National Mdgs Orientation: For Parliamentary Task Forces

National MDGs Orientation
for Parliamentary Task Forces

2014
PAKISTAN INSTITUTE FOR

PARLIAMENTARY SERVICES
DEDICATED TO PARLIAMENTARY EXCELLENCE

“It is my belief that our salvation lies in following the golden rules of
conduct set for us by our great law-giver-the Prophet (Peace be upon
him) of Islam. Let us lay the foundation of our democracy on the basis of
true Islamic ideals and principles. Our Almighty Allah has taught us
that our decisions in the affairs of the State shall be guided by
discussions and consultations.”
(Speech at Shahi Darbar, Sibi, 14th February, 1948)
Foreword
Islamabad, May 22, 2014
I t gives me a great sense of satisfaction that Pakistan has embarked on strategising and
implementing its development agenda in line with the Millennium and Sustainable Development
Goals (MDGs and SDGs) with a distinct approach. The process adopted is institutionalised,
inclusive, and cohesive that is being spearheaded by the law makers across Pakistan. Spread over a
period of eleven months, the efforts have been increasingly relentless and collaborative, resulting in
the culmination of a historic national Conference on MDGs 2014, that will frame action plans and set
stage for informing and shaping the social, economic and political landscape of Pakistan.
June 2nd – 4th 2014, is indeed a great opportunity for us, legislators, to derive and own our social and
economic priorities in an institutionalised manner which will feed into a global post 2015
development agenda. This event intends to bring members of all the Provincial and Legislative
Assemblies together at national level to enhance their knowledge base on their role of oversight,
legislation and representation in the development paradigm of Pakistan.
Our journey on the road to MDGs since 2000 has been extremely challenging on account of natural
calamities, road blocks to democracy, and continuous deteriorating security scenarios. This has
derailed and distracted us from developing robust plans and from the implementation of social and
economic development agenda.
With an increased commitment of the democratically elected government to development, the time
is right for us to review and develop inclusive sustainable mechanisms that would help design, own
and commit the parliamentarians to jointly deliver a collective set of social and economic priorities
and enable us to break the cycle of perceived apathy at the international and national level.
The Conference will provide a platform on which, we parliamentarians, through discussions and
consultations with experts from within as well as from civil society and private sector be able to share
relevant knowledge, respective contexts and best practices, emerging parliamentary mechanisms,
and modern techniques in good governance as vital tools for providing enabling environment within
which the post 2015 development agenda can be formulated and achieved. This would also provide a
great bonding and networking opportunity to the participants. Let us, therefore, capitalize this
momentum and political goodwill to deliver the much needed relief for the citizenry of Pakistan.
I hope you will find the conference interesting, challenging, valuable and productive. I wish you a
comfortable stay in Islamabad.
Marriyum Aurengzeb. MNA

Convener National Task Force on MDGs
i
Acknowledgements
Islamabad, May 20, 2014
P arliament, defined in the simplest of terms, is the forum in which the elected representatives
of the people meet, plan, deliberate upon and review the government of the State and it
endeavours for perpetual emancipation of its citizens. Legislature accordingly makes laws and
provides guiding frameworks for the effective and efficient conduct of the State. Over time, the task of
government has become more complex as populations grew and maintenance of a sustainable
society with appropriate provision of food, shelter, health, education and a secure environment
became arduous.
The inaugural Millennium Summit 2000, held in New York by bringing together representation of 189
UN member states, announced a rights based global commitment, in the shape of Millennium
Development Goals (MDGs) to liberate people from the shackles of poverty through the reaffirmation
of the fundamental values of freedom, equality, solidarity, tolerance, and respect for the planet and
shared responsibility. The role of people's representatives in achieving the MDG agenda remains
decisive and imperative for Pakistan, which was envisioned as a pluralistic parliamentary democracy
based on the equality and social justice by its founding fathers.
Parliamentarians are committed to make laws for the benefit of the people; keep a vigilant oversight
over the executive to ensure the growth of a harmonious society and to make effective
representation of the constituents, highlighting the plight of the community. In this context the
incumbent Speaker of the National Assembly of Pakistan Honorable Sardar Ayaz Sadiq, MNA,
envisioned the setting up of a National MDGs Taskforce comprising members of not only the National
Parliament but all four provincial assemblies as well as the two legislative assemblies. It is a matter of
great satisfaction that the Honorable Chairman Senate Syed Nayyar Hussain Bokhari and Honorable
Speaker National Assembly Sardar Ayaz Sadiq as well as Honorable Speakers of provincial assemblies
of Balochistan, Khyber Pakhtunkhwa, Punjab and Sindh as well as legislative assemblies of Azad
Jammu and Kashmir and Gilgit Baltistan have fully endorsed the task forces.
We are pleased to share this handbook on NATIONAL MDGs ORIENTATION FOR PARLIAMENTARY TASK
FORCES 2014, at the inaugural orientation workshop on June 2‐4, 2014 at the Pakistan Institute for
Parliamentary Services. It extensively focuses on Pakistan's Social Reforms Agenda and country's
performance as well as international commitments in shape of the Millennium Development Goals.
The book is developed in the guidance of Honorable Ms Marriyum Aurangzeb, MNA and Chairperson
National Parliamentary MDGs' Taskforce. Its contents are based on infographics, factsheets as well as
excerpts from the Pakistan MDGs Report 2013 published by the Ministry of Planning, Development
and Reforms.
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Acknowledgements
The handbook will provide Members of the Parliament with essential insights regarding the concept
and plans of the MDGs in addition to apprising them of the progress made by Pakistan in this regard.
Most importantly it identifies the multiple roles of advocacy, oversight of executive and
representation of people's will, which the parliamentary taskforces are expected to perform. The
Parliamentary Taskforces at the National Parliament, four provincial assemblies and legislative
assemblies will:
i. Promote discussion through provincial assemblies debates and questions to obtain

