Fertility in Pakistan has shown a stubborn resistance to change. Because of sharp declines in mortality following World War II, the population of Pakistan was growing at the rate of 2.7 percent per annum around 1960.

India has an extensive network of hospitals and health centres with a large field staff in the government sector, which has been providing primary health care. Of late this infrastructure has been effective in delivering immunization services to the community.

The Government of India has adopted the 1994 Cairo agenda with speed and commitment at the highest level, recognising that improving reproductive health, including family planning, is essential to the development of the family welfare programme.

A number of recent studies [A] [D] have documented evidence to show that couples have a decided preference for a particular sex combination of children. For example, in many South Asian countries, including India, there is a strong preference for sons over daughters.

In recent years, fertility has become an important subject of inquiry for economists. The decision to have children and their number and timing involve trade-offs which constrain the purchase and consumption of durables and other household items vying for the family's scarce resources.