Pakistan faces one of the world’s largest gaps between the desire to plan pregnancies and the ability to do so. More than six million unintended pregnancies occur there each year, and only half of the demand for family planning is currently met. A new peer-reviewed study from The Challenge Initiative’s (TCI) Pakistan team offers encouraging evidence that a public-private partnership model can help close that gap.
Researchers examined the impact of TCI’s work in two urban districts, Rawalpindi in Punjab province and Malir in Sindh province, comparing them to similar districts that had not yet engaged with the program. Using five years of government health data and rigorous statistical methods, the study found that the partnership led to a significant, sustained increase in the number of people accessing modern contraceptive methods through public health facilities.
At the national level, the program was linked to roughly 3,700 additional family planning clients served each month. The gains were especially strong within Departments of Health, where monthly client numbers rose by more than 6,000, driven largely by increased use of injectable contraceptives and birth control pills. In some facilities, monthly volumes grew from near zero to more than 15,000 clients.
The approach behind these results is notable: rather than running a standalone program, TCI works inside existing government health systems, training staff, organizing dedicated service days, running mobile outreach, and upgrading facilities, all while encouraging local governments to fund and sustain these activities themselves. This is a marked contrast to short-term, donor-funded programs that often lose momentum once outside funding ends.
The study also found that results varied by department. While Departments of Health saw strong and lasting gains, Population Welfare Department facilities showed more mixed results, largely due to ongoing contraceptive supply shortages that limited how many clients could be served despite improved training and outreach. In one district, the program also helped activate family planning services through a primary healthcare network that had not previously operated in the area, opening access for a new population.
Researchers note some limitations. The evaluation focused on four districts selected for comparability, and broader structural changes within Punjab’s health system in recent years made it harder to isolate the program’s effects there. The study also measured service volumes rather than population-wide contraceptive use, so future research using household surveys would help confirm whether these facility-level gains are translating into broader increases in contraceptive use across communities.
Even with these caveats, the findings add to a growing body of global evidence suggesting that embedding family planning services within public health systems, rather than running them separately, produces more durable results. For a country working toward its family planning targets under the global FP2030 initiative, the study offers a practical case for continued investment in strengthening government-led service delivery, alongside more consistent contraceptive supply chains to fully realize that potential.