information, raise awareness, to hold our governments to account and to draw attention to the
post 2015 debate
ii. Conduct committee hearings that investigate provincial priorities in greater depth and that give
opportunities to hear testimony from independent expert and civil society representatives.
iii. Convene constituency meetings and public fora to establish dialogue with members of the
public to inform them of the issues and ensure that their voices are heard.
iv. Engage with local and relevant authorities, civil society organisations, media and the private
sector by sharing information and supporting their participation in decision making.
v. Provide representation to all sectors of society by ensuring that citizens, different stakeholders
and civil society groups have a voice at the national level and are able to participate in the
decision making process.
vi. Influence the formulation of the new development goals by engaging with the inter-
governmental negotiations and policy discussion at provincial Level.
The bilingual handbook also includes briefs on each MDG in Urdu to ensure wider understanding
among civil society and public at large on the subject. Ms Marriyum Aurangzeb, Chairperson, National
MDGs Taskforce, is also keen to set up a National Secretariat for the MDGs Taskforce at the Parliament
House, Islamabad, which will provide guidance and an essential platform for this imperative social
reformation agenda in the future.
We are really grateful to the United National Development Program (UNDP) for their keen and
generous support in organizing the inaugural National MDGs Orientation for Parliamentary
Taskforces June 2014. We hope they will continue their committed zeal for all future endeavours in
this direction.
We welcome any feedback and suggestions by the participants and readers of the handbook at:
research@pips.org.pk
Wishing all readers and delegates of the National Orientation a happy reading and great success,
Pakistan Zindabad!
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Acknowledgements
National and International Partners of the Inaugural

National MDGs Orientation Workshop for Parliamentary Task Forces
Islamabad, June 2‐4, 2014
The Parliament of Pakistan and the National parliamentary task forces at the National Assembly,
Senate, provincial assemblies of Balochistan, Khyber Pakhtunkhwa, Punjab and Sindh as well as
legislative assemblies of Azad Jammu and Kashmir and Gilgit Baltistan acknowledge the generous
support of United Nations Development Programme in organising the inaugural National MDGs
Orientation Workshop 2014 at the Pakistan Institute for Parliamentary Services (PIPS). Our heartfelt
felicitations to the UNDP especially their Parliamentary Support Project, for their entire support in
making the conference a reality.
We also owe our thanks to all other partners who are conducting various thematic sessions, which
include Planning Commission, Ministry of Planning, Development and Reforms, Govt of Pakistan,
Economic Affairs Division, EAD, Ministry of Finance, Govt of Pakistan, Climate Change Division,
Pakistan Environmental Protection Agency, UNAIDs, UNICEF, ALIF AILAAN, World Wildlife Fund,
World Wildlife Fund, World Health Organisation (WHO) and the Water Supply and Sanitation
Collaborative Council (WSSCC).
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Contents
Introduction 1
MDG 1: Eradicate Extreme Hunger & Poverty 2
MDG 2: Achieve Universal Primary Education 5
MDG 3: Promote Gender Equality & Empower Women 8
MDG 4: Reduce Child Mortality 11
MDG 5: Improve Maternal Health 14
MDG 6: Combat HIV/AIDS, Malaria & Other Diseases 17
MDG 7: Ensure Environmental Sustainability 20
MDG 8: Develop a Global Partnership for Develo pment 24
Social Development in Pakistan: Gaps & Challenges 29
Millennium Acceleration Framework (MAF) 33
Gaps, Challenges & Lessons Learnt of MDGs 36
Post 2015 Development Agenda 37
Building Blocks for a Sustainable Development A g e n da 38
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Introduction
T he basic duty of the parliamentarians is to make laws for the benefit of the people; keep a
vigilant oversight over the executive to ensure the growth of a harmonious society and to
make effective representation of the constituents, highlighting the plight of the community.
The booklet deals extensively with the development of a Social Reforms Agenda, the international
commitments in shape of the Millennium Development Goals and the devolution of the related
sectors to the provinces.
Millennium Development Goals 2000-2015

The inaugural Millennium Summit held in New York announced a rights based global commitment,
which was the dawn of Millennium Development Goals. It brought together representation of 189 UN
member states in 2000 to liberate people from the shackles of poverty through the reaffirmation of
the fundamental values of freedom, equality, solidarity, tolerance, and respect for the planet and
shared responsibility.
The pledge resulted in the Millennium Development Goals (MDGs) Declaration which called for
eradication of extreme poverty and hunger, universal primary education, promoting gender
equality and women empowerment, reductions in child mortality, improvements in maternal
health, combat HIV/aids, malaria and other diseases, ensuring environmental sustainability
and developing a Global Partnership for development by 2015.
What were the Objectives?

Historically various countries, through different initiatives were pursuing their social
development agenda in silos. The MDGs provided an unprecedented common platform for
global dialogue on social development articulating clearly defined targets and key
measureable indicators using a baseline of 1990. The MDGs also helped to streamline and
channel development aid assistance in one bucket providing more transparency and clarity and
prioritizing the investments to various social development programmes.
Goal 1: Eradicate extreme poverty and hunger

Goal 2: Achieve universal primary education
Goal 3: Promote gender equality & empower women
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other diseases
Goal 7: Ensure environmental sustainability
1
MDG 1: Eradicate Extreme Hunger & Poverty
Introduction
Poverty is dynamic and multifaceted in its nature, and dependent upon a
host of factors including food price volatility, access to financial capital and
physical assets, employment opportunities, internal and external
economic shocks; level of literacy, health and access to other social
services, economic growth, if inclusive and equitable can lead to poverty
reduction.
MDG 1 aims to halve the proportion of people living under the poverty line
by 2015, and ensure full and decent employment for all, and halve the
proportion of people suffering from hunger. Progress is measured against
three indicators: proportion of population below the calorie based food
plus non‐ food poverty line; prevalence of underweight children under 5
years of age; and proportion of population below minimum level of dietary
energy consumption.
Targets Indicators
Target 1A 1.1 Proportion of population below $1 (1993 PPP) per day
Halve, between 1990 and (World Bank)
2015, the proportion of people 1.2 Poverty gap ratio [incidence x depth of poverty]
whose income is less than $1 (World Bank)
a day 1.3 Share of poorest quintile in national consumption
(World Bank)
Target 1B 1.4 Growth rate of GDP per person employed (ILO)
Achieve full and productive 1.5 Employment-to-population ratio (ILO)
employment and decent work 1.6 Proportion of employed people living below $1 (PPP)
for all, including women and per day (ILO)
young people
1.7 Proportion of own-account and contributing family
workers in total employment (ILO)
Target 1.C 1.8 Prevalence of underweight children under five year
Halve, between 1990 and of age (UNICEF-WHO)
2015, the proportion of people 1.9 Proportion of population below minimum level of
who suffer from hunger dietary energy consumption (FAO)
2
Where We Stand
Under MDG1, Pakistan aims to halve by 2015, the proportion of people living below the national
poverty line, achieve full and productive employment and decent work for all, and halve the
proportion of people who suffer from hunger. There has been a persistent downward trend in poverty
incidence over the past decade ‐ the percentage of population below the poverty line fell from 34.5
percent in 2001/02 to 12.4 percent in 2010/11 and Pakistan is on track to achieve the MDG target with
regard to poverty. Factors contributing to the drop include increased allocations to the poor under the
Benazir Income Support Program; those contributing to poverty include natural and manmade
disasters, despite slow economic growth, the global recession and higher food inflation. Pakistan's
unemployment to population ratio increased from 27.1 percent in 2001/02 to 30.9 percent in
2010/11, making the prospect of full employment by 2015 highly unlikely. Malnutrition, measured as
prevalence of underweight children under‐5 years of age, decreased slightly from 40 percent in
1990/91 to 31.5 percent in 2011/12, but is still far off the MDG target of less than 20 percent. With two
out of three targets off‐track, the country is unlikely to achieve MDG 1.
Status of Indicators – MDG 1
3
Initiatives in the Right Direction

