How investment in children shape fertility choices of families: Evidence from Pakistan.

Fertility patterns are transitioning globally in that couples are choosing to have fewer children as they become more affluent, and parents are investing more time and resources in the lives of their children than they can receive back. This change is more established in developed countries and is now being recognized in developing countries. We explored this phenomenon and its implications for family planning in Pakistan, hypothesizing a quantity-quality transition underway. We examine the correlation between increased investment in children's education and the use of family planning services among Pakistani families. We conducted a secondary analysis of publicly available data from the Pakistan Social and Living Standards Measurement (PSLM) survey and its complementary Household Integrated Economic surveys (HIES) for 2018-19 accessed through the Pakistan Bureau of Statistics (PBS) website. The study included married women of reproductive age (MWRA) aged between 15 to 49 years of age. The current use of different contraceptive methods by MWRA was the outcome variable, whereas the education expenditure per child, and mother-level, child-level, and household-level factors, as control variables. The study employed multinomial logistic regression to assess the correlation between contraceptive use and education expenditure per child while controlling for other variables using STATA (version 17.0, STATA Corporation, College Station, Texas, USA). Data from 24,024 MWRA and 56,128 children were analyzed. 7,584 (30%) households have no children while 1,658 (10%) don't send any child to school. All households that send children to school incur at least some education related expense. The rise in education spending outpaces rates of rise in household incomes, suggesting that education is procured as a luxury good. However, the rate of spending on education falls off from the third child onwards. After controlling for confounders, the odds of using contraceptives increases as education expenditure rise, from 1.172 [CI, 1.029,1.336] when they spend under PKR 2000 (USD 13) to 1.495 [CI, 1.327,1.683] if they spend more than PKR 13,000 (USD 84) annually on the education of a child, compared to no education expenditure at all. There is one exception in the case of households in the wealthiest quintiles located in rural areas, where FP use reduces. Our findings support the hypothesis of a quantity-quality transition in Pakistan, where increased wealth and educational investment in children are linked to reduced fertility and higher contraceptive use households. The use of FP increases from the poor to the richest wealth quintiles nationally and correlates with spending on the education of an older child. However, an important exception was observed among the wealthiest rural households, where family planning use decreases despite higher income levels. This suggests that affluent women, particularly in rural areas, may opt for larger families due to limited labor market opportunities or cultural preferences. We describe a major social change that reflects evolving values in families.