Preliminary results from a new national census — the first conducted since 1998 — show that the population has grown by 57 percent since then, reaching 207.7 million and making Pakistan the world’s fifth-most-populous country, surpassing Brazil and ranking behind China, India, the United States and Indonesia. The annual birth-rate, while gradually declining, is still alarmingly high. At 22 births per 1,000 people, it is on a par with Bolivia and Haiti, and among the highest outside Africa.
“The exploding population bomb has put the entire country’s future in jeopardy,” columnist Zahid Hussain wrote in Dawn newspaper. With 60 percent of the population younger than 30, nearly a third of Pakistan is living in poverty and only 58 percent literate, he added, “this is a disaster in the making.”
The chief causes of the continuing surge, according to population experts, include religious taboos, political timidity and public ignorance, especially in rural areas. Only a third of married Pakistani women use any form of birth control, and the only family-planning method sanctioned by most Islamic clerics is spacing births by breast-feeding new-borns for two years.
Even if the birth-rate slows, some experts estimate that Pakistan’s population could double again by mid-century, putting catastrophic pressures on water and sanitation systems, swamping health and education services, and leaving tens of millions of people jobless — prime recruits for criminal networks and violent Islamist groups.
But instead of encouraging fresh ideas to address the population crisis, the census has triggered a rash of arguments over whether certain areas have been over- or undercounted, or reclassified as urban instead of rural. These squabbles amount to fights over political and financial spoils, including the number of provincial assembly seats and the amount of funding from the central government.  
In village life, the influences of traditional culture and Islamic teachings are stronger, and the reach of public media campaigns about baby spacing is much more limited. 
Attempts to open rural family welfare offices are often met with community suspicion and political opposition, but health officials say more mothers are asking about birth control. The remaining major taboo, they said, is permanent contraceptive practices such as vasectomies or tubal ligations.
In Khyber Pakhtunkhwa province, the population nearly doubled, from 17.7 million in 1998 to 30.5 million this year. The province is home to several million Afghan refugees, numerous Islamist militant groups and conservative religious leaders suspicious of supposed foreign plots to sterilize Muslims.

(With thanks to Pamela Constable’s despatch in The Washington Post, Sept 9, 2017)