Major policy documents like the PRSPs had a significant focus on poverty, with Goal 1 in perspective.
Enhanced allocations for the social sectors, recognizing the need for a comprehensive social safety
nets framework to protect the poor and vulnerable, focus on the rural economy, water resource
availability and health and social services, all reflected the level of influence of the MDGs on the MTDF
and Vision 2030.
At the policy level, the National Social Protection Strategy (2007) more specifically addressed key
targets of Goal 1 such as food insecurity and investment in human and physical assets. At the program
level the government aligned its existing social safety net programs, i.e. the Zakat program (1980) and
Pakistan Bait‐Ul‐Mal (1992), with the adapted indicators. The Food Support Program (2002) was
another success story whereby Rs. 2,000 per year were extended to around 1.25 million poor families
in two biannual installments of Rs. 1,000 through country‐wide post offices; with rising levels of need
the subsidy amount was increased.
The Khushhal Pakistan Programme (KPP) generated economic activity through public works and
temporary employment covering 17 sectors implemented by the district governments.
Implementation of income generation projects relating to roads, water supply and sanitation
improved people's quality of life.
Similarly the Pakistan Poverty Alleviation Fund (PPAF) was set up in 2000 with a view to enhance
access of low‐income communities to government socioeconomic services. The Benazir Income
Support Program (2010) targeted the poor through unconditional cash transfers. Various initiatives at
provincial level such as the Sasti Roti (affordable bread) scheme in Punjab and the Bacha Khan Rozgar
Scheme are a clear reflection of the MDGs influence at the programme level.
4
MDG 2: Achieve Universal Primary Education
Introduction
It is now widely accepted that development of human capital, notably
education and skills, is critical to a country achieving growth and prosperity
and improving human development outcomes.
MDG 2 aims endeavors to increase access to primary education and

achieve universal primary education (UPE) in the country by 2015.
Progress is measured through tracking three indicators: primary
enrolment rate, completion rate (grades1‐5) and adult literacy rate.
Under Article 25a of the constitution of Pakistan two significant provisions

impacting education have been introduced. One, education has been
made a basic human right for every citizen of the state. Two, it is now the
state's responsibility to “provide free and compulsory education to all
children of the age of five to sixteen years”. The 18th Amendment also
provided for extensive devolution of functions to provincial governments
including the subject of education.
Targets Indicators
Target 2.A 2.1 Net enrolment ratio in primary education
Ensure that, by 2015, children (UNESCO)
everywhere, boys and girls alike, will be 2.2 Proportion of pupils starting grade 1 who
able to complete a full course of primary reach grade of primary (UNESCO)
schooling 2.3 Literacy rate of 15-24 year-olds, women
and men (UNESCO)
5
Where We Stand
The MDG2 for Pakistan targets 100 percent primary school enrolment, 100 percent completion of
education from grades 1‐5 and an 88 percent literacy rate. Rates of net primary enrolment and
completion increased up to the mid‐2000s but thereafter slowed and fluctuated, and in 2011/12
were 57 percent and 50 percent respectively. The literacy rate is 58 percent overall, but this is highly
skewed towards males – 70 percent of males are literate compared to 47 percent of females. Pakistan
is thus off‐track on all three targets, and therefore not likely to achieve MDG 2.
6

The common factor in Goals 2 and 3 is ensuring primary education for both boys and girls, with a focus
on girls' education. Goals 2 and 3 respectively address secondary education, adult literacy and youth,
women empowerment and employment. Benchmarks for Goal 2 include Net Enrolment Ratio (NER),
completion/survival rate (grade 1 to 5) and the literacy rate.
In aligning with MDG 2 of achieving universal primary education, the interim and first PRSPs took
major initiatives to address primary enrolment, dropout and literacy rates, with enhanced focus on
resource management capacity of the government. The provision of free books, waiver of school fees,
and scholarships to girls significantly improved girls' enrolment. Financing new and existing programs
for adult literacy continued nationwide to achieve the MDG indicators.
The National Education Policies (1998) and (2009) are the two main policy documents advocating the
cause and spirit of the MDGs. These emphasized the removal of urban, rural and gender imbalances
specifically addressing the issue of out of school children and expansion of non‐formal education to
complement the formal system, and suggested initiatives such as functional literacy programs for
adults, curriculum reform, strengthening education facilities, encouraging private sector
participation and effective community involvement. Issues like lack of basic facilities in schools for
equal access to education for underprivileged/marginalized groups, were focused on to increase
enrolment and improve retention and completion rates.
A number of programs were initiated in line with the targets set by the MDGs. The combination of the
Education Sector Reforms Programmes (ESR) and the National Plan of Action of Education for All (EFA)
was an important step. The entire focus was on universal primary education, reducing illiteracy, and
eliminating gender disparities in primary and secondary education partly funded by various
international development partners. Two additional programs in support of MDG 2and 3 were
launched at provincial level, namely National Education Assessment System (NEAS) and Education
Sector Reform Assistance (ESRA) to ensure the achievement of targets. Other noteworthy programs
included the National Literacy Program addressing the learning and education needs of out‐of‐school
children, young people and adults; and the Tawana Pakistan Programme focused on poor nutritional
status and school enrolment of primary school age girls.
The Jafakash Aurat (Hardworking Women), Education Sector Reforms and Child Friendly Schools (CFS)
in Punjab were other noteworthy interventions. The Gender Based Governance Systems (GBG)
project in Khyber Pakhtunkhwa supported by UNDP, SDC and the Early Childhood Education and Early
Learning Education Program in Sindh are other important initiatives at provincial level. The
Government of Balochistan also initiated various programs for improvement of education and
women empowerment.
7
MDG 3: Promote Gender Equality & Empower Women
Introduction
Gender parity is at the core of the MDGs. At the onset of the MDGs, it was
clearly realized that gender equality is not only a fundamental right, but an
enabler for all development outcomes.
MDG 3 focuses upon the key challenges faced by women in three major
areas: education, employment and political participation. Female
education not only results in a large segment of society (women) having
access to labour opportunities and higher wages, it also directly affects
their children, who end up attaining higher education levels. Moreover,
female education directly reduces mortality rates, and thus impacts
beyond the scope of this MDG alone.
Wage employment is also an important indicator of women's economic

