Bayesian Modeling of Subnational Contraceptive Prevalence in Pakistan: are the 2018-2030 policy targets achievable?

Pakistan’s 2018-2030 Family Planning and Population Policy set forth ambitious targets, aiming for a 2 percent annual increase in overall contraceptive prevalence rate (CPR) at both national and subnational levels. This study evaluates the feasibility of these targets through a comprehensive Bayesian analysis, leveraging publicly available datasets. By reconstructing historical CPR trends and employing advanced statistical approaches—including generalized additive models (GAM) and logistic growth models—our analysis accounts for Pakistan’s significant demographic diversity and varying regional contexts. The findings reveal substantial disparities in contraceptive use across provinces and regions, with some areas demonstrating steady progress while others lag behind due to persistent socio-cultural, economic, and infrastructural barriers. Our projections indicate that, although select provinces may approach the policy’s CPR goals by 2025, most subnational units are unlikely to meet the 2 percent annual increase without substantial improvements in health service delivery, supply chain management, and community engagement. The study underscores the importance of tailored, region-specific interventions and sustained political commitment to advance family planning outcomes. Limitations include reliance on modelling approaches, availability of uniform data and potential underreporting in certain areas. Overall, while the national targets are laudable, achieving uniform progress requires nuanced, evidence-based strategies responsive to local needs. The results provide critical insights for policymakers and stakeholders to recalibrate expectations and prioritize investments that can accelerate contraceptive uptake and contribute to broader reproductive health objectives in Pakistan.