Pakistan's family planning challenge extends beyond access to contraceptives. Deeply entrenched social norms, limited decision-making space and constraints on women's agency remain major barriers to couples achieving their desired family size.

One in five women who would like to plan and space their families is unable to do so. Research into the underlying causes of unmet need for family planning shows that decisions are rarely made by couples in isolation but are often shaped by the fear of social disapproval. Education, income opportunities, household structure, kinship networks, living arrangements where several generations share a household, and prevailing expectations about marriage and childbearing all shape what women and men believe they can decide. These patterns must be understood, discussed and, where necessary, challenged if couples are to plan their families according to their aspirations.

Pakistan's religious context offers an important, and underused, pathway for challenging entrenched........

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