empowerment. Similarly, adequate representation of women in legislative
forums ensures that the country's policies, programmes and legislations
reflect the priorities of the fifty percent of the population comprising
females.
MDG3 progress is measured against five indicators: gender parity index
(ratio of females to males enrolled) in schools at primary level, GPI at
secondary level, and GPI for youth literacy (ratio of literate 15‐24 year old
women to men of the same age bracket), and share of women in non‐
agricultural wage employment, and proportion of women holding seats in
the National Parliament. Targets have been set for the first four indicators.
Targets Indicators
Target 3.A 3.1 Ratio of girls to boys in primary,
Eliminate gender disparity in primary and secondary and tertiary education (UNESCO)
secondary education, preferably by 2005, 3.2 Share of women in wage employment in
and in all levels of education no later the non-agricultural sector (ILO)
than 2015
3.3 Proportion of seats held by women in
national parliament (IPU)
8
Where We Stand
MDG3 aims to eliminate gender disparity in primary and secondary education by 2005, and in all
levels of education by 2015. Gender parity in education has improved –for primary education,
secondary education and youth literacy, but still falls short of the MDG targets set for 2015. Punjab,
with its higher base, remains the leader in education indicators, but inter‐provincial disparities
between Punjab, Sindh and Khyber Pakhtunkhwa have narrowed; Balochistan is the exception – it
improved but still lags behind the others. The share of women in non‐agriculture wage employment is
10.45 percent in 2010/11, still short of the 14 percent target. Again, Punjab at 13.25 percent is very
close to the MDG target; by contrast, Balochistan's figure of 2.32 percent in 2010/11 is extremely low.
There has been considerable progress on increasing women's representation in legislative bodies.
Overall, with all four indicators (with set targets) of this goal off‐track, Pakistan is unlikely to meet
MDG 3.
9

The common factor in Goals 2 and 3 is ensuring primary education for both boys and girls, with a focus
on girls' education. Goals 2 and 3 respectively address secondary education, adult literacy and youth,
women empowerment and employment. Benchmarks for Goal 2 include Net Enrolment Ratio (NER),
completion/survival rate (grade 1 to 5) and the literacy rate.
There was a strong commitment to enhance employment opportunities for young women, through
investment in innovative programs and harnessing support from private and non‐governmental
sectors. In parallel the MTDF included strategies to reduce gender gaps in enrolment and retention by
providing financial and nutritional incentives to girl students, especially in rural areas. Mechanisms
like employment quotas, micro credit and low interest credit for women entrepreneurs were
introduced as important tools for economic empowerment of women. Vision 2030 clearly reflected
its commitment to the set targets with a focus to reduce gender gaps in terms of access to education
and employment.
Specific policies addressing empowerment of women were formulated in line with international
commitments and MDGs. The National Commission on the Status of Women (2000) and the National
Policy for the Development and Empowerment of Women (2002) were key steps to ensure a gender
sensitive approach to development planning and implementation. Similarly the Labour Policy 2002
and Labour Protection Policy 2006 renewed the government's commitment to reduce gender
disparities in wages and promote equal employment opportunities. The Gender Reforms Action Plan
(GRAP) 2005 was constituted at the national and sub‐national levels. This plan worked on
engendering planning and budgetary processes, restructuring the national machinery dealing with
gender issues, and facilitating the requisite policy shifts.
A number of other programs including the National Programme for Women's Political Participation
(2002) and Gender Mainstreaming in Planning and Development Project (2004‐2007) were initiated
to promote women's full and equal participation at all levels of governance, formulation,
implementation, and monitoring and evaluation of government policies, plans, programs and
projects. Two noteworthy legal initiatives in line with MDG targets included the Protection of Women
Act 2006 and the Reproductive Healthcare and Rights Bill 2009.
The Jafakash Aurat (Hardworking Women), Education Sector Reforms and Child Friendly Schools (CFS)
in Punjab were other noteworthy interventions. The Gender Based Governance Systems (GBG)
project in Khyber Pakhtunkhwa supported by UNDP, SDC and the Early Childhood Education and Early
Learning Education Program in Sindh are other important initiatives at provincial level. The
Government of Balochistan also initiated various programs for improvement of education and
women empowerment.
10
MDG 4: Reduce Child Mortality
Introduction
The international target for reducing child mortality is to reduce by two‐
thirds, the under‐five mortality rate (U5MR) between 1990 and 2015.
There are a number of cross‐cutting issues which accentuate and
aggravate child health and mortality. For instance, poor health and
sanitation facilities lead to high rates of diarrhea, which is one of the
leading causes of child mortality. Similarly, education of the mother and
availability of basic health facilities have a positive impact on reducing child
mortality. The inter‐dependency of this indicator with MDGs 3 and 5
suggest that multi‐sectoral government interventions will positively
impact this indicator. After 18th Constitutional Amendment, functional
and administrative responsibilities in relation to the social sectors,
including health, have been devolved to provincial level since 2011. The
increase in responsibilities of the provinces has led to new challenges as
well as opportunities for health and other MDGs. To capitalize on the
devolved responsibilities, the provinces will need to improve the overall
governance structure, increase resource allocations for health, human
resource development especially Lady Health Workers (LHW) as well as to
ensure equity, quality and efficiency in health care services.
Progress on MDG 4 is measured against six indicators: under‐five child

