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In: Bloch LS, ed. The physician and population change: a strategy for Africa, the Middle East and Europe. Bethesda, Maryland, World Federation for Medical Education, 1979 Mar. 149-67.The family planning program in Pakistan began in 1953 with the formation of the Family Planning Association of Pakistan. In 1960 the Second 5-Year Plan allocated 30.5 million rupees and attempted to provide services to 600,000 couples. The 1965 Plan attempted to reduce the crude birth rate from 50/1000 to 40/1000. 148.2 million rupees was allocated and indigenous midwives were incorporated into an autonomous 3-tiered administration with the district the main unit of operation. This program was the most successful, and the basic structure continues unchanged, with the addition of a "Continuous Motivation System" which has male-female teams assigned to local areas who contact clients and prospective clients. Population education has been introduced into school curricula. The 5th Plan hopes to deliver more services to rural areas. All MCH centers are involved in motivation, education, and providing contraceptives. Family planning clinics have been set up in established hospitals. Paramedical personnel man clinics in rural areas where services include family planning, MCH, and treatment of minor ailments. In 1978 the population of Pakistan was 75.6 million; the crude birth rate was 43.6, the death rate, 13.6. The sex ratio is 876 females to 1000 males. Approximately 19% of women are in the reproductive age group. The maternal mortality rate is 6.0/1000 females giving birth; the infant mortality rate is 115/1000 live births.