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This agency was charged with the delivery of both family planning services and maternal and child health care.

This reorganized structure corresponded with the new population planning strategy, which was based on a multifaceted community-based "cafeteria" approach, in cooperation with Family Welfare Centres (essentially clinics) and Reproductive Health Centres (mostly engaged in sterilizations).

Pakistan is one of the few countries in the world with an inverse sex ratio: official sources claim there are 111 men for every 100 women.

The discrepancy is particularly obvious among people over fifty: men account for 7.1 percent of the country's total population and women for less than 5 percent.

In 1950 the mortality rate was twenty-seven per 1,000 population; by 1990 the rate had dropped to twelve (estimated) per 1,000.

Yet throughout this period, the birth rate was fortyfour per 1,000 population.

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Pakistan's extremely high rate of population growth is caused by a falling death rate combined with a continuing high birth rate.

Community participation had finally became a cornerstone of the government's policy, and it was hoped that contraceptive use would rise dramatically. In preparing the Sixth Five-Year Plan (1983-88), the government projected a national population of 147 million in the year 2000 if the growth rate were to be a constant at 2.8 percent per year, and of 134 million if the rate were to decline to the desired 2.1 percent per year by then.

By the Seventh Five-Year Plan (1988-93) period, the multipronged approach initiated in the 1980s had increased international donor assistance and had begun to enlist local NGOs.

In an attempt to control the population problem, the government introduced several new programs.

First, the Continuous Motivation System Programme, which employed young urban women to visit rural areas, was initiated. Based on the premise that greater availability would increase use, shopkeepers throughout the country stocked birth control pills and condoms. The unmarried urban women had little understanding of the lives of the rural women they were to motivate, and shopkeepers kept the contraceptives out of sight because it was considered mannerless to display them in an obvious way.

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