mortality rate; infant mortality rate; proportion of children 12‐23 months
fully immunized; proportion of children under one year of age immunized
against measles; proportion of children under five years of age suffering
from diarrhea in previous 30 days; and Lady Health Worker coverage.
Targets Indicators
Target 4.A 4.1 Under-five mortality rate
Reduce by two-thirds, 4.2 Infant mortality rate
between 1990 and 2015, the
under-five mortality rate 4.3 Proportion of 1 year-old children immunised against
measles
Where We Stand
Pakistan has set itself the objective of reducing the under‐five child mortality (U5MR) by two‐thirds.
The country has shown slow and gradual progress on all the indicators related to this MDG. Under‐five
morality fell from 117 deaths in 1990/91 to 89 deaths per 1,000 live births in 2012/13; and the infant
mortality rate in this period from 102 to 74 deaths per 1,000 live births. However, both are still short of
the MDG targets of 52 deaths per 1,000 live births for under‐five mortality, and 40 deaths per 1,000
live births for infant mortality. The coverage for fully immunized children increased from 75 to 80
percent and of measles immunization from 80 to 81 percent in this period; both are still short of the
target of above 90 percent coverage.
11
Pakistan was able to achieve the MDG target (less than 10 percent) for reducing the proportion of
children under five who suffered from diarrhea in the last thirty days; it fell from 26 to 8 percent. Lady
health worker coverage stood at 83 percent in 2008/09 against the target of 100 percent. Progress on
health indicators has been affected by a number of internal and external factors and therefore despite
the gains, Pakistan is off‐track on five out of six indicators and hence unlikely to attain MDG 4.
12

The Lady Health Worker (LHW) Programme was launched in 1994 and is also known as the National
Programme for Family Planning and Primary Health Care. The LHWs have a number of roles that
include identifying pregnant women, providing them with multi‐vitamin supplements, referring
them to antenatal care services at the Basic Health Units (BHUs), and basic functions of providing
family planning advice and basic health care. The LHWs visit homes, interact freely with married
female members, thus helping overcome women's lack of education and mobility. The number of
LHWs in the field increased from 95,000 in 2008 to almost 100,000 in 2011.
Given their coverage and outreach, the LHWs are also utilized by the government for other
programmes, e.g. polio campaigns, tuberculosis treatment initiatives. There is lack of data of the
progress of the programme after the 18th Amendment and devolution of the federal Health Ministry
to the provinces. The latest data at federal level for 2008/09 estimates the share of the target
population covered by LHWs to be 83 percent, progressively increasing from 38 percent in 2001/02.
Sparse and patchy provincial time series data show that the coverage of target populations by LHWs at
provincial level has remained between 28 ‐ 58 percent. Given that health is now a provincial subject,
strong financial and administrative commitment is needed from provinces to reach the target of 100
percent coverage in a short period of three years.
13
MDG 5: Improve Maternal Health
Introduction
Millennium Development Goal 5 aims to substantially decrease maternal
mortality rates by 2015. Maternal mortality is affected by numerous
factors, notably access to pre and post‐natal care, as well as general access
to health care services, and access to family planning and services. The
government's National Maternal, Neonatal and Child Health Programme
(NMNCH), initiated in 2006, is based on the 3‐delays model (of Thaddeus
and Maine). This states that successful maternal and child emergency
interventions depend on an effective referral process that enables
movement of patients to an appropriate facility and/or from one level of
care to the next with speed and agility, resulting in adequate treatment
being provided in a timely manner. Progress on MDG 5 is measured against
five indicators: MMR, proportion of births attended by skilled birth
attendants (SBAs), contraceptive prevalence rate, total fertility rate, and
proportion of women aged 15‐49 years who gave birth in the last three
years who had at least one antenatal consultation.
Targets Indicators
Target 5.A 5.1 Maternal mortality ratio
Reduce by three quarters, between 5.2 Proportion of births attended by skilled health
1990 and 2015, the maternal personnel
mortality ratio
Target 5.B 5.3 Contraceptive prevalence rate
Achieve, by 2015, universal access to 5.4 Adolescent birth rate
reproductive health 5.5 Antenatal care coverage (at least one visit and
at least four visits)
5.6 Unmet need for family planning
14
Where We Stand
By 2015, Pakistan intends to reduce the maternal mortality rate (MMR) by three‐quarters and ensure
universal access to reproductive health. Over the past decade or so, a renewed focus on providing
timely and efficient health care options to women of child‐bearing age is apparent. Pakistan has
shown considerable yet insufficient progress for achieving the targets set for 2015: MMR has been
almost halved (down to 276 per 100,000 births in 2006/07), contraceptive usage has almost tripled
(up to 35.4 percent), proportion of births attended by skilled birth attendants (SBAs) have more than
doubled (up to52.1 percent), and antenatal consultations have more than quadrupled (up to 68
percent) since 1990/91.The total fertility rate at 3.8 remains considerably higher than the target of
2.1. Overall, Pakistan is off track on all indicators and therefore unlikely to achieve MDG 5.
15

Antenatal services are of particular concern as they not only represent women's access to proper
health provision but timely consultations with specialists can ensure that any complications in the
process of childbirth are identified and proper referrals made in an effective manner. Thus, prenatal
visits to doctors impact MMR and IMR, as well as the general health of the mother and child. Coverage
of the LHW programme increased during the period, and is currently around 83 percent as noted
under MDG 4. The LHW programme is particularly beneficial in downtrodden rural areas where it
provides an accessible means of support to women who might not otherwise have been able to get
even rudimentary checks.
The national figure was 15 percent in 1990/91, which increased to 35 percent in 2001/02. It further
increased to 50 percent in 2004/05. Progress on this indicator then slowed, reaching 58 percent in
2008/09. It picked up momentum again in 2011/12 to reach 68 percent. If this can be sustained,
Pakistan could come very close to the target of 100 percent for 2015.
16
MDG 6: Combat HIV/AIDS, Malaria & Other Diseases
Introduction
Millennium Development Goal 6 pertains to the control and eventual
elimination of three debilitating, communicable and life‐threatening
diseases, HIV/AIDS, tuberculosis and malaria. For Pakistan, HIV prevalence
is largely in control, insofar as its spread is limited to specific vulnerable
groups of society like sex workers, drug users etc.
Pakistan remains particularly vulnerable to viral, in particular water borne

infections such as dengue, and in relation to this MDG, malaria. Similarly,
Hepatitis B & C are endemic, as is tuberculosis, a disease which has almost
been eradicated in the developed world. However, TB continues to affect a
significant proportion of the population, and its communicability gives it
more scope to afflict large numbers of people unless it is completely
eliminated.
Progress on MDG 6 is measured against five indicators: HIV prevalence

