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5.3.5 Education of women & Use of Contraception
Contraceptive use is positively associated
with education. Women with higher education (Class 8 or above) show the highest usage (42%) compared to those with no education (33%). Urban–rural differences persist at all education levels, with urban women reporting consistently higher use. Comparison with 2018 –19 data indicates an overall increase across most education categories, suggesting that education continues to play a critical role in shaping family planning behaviour. 5.3.6 Use of Contraception and Number of Children
The likelihood of using family planning methods rises sharply with the number of children. Only 6% of women without children use contraception, compared to 51% among those with 3–4 children and with five or more children. This pattern is more or less consistent across urban and rural areas. Compared to 2018–19, modest improvements are visible in all parity groups, particularly among women with one child and two or more children, indicating growing awareness of birth spacing and fertility control.
30 34 36 37 39 33 37 38 41 42 No Education Class 1-2: Class3-4: Class 5-7: Class 8 or higher: 2018-19 2024-25 Figure 5.9:Use of CPR- By Education Level Figure 5.10: Use of CPR by number of children 6 21 35 51 51 2 12 29 45 48 No Child 1 Child 2 Child 3-4 Child 5+ Child 2024-25 2018-19
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5.3.7 Commonly Known Methods of Family Planning Table 8 highlights the types of family planning methods most commonly known across Pakistan and its provinces. Overall, modern methods such as pills (9 1%), condoms (90%) and injections ( 86%), are the most commonly known methods nationwide. Awareness about tubal ligation (80%) and IUDs (78%) also remains notable, reflecting more understanding toward more reliable and long-term contraceptive methods. Sindh & Punjab demonstrate the highest awareness of modern contraceptive methods, including both reversible and permanent options, with particularly strong knowledge of pills, injections, and tubal ligation. In contrast, Balochistan consistently shows the lowest levels of awareness across nearly all methods. Khyber Pakhtunkhwa (KP) falls in the middle, with moderate overall knowledge and relatively better understanding of injections and traditional methods such as withdrawal (Figure 5.11). Methods of Family Planning Currently being used
Table 9 shows the distribution of family planning methods currently used in Pakistan by province and urban –rural residence. At National level in 2024 –25, condoms are the most commonly used method (36%), followed by tubal ligation (22%) and withdrawal (17%) Figure 5.12. However in 2018 –19, withdrawal was the leading method (27%), followed by condoms (26%) and tubal ligation (23%), indicating a shift in method preference over time. Figure 5.11: Commonly Known Methods of Family Planning by Province Punjab Sindh KP Balochistan Others Rhythm Withdrawal Condom IUD Tubal ligation Injection Pill
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Across provinces, notable variations in contraceptive use are observed. In Punjab, condoms (35%) and tubal ligation (26%) are most commonly used in 2024 –25, whereas in 2018 –19 withdrawal (30%) was highest, with condom s and tubal ligation both at 26%. In Sindh, condom use rises to 39% in 2024 –25, followed by tubal ligation (2 4%), compared with 28% and 27% respectively in 2018 –19. In KP, condoms (3 7%) and withdrawal (3 1%) dominate in 2024 –25, indicating a preference for short-term or traditional methods, while in 2018–19 withdrawal (36%) and injections (23%) were more common. In Balochistan, the most used methods in 2024 –25 are condoms (33%) and withdrawal (19%), similar to 2018–19 when both were the most preferred at around 25%.
At the National level, Modern contraceptive methods dominate family planning in Pakistan, accounting for 29% of total use, while traditional methods make up 9%.
Pill 6% Injection 7% Tubal ligation 22% IUD 5% Condom 36% Withdrawal 17% Rhythm 5% Others 2% Figure 5.12:Currently Used Methods of Family Planning 2024-25
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5.4.1 Source of Family Planning methods currently being used
The main sources of family planning methods vary between urban and rural areas. Table 10 & Figure 5.13 shows in 2024–25, spouses, relatives, and friends were the leading sources of contraceptives (47% overall), marking a increase from 25% in 2018 –19. Government family planning clinics & Gov health facilities account for around 33% of users as compared to 36% in 2018-19, showing decrease over time. The role of private hospitals and practitioners remains notable at 1 6% as compare to 19 % in 2018 -19. However, reliance on village family planning workers has sharply declined from 8% in 2018 –19 to nearly negligible levels in 2024–25. Shops and chemists now contribute only 1% of supplies, compared to 10% previously, indicating a shift toward more formal and interpersonal sources of family planning services. 5.4.2 Satisfaction with the family planning method
Overall satisfaction with family planning methods remains high across Pakistan, Table 11 indicates 97% of women reporting satisfaction in 2024 –25 as compare d to 96% in 2018 -19. Provincial trends are consistent, showing minimal rural–urban differences. A uniform satisfaction rate of 97% is reported in Punjab, Sindh, KP & Balochistan, indicating strong acceptance of family planning methods nationwide.
Figure 5.13:Source of Family Planning Method 47 33 0 1 16 0 1 0 25 36 8 1 19 0 10 0 0 10 20 30 40 50 Spouse/relative/friend Govt. Health facility Village F. Planning Worker NGO family planning clinic Private hospital/practitioner Dai/Homeopath/Hakeem Shop or Chemist Others 2024-25 2018-19
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5.4.3 Reasons for dissatisfaction from family planning method
Among women who expressed dissatisfaction, Figure 5.14 depicts the most common reason was adverse side effects (40%), followed by the perception that methods are not effective (15%) and high costs (12%). Other reasons included irregular supply (10%) and disapproval from husbands (14%). These findings suggest that while overall acceptance is strong, addressing side effects, affordability, and supply consistency could further improve satisfaction and sustained use of family planning methods.
