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The 1994 International Conference on Population and Development developed international consensus amongst health providers, policy makers, and group representing the whole of civil society regarding the concept of reproductive health and its definition. In line with this definition, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. Reproductive health care saves lives and prevents significant levels of morbidity through family planning programmes, antenatal, delivery and post-natal services, prevention and management programmes for reproductive tract infections (including sexually transmitted diseases and HIV/AIDS), prevention of abortion and management of its complications, cancers of the reproductive system, and harmful practices that impact on reproductive function. Reproductive health care needs are evident at all stages of the life cycle and account for a greater proportion of disability adjusted life years (DALYS) in girls and women than in boys and men. Reproductive health protects infant health by enabling birth spacing and birth limitation to be practiced through family planning. The prevention and early detection of reproductive tract infections, including sexually transmitted diseases and HIV, through the integration of preventive measures in family planning service delivery not only improves the quality of care provided but is also directly responsible for improvement in survival and health of infants. Addressing harmful practices such as son preference, sex selection, sexual violence and female genital mutilation complements the positive impact of planned and spaced children through family planning services on infant mortality and the reproductive health of young girls and women. They are also in addition to prenatal, delivery and postnatal services, positive determinants of low maternal mortality and morbidity and are integral to the promotion of reproductive health in women of child bearing age. Reproductive tract infections, including sexually transmitted diseases and HIV contribute to significant level of ill-health in women of reproductive age and continue to pose a threat through the menopause which in turn brings with it increasing risk of cancers of the reproductive system.

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This is a critical historical moment, in the 50th year of our independence. Our decisions, commitment and action in the next few years will affect our country for much of the 21st century. The decisions needed would be a challenge for any country: for Pakistan they involve a drastic change in development priorities. Our development efforts since Independence have gone into building the economy. In the early years this was quite successful: we harnessed the great rivers for power and irrigation; we revolutionised agriculture, we pushed exports up to new levels. For a time economic growth was quite dynamic. But we were always aware that something was missing. At Independence Pakistan started more or less even with other countries in the region. All our efforts since then have left us lagging behind. In 1950 the Republic of Korea had about the same GNP per head as Pakistan. Today Korea’s GNP is $7,670; ours $476. That is a difference of 1,611 percent.

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