among pregnant women aged 15‐29 years, and among vulnerable groups;
proportion of population in malaria risk areas using effective prevention
and treatment measures; incidence of TB; and TB cases detected and cured
under DOTS.
Targets Indicators
Target 6.A 6.1 HIV prevalence among population aged 15-24
Have halted by 2015 and begun to years
reverse the spread of HIV/AIDS 6.2 Condom use at last high-risk sex
6.3 Proportion of population aged 15-24 years with

comprehensive correct knowledge of HIV/AIDS
6.4 Ratio of school attendance of orphans to school
attendance of non-orphans aged 10-14 years
Target 6.B 6.5 Proportion of population with advanced HIV
Achieve, by 2010, universal access to infection with access to antiretroviral drugs
treatment for HIV/AIDS for all those
who need it
Target 6.C 6.6 Incidence and death rates associated with
Have halted by 2015 and begun to malaria
reverse the incidence of malaria and 6.7 Proportion of children under 5 sleeping under
other major diseases insecticide-treated bednets
6.8 Proportion of children under 5 with fever who are
treated with appropriate anti-malarial drugs
6.9 Incidence, prevalence and death rates associated
with tuberculosis
6.10 Proportion of tuberculosis cases detected and
cured under directly observed treatment short course
17
Where We Stand
MDG 6 strives to reverse the spread of HIV/AIDS and the incidence of malaria and other major diseases. Most of
the indicators show positive trends, particularly in the case of HIV prevalence among pregnant women, and
detection and provision of healthcare for TB patients. The latter has been achieved and the former is likely to
be. This can be attributed to swift and focused action on the part of the government, particularly in the case of
TB. However, the year on year growth of overall TB cases (up to 230 cases/10,000 population cf. target of
45/10,000) represents one of the worst faring indicators for Pakistan in all the MDGs. HIV/AIDS trends among
vulnerable groups are also alarming. The proportion of people in malaria risk areas using effective prevention
and treatment measures remains low (75 percent against the target of 40 percent). Pakistan is off‐track on
three out of five indicators and therefore unlikely to achieve MDG 6.
18

Analysis of national trends indicates a positive trend in terms of the proportion of population
employing preventive measures and treatment against Malaria. In 2001/02, this was 20 percent,
increasing to 30 percent in 2004/05 but then reversed to 25 percent in 2005/07. But given the 2015
target of 75 percent for this indicator, it is unlikely that this will be met at the current slow pace of
growth.
Direct Observation Treatment Short Course (DOTS) is one of the core strategies adopted to reduce TB.
It has five basic elements: political commitment, case detection, standardized treatment, effective
drug supply system and monitoring and evaluation system. Starting with 79 percent in 2001/02,
Pakistan achieved the 2015 target of 85 percent in 2005/06 for detecting the proportion of cases
under Direct Observation Treatment Short Course (DOTS). By 2009/10, it had attained 91 percent
detection, and thus surpassed the MDG target set for this indicator.
19
MDG 7: Ensure Environmental Sustainability
Introduction
The environmental strains faced by Pakistan over the last decades have
become a major challenge for its citizens and economy.
Climate change is a grave threat to gains made in poverty reduction and

development. While climate change is a global phenomenon, its impact is
felt more severely by the developing world due to their greater
vulnerabilities and lesser capacity to manage the effects of climate change,
and similarly, within society, by marginal and vulnerable groups including
women and children. Pakistan's emissions of greenhouse gases (GHGs) are
much lower than those of the rest of the world. Environmental
degradation along with poor home hygiene, lack of basic sanitation and
unsafe drinking water has a huge impact on the health of the population,
particularly children under five. The estimated cost to the economy due to
poor sanitation and access to clean drinking water is Rs. 112 billion or 1.81
percent of the GDP, while that due to environmental and resource related
damage is Rs. 365 billion per year or 6 percent of GDP. The total health costs
are estimated at Rs. 62‐65 billion which is equivalent to 1 percent of GDP.
Targets Indicators
Target 7.A 7.1 Proportion of land area covered by forest
Integrate the principles of sustainable (FAO)
development into country policies and 7.2 Carbon dioxide emissions per capita and per
programmes and reverse the loss of $1 GDP (PPP) (UNFCCC, UNSD)
environmental resources 7.3 Consumption of ozone-depleting substances
7.4 Proportion of fish stocks within safe biological
limits
7.5 Proportion of total water resources used
Target 7.B 7.6 Proportion of terrestrial and marine areas
Reduce biodiversity loss, achieving, by protected
2010, a significant reduction in the rate of 7.7 Proportion of species threatened with
loss extinction
Target 7.C 7.8 Proportion of population using an improved
Halve, by 2015, the proportion of people drinking water source (UNICEF-WHO)
without sustainable access to safe drinking 7.9 Proportion of population using an improved
water and basic sanitation sanitation facility (UNICEF-WHO)
Target 7.D 7.10 Proportion of urban population living in slums
By 2020, to have achieved a significant (UN-HABITAT)
improvement in the lives of at least 100
million slum dwellers
20
Where We Stand
MDG 7 aims to promote sustainable development, and has the target of halving the proportion of
people without sustainable access to safe drinking water and basic sanitation, and bringing about a
significant improvement in the lives of slum dwellers. Of the seven MDG 7 indicators, Pakistan is on
track to achieve four: protecting areas for wildlife conservation (11.6 percent against the target of 12
percent), reducing sulphur content in high speed diesel, improving GDP per unit energy (measure of
energy efficiency) and improving access to safe drinking water (89 percent against the target of 93
percent). However, it is lagging on access to sanitation; currently72 percent of the populations have
access to this facility against a target of 90 percent. Pakistan has also made progress on increasing
forest cover – currently 5.2 percent – but is still short of the 6 percent target. Overall, with four out of
seven indicators on track, Pakistan is likely to achieve MDG 7 with continued efforts; this is the only
goal to be attained where the majority of indicators are on‐track.
21
22

