environment had occurred there were comparatively stronger correlations of these two variables with women’s schooling changes in access to schooling and an indicator of community level development. In terms of policy the findings therefore indicate that investment in human development in rural communities is just as important as family planning programmes for facilitating a reduction in fertility.