5.4.4 Reason for Not Practicing Family Planning Table 7 shows that at the National level, the most common reason for not using family planning among women aged 15–49 years is the desire for more children (36%), which increased as compare to 30% in 2018 -19. This reason is most prominent in Sindh (42%) and lowest in Balochistan (25%). Spouse opposition (8%) has increased in Punjab since 2018–19, highlighting the continued influence of male decision-making. Religious reasons remain generally low nationally (6%) but are significantly higher in Balochistan (2 0%) & KP (7%) . Encouragingly, biological reasons such as pregnancy and Costs too much 12% Irregular supply 10% Adverse side effect 40% Not effective 15% Husband does not like 14% Other 9% Figure 5.14:Reasons for Dissatisfaction 2024-25
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lactation have declined across all provinces, reflecting improved awareness of post-partum family planning. The category “Others” remains significant across provinces and reflects a mix of health concerns (e.g., infertility, hysterectomy, not menstruated since last birth), social factors (self or family opposition, husband away), and service -related issues (lack of information, unavailability of preferred methods, irregular supply, and perceived ineffectiveness), as well as do n’t know responses.
Women In Decision Making
This chapter presents data for women aged 15 –49 years regarding their involvement in decisions related to education, employment, marriage, family planning, food consumption, clothing, medical treatment, and recreation and travel. Different questions were asked to capture women’s roles in various domains, and the findings indicate that overall, women have a limited role in making decisions about their own lives, particularly in matters of employment and marriage. PBS has been collecting information on women’s participation in decision -making for several years; however, the findings are being presented in this report for the first time for the year want childern 36% Spouse prefer not 8% Religious reason 6%side effect 3%Hysterectomy 1% Infertility 2% Menopusal 4% Lactating 9% Pregnant 11% others 20% Figure 5.15:Main Reasons for Never Practicing Family Planning
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2024-25. The data offer valuable insights into the extent of women’s involvement in personal and household decisions and highlight areas where decision-making power remains limited. 5.5.1 Education Decisions:
Women’s education decisions at National level are primarily made by household heads (31%) or jointly with spouses (30%), while only 23% involve the woman herself or head of the household with consultaion of the concerned women.
Table 5.1Education Decisions Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 10 31 30 13 17 Punjab 15 18 39 15 14 Sindh 6 43 17 8 26 Khyber Pakhtunkhwa 3 54 19 15 10 Balochistan 2 39 35 5 19 5.5.2 Employment Decisions:
Decisions about women’s employment in Pakistan are mostly made jointly by head and spouse accounting for 32% and head alone for 27%, while only 24% of decisions involve the woman herself or head of the household with consultaion of the concerned women. Figure 5.16:Decision Makers for Women Education 2024-25
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Table 5.2: Employment Decisions Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 10 27 32 14 17 Punjab 13 16 41 16 13 Sindh 8 38 19 11 25 Khyber Pakhtunkhwa 2 45 22 16 15 Balochistan 2 39 34 6 19 5.5.3 Marriage Decisions:
Most decisions about women’s marriage in Pakistan are made by the household head & spouse (47%), while head alone (24%) and (23%) involve the woman herself or head of the household with consultaion of the concerned women. Table 5.3:Marriage Decisions Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 3 24 47 20 6 Punjab 3 16 52 25 4 Sindh 5 36 40 13 6 Khyber Pakhtunkhwa 2 25 43 20 10 Balochistan 1 35 47 7 9
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5.5.4 Family Planning Decisions:
Decisions regarding Family Planning at National level are overwhelmingly made jointly by husband & wife (68%) or by the husband alone (9%), while only 1% of decisions are made independently by the woman.
Table 5.4:Family Planning Decisions Province Woman Herself Husband Alone Husband Woman Jointly Others Pakistan 1 9 68 22 Punjab 1 6 76 17 Sindh 1 12 50 37 Khyber Pakhtunkhwa 3 13 76 8 Balochistan 0 18 35 46
Tables 5.5.5 to 5.5.8 present information on women’s decision-making regarding food consumption, clothing, medical treatment, and recreation & travel.
5.5.5 Woman decision making for Food Consumption Items
Table 5.5:Woman decision-making for Food Consumption Items Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 29 15 34 14 8 Punjab 42 6 32 16 4 Sindh 14 27 35 12 12 Khyber Pakhtunkhwa 16 27 27 14 16 Balochistan 9 23 58 7 3
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5.5.6 Woman decision making for their Clothing items
5.5.7 Woman decision making for their Medical Treatment
5.5.8 Woman decision-making for Recreation & Travel
Table 5.6 : Woman decision making for their Clothing items Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 33 11 37 16 5 Punjab 38 5 39 15 3 Sindh 28 15 34 18 6 Khyber Pakhtunkhwa 29 20 26 16 8 Balochistan 14 18 55 10 3 Table 5.7:Woman decision-making for their Medical Treatment Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 12 13 45 24 6 Punjab 15 6 50 26 3 Sindh 8 22 41 21 9 Khyber Pakhtunkhwa 9 18 34 29 10 Balochistan 5 27 54 11 4 Table 5.8: Woman decision-making for Recreation & Travel Province Woman Herself Head Alone Head Spouse Alone Head with Concerned Woman Others Pakistan 9 18 43 20 10 Punjab 12 9 50 23 7 Sindh 5 29 37 15 15 Khyber Pakhtunkhwa 7 29 29 23 12 Balochistan 2 33 48 9 7