Environmental sustainability was initially addressed by the interim‐PRSP through the National
Conservation Strategy (NCS) within which the National Environment Action Plan (NEAP) was also
approved. This helped the government develop provincial capacity for implementing environmental
protection laws. The MTDF framework was prepared with the long‐term objective of attaining
sustainable economic growth without environmental degradation. It identified the country's specific
priorities and addressed them within the framework of comprehensive national strategies, the
Johannesburg Plan of Implementation and the Water, Energy, Health, Agriculture and Biodiversity
Frameworks. Vision 2030 for environmental conservation and management aims at equitable sharing
of environmental benefits, increased community management of national resources, and integration
of environmental issues into socio‐economic planning to achieve sustainable development.
Many of the policies in the environment sector address MDG targets such as water, sanitation, forests
and climate change. The key points of the National Environment Policy 2005 aligned with the MDGs
include: effective management of resources and sustainable development; conservation of the
country's water resources; sustainable management of natural forests; and effective management of
protected areas. The National Sanitation Policy 2006, National Forest Policy 2010 and National
Drinking Water Policy 2009 adequately cover the targets of MDG 7. These include adequate
sanitation coverage and integration of sanitation programs with planning policies through innovative
actions such as the use of component sharing model and incentives; monitoring by the environment
protection agencies; capacity building and awareness of officials and communities. These policies
also cover the conservation of surface and groundwater resources, use of appropriate technologies
and standardization, community participation, and public awareness and the sustainable
management of forests and allied natural resources. In addition, the National Climate Change Policy
2012 addresses challenges of climate change by integration with the other inter‐related
aforementioned national policies.
Noteworthy programs under this goal include: the National Environmental Information Management
System (NEIMS) 2005; Clean Drinking Water for All (CDWA) Programs (2005); Community Led and
School‐Led Total Sanitation (CLTS) Programs. The provinces mainly follow the national policies,
however a few province‐specific examples include: the Punjab Clean Drinking Water Policy;
establishment of the Sindh Environmental and Alternate Energy Department; the Khyber
Pakhtunkhwa Sanitation and Drinking Water Supply Policy/Strategy; and the Balochistan
Environment, Sports and Youth Affairs Department.
23
MDG 8: Develop a Global Partnership for Development
Introduction
In framing of the MDGs in the late nineties, it was recognized that any effort
to achieve the MDGs by developing countries ‐ and specifically by the least
developed countries ‐ would be difficult if not impossible without the
partnership and support of more well‐off nations. 'Partnership for
development' was defined in a holistic manner to include financial,
technical and capacity support along with frameworks to foster
multilateral, bilateral and regional north‐south trade.
The linkages between specific MDGs and strengthened global partnership

include: a) MDG1 for poverty reduction is intimately linked with enhancing
growth and employment opportunities and thus with provision of market
access and fair trade regimes; b) Meeting the targets of MDGs 2‐6 requires
increased diversion of resources to social sectors. Efforts at additional
domestic resource mobilization and creation of fiscal space through debt
reduction can help ensure this. Greater flow of ODA can also boost
investment in social capital to attain the above five MDGs; c) In many
countries where resources are not the binding constraint, cooperation in
capacity building at institutional and administrative level, specifically
through use of ICT, in the services sector will speed up the attainment of
MDGs.
The inclusion of MDG 8 in the UN Agenda is a reflection of the commitment

and contribution of developed nations towards the MDGs in the shape of
increased market access, official development assistance (ODA) and
transfer of technology. Developing countries commitment to achieve
sustainable debt ratios is a derivative of commitments made by the
developed world.
Where We Stand
MDG 8 represents the collaborative efforts and commitments of the developing and developed
countries to foster multilateral, bilateral and regional north‐south trade. Under this MDG the
developed countries have committed financial, technical and capacity development support. For
Pakistan, efforts to improve market access regionally and globally achieved mixed results: there was an
impasse in the Doha Round of WTO negotiations, bilateral trade with India strengthened but remains
hampered by security concerns and mistrust; Pakistan did secure preferential trade agreements with a
number of key partners (e.g. Malaysia, Iran, China, Sri Lanka). The trend in average tariffs imposed by
developed markets upon developing markets imports, as one indicator of market access, are
comparatively high for Pakistan ‐ 8 percent compared to 6 percent for developing market economies.
Debt sustainability indicators have shown improvement since their highs in 2001. ODA forms an
important component in the realization of MDG 8.Aid as a percentage of Pakistan's GNI has mostly
remained in the range of 0.9‐1.7 percent since 2001. In absolute terms, aid per capita fluctuated
between US$ 5‐20 and total ODA between US$ 732 million to US$ 3.5 billion during this period.
24

Official Development Assistance
Official Development Assistance (ODA) is an indicator of total monetary and non‐monetary assistance
provided to developing and least developed countries, and includes both standard loans as well as
proportioned grants. The actual performance of Development Assistance Committee (DAC) countries
in disbursing ODA has fallen short of the above commitments. In 2011, the DAC countries had
disbursed US$ 133.5 billion, equivalent to 0.31 percent of their combined GNI. US$3.2 billion has
been received by Pakistan from the US under the Kerry Lugar Bill since 2009, of which US$ 2.1 billion
was disbursed as bilateral civilian assistance, whilst the remaining US$ 1.06 billion was provided
under the Emergency Flood Response.
Table below gives the trend for three indicators for ODA received by Pakistan from 2000 to 2011. Aid
as a percentage of Pakistan's GNI has remained in the range of 0.9 to 1.7 percent for most of the
period except for the years 2001 and 2002, when it exceeded 2 percent ‐ the result of support from
western countries for Pakistan's participation in the war against extremism. In absolute terms, aid per
capita fluctuated between US$ 5‐20 and total ODA between US$ 732 million to US$ 3.5 billion during
the period. The peaks in cyclical fluctuations in absolute amount of ODA reflect the periods when
Pakistan was under a structural/standby agreement with multilateral donors.
The following factors can largely explain the reasons for the fluctuating ODA to Pakistan and
consequent low financing of MDGs. Although an ally in the war against extremism, Iraq and
Afghanistan competed with Pakistan for ODA and thus ‐ from a geopolitical perspective ‐ it remained a
low priority. Commitments made to Pakistan in various forums were not honored, for example
commitments following the 2005 Earthquake and those made under “Friends of Democratic
Pakistan”. Thirdly, the momentum for ODA for MDGs weakened with the onset of the global financial
crisis affecting developed countries from 2008 onwards.
25
Official Development Assistance (ODA) Indicators for Pakistan
Year Aid (%) of Pakistan’s GNI Aid per Capita (Current US$) ODA (Million US$)
2000 1.24 5.4 732

