Sindh At A Glance

            Sindh with its 55.69 million population, stands as the second largest province in Pakistan and, with an area of 140,914 Sq.Km, is the third largest. Sindh is the most urbanized and industrialized province in the country. However, the rapidly growing population impedes the government’s efforts to bring about development in all sectors. Early marriages, repeated pregnancies, and lesser use of contraceptives contribute to maternal mortality, infant mortality, and unintended pregnancies, leading to abortions.

            Pakistan is one of the pioneers in the region to initiate a family planning program, starting in the mid-20th century. In 1960, the Government of Pakistan launched the National Family Planning Program (NFPP) under the Ministry of Health. This program continued until 1965, after which a semi-autonomous body called the “Pakistan Family Planning Board” (for both East and West Pakistan) was established under the Ministry of Health and operated until the early 1980s. In 1983, Population Welfare activities were transferred to the provinces, which established independent Population Welfare Departments, though the program continued to receive federal funding.

            In 2010, following the 18th Constitutional Amendment, the Ministry of Population Welfare was devolved, and its functions were transferred to the provinces. Consequently, the provinces took over all assets and liabilities of the devolved subjects. Sindh was the first province to formulate a Provincial Population Policy in 2016, demonstrating its commitment to the cause of Family Planning and Reproductive Health services.

            Sindh is committed to achieving the Family Planning (FP) 2030 Goals in view of SDG target 3.7 and 5.6. In this regard, Sindh FP-2030 Road Map is developed with the vision to reshape the lives of the people across Sindh through a rights-based approach. Thus, creating an enabling environment, to ensure the transformation of social and gender norms – hallmark of a progressive society.

            As per the Census Report 2023, Sindh's population stands at 55.69 million, with 46.27% residing in urban areas and 53.73% in rural areas. The inter-censual growth rate is alarmingly high at 3.50%. Such a high population growth rate, coupled with low socio-economic indicators, necessitates immediate efforts to increase the Contraceptive Prevalence Rate (CPR) and decrease the Total Fertility Rate (TFR).

            The unmet need of Sindh for family planning is 17.7% (PDHS-2017-18), which requires holistic efforts by public and private stakeholders. The prominent causes are low literacy rate, poverty, sociocultural taboos and lesser involvement of women in decision-making. Despite these hurdles, Government of Sindh has undertaken different efforts such as:

• Functional Integration: The functional integration with public and private sectors is streamlined for providing Family planning services. Around 350 service delivery centers are re-located to Health Facilities and trainings on FP and commodities are provided to Service Providers of Health Department. All Public and Private health facilities at are also providing FP Services, 421 RHS-B Centers registered, commodities are provided free of cost. Family Health Days and FHMs (Family Health Melas) are held at unserved areas.

• Post-Partum Family Planning: The footsteps of pregnant women are high in Gynae wards. To capitalize this opportunity, PPFP (Post Partum Family Planning) and PAFP (Post Abortion Family Planning) services are introduced at Tertiary Care Hospitals.
• Strengthening of Training Institutes & Service Delivery Points: Population Welfare Training Institute (PWTI) at Karachi is made fully functional and RTI, Karachi & Hyderabad have been strengthen. Branding of 230 FWCs is done which has improved visibility of Family Welfare Centers and FP client’s number has also increased.
• Supply Chain System: Supply Chain System of contraceptives from Central Warehouse to Districts is strengthened.                                           
• Monitoring Mechanism: Traditional report-based Monitoring Mechanism is improved by introducing modern electronic and real time web-based Monitoring system.

• Electronics Record System: Paper-based registration of clients is shifted to Electronic Clients Record (ECR), embedded in the Contraceptive Logistic Management Information System (cLMIS). The robust data recorded in ECR would be instrumental in evidence-based decision making. 700 plus out of 1200 facilities are presently reporting on ECR.

Different forums are also working to track progress and accountability: 

• Sindh Population Task Force headed by the honorable Chief Minister Sindh,
• Besides, Sindh FP-2030 Working Group meetings are held to monitor the progress and track the
• DC&IC meetings are also held at District Level on quarterly basis.
• The targets set are being monitored with recently introduced Electronic Client Registers and E-Monitoring application.