2001 2.7 13 1942
2002 2.9 14 2105
2003 1.2 7 1072
2004 1.4 9 1439
2005 1.4 10 1614
2006 1.7 14 2180
2007 1.6 14 2269
2008 0.9 9 1549
2009 1.7 16 2769
2010 1.6 17 3013
2011 1.6 20 3508
Source: World Development Indicators
Pakistan received a total of US$ 16,605 million as ODA between 2000/01 and April 2013, with the
largest share (US$ 8,016 million) coming from the International Development Association (IDA).
Market Access
Access to the global trade markets is essential to the economic viability of any country, and
particularly so for a struggling economy. With the global economic crunch persisting, Pakistan's
primary export markets shrank by about 4.8 percent in 2009‐2010. In Pakistan almost all tariffs (99.4
percent) are ad valorem (levying of tax or customs duties in proportion to the estimated value of the
goods or transaction concerned) and peak ad valorem rates have dropped from 250 percent to 90
percent. 128 Pakistan's economic strategy is to strengthen economic ties with its key allies and
economic partners, as well as push for access to markets at various international trade forums and
consortiums.
Market Access Indicators

Owing to a collaborative effort between ITC, UNCTAD and WTO, two indicators are selected to
compare market access among developing countries. Under MDG 8, the indicator that refer to share
of imports by developed market economies from Pakistan (developing market economies and LDCs),
remained in the low 20s (see Figure 32). At its peak this reached 58 in 2003, but this was still much less
than that of developing market economies, whose share increased to 70.
26
A Comparison of Tariff
Under MDG 8, the indicator that refers to average tariffs imposed by developed markets upon less
developed market's imports, Pakistan was subjected to higher tariffs in comparison to other
developing markets. It is evident from these indicators that market access is an issue that is
constraining Pakistan's economic standing as a global partner, and in particular, leads to slower
economic growth in comparison to similar developing economies.
External Debt Sustainability
Debt sustainability is an important measure of a country's ability to service its debt, as well as to
assess its capacity to pay the principal amount of debt, and its potential to incur more debt for its
development needs. A number of comparative ratios are calculated that indicate if debts accrued by
the country are sustainable.
Indicators for External Debt Sustainability

(In million Rupees)
(In Percent) 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
EDL/FER 11.5 5.8 3.3 3.0 2.7 2.9 3.0 4.0 4.2 3.7 3.6 4.3
EDL/GDP 52.1 50.9 43.1 36.7 32.7 29.4 28.3 28.1 32.3 34.9 31.5 28.5
EDL/FEE 2.6 2.4 1.8 1.6 1.3 1.2 1.2 1.2 1.5 1.6 1.4 1.4
DS/FEE N/A N/A N/A N/A N/A 13.2 12.6 11.8 18.0 16.6 11.4 12.7
DS/XGS 32.7 36.7 22.8 32.5 11.1 10.0 9.2 8.6 13.2 12.2 n/a n/a
Source: Pakistan Economic Survey, Various Issues; SBP Annual Reports
27
Indebtedness can be gauged by the External Debt and Liabilities to GDP (EDL/GDP) ratio, which
assesses a country's net economic productivity in comparison to the loans accrued. Pakistan's
EDL/GDP ratio decreased from 52.1 percent in 2001 to 28.5 percent in 2012. The IMF has recently
approved a financial assistance package to the tune of US$ 6.7 billion for the country. It is a three‐year
arrangement, aimed at supporting Pakistan's plans of economic reform and inclusive growth, under
the Extended Fund Facility (EFF).
A country's capacity for debt repayment is more accurately captured by expressing EDL as a
percentage of foreign exchange earnings and reserves, i.e. FEE and FER. In 2012, external debt and
liabilities were 4.3 times foreign exchange reserves. The external debt to foreign exchange earnings
(FEE) ratio is better than EDL/FER as FEE includes remittances from Pakistani expatriates in the Middle
East and Western countries. It closely follows the trend of EDL/FER. With regard to DS/XGS, after
reaching a low of 8.6 percent in 2008, it is again rising due to pressure on balance of payments.
28
Social Development in Pakistan: Gaps & Challenges
S ince the inception of

Pakistan, social development
initiatives have been
severely neglected due to
oscillating political ideologies and
disruption to the country's political
process. The MDGs gave a structure
and a framework to redress many
social, economic and gender
inequalities that continue to
hamper the overall progress of
Pakistan as a Global Citizen.
History and nature have played a

significant role in diverting and
dispersing Pakistan's focus on
MDGs. Up until 2010, the military
coup in 2000 and oscillating
political landscape coupled with
devastating natural calamities
including the earthquake (2008)
and floods (2010, 2011), were
unmitigated setbacks to the
advancement on many goals and Map of Pakistan Showing province wise status down of progress on
targets of MDGs in Pakistan and for MDGS. The overall progress of Pakistan is 29% on 10/34 indicators.
overall economy of the country. Source: Pakistan MDG Report 2013, Planning and Development
The stark inequalities and the growing disparity between the haves and the
3.6%
have‐nots translate to a much wider consequence that of civil unrest, rise of GDP Growth
fundamentalism and strengthening a legitimizing sedition.
The continued war on terror and the huge number of internal displaced 58%
people (IDPs) has placed a heavy burden on the already eroded institutions Literacy Rate
and weakened capacity of systems to deliver education, health and other
basic services. Furthermore the crippling impact of war on terror has had a
21.1%
catastrophic impact on the overall human situation, both economic and Female Seats
psychosomatic on the citizens of Pakistan. The cost of war for Pakistan has in Parliament
been paralytic. In addition, damage to infrastructure, destruction of
investment climate and a sharp deceleration of economic activity across the
2%
country was witnessed. Pakistan has shown gradual progress on almost all Population
the indicators despite the volatile regional and national situation impacting Growth Rate
the socio, political and economic landscape.
29
P akistan committed to 16 targets and 41 indicators against which progress towards achieving
the Eight Goals of the MDG's is measured. Time series data available for 33 of these indicators
reveal that Pakistan is on track to achieve the targets on 9 indicators, whereas its progress on
24 indicators is off track. Considering the Progress on MDGs so far, it is evident that Pakistan will miss
majority of the MDGs targets if “business as usual” continues until the deadline of 2015.
The table below shows the detail of the performance on the Indicators for Pakistan:
Pakistan's Progress on MDGs

Pakistan is unlikely to achieve its MDG target since it is still off‐track in 2 out of 3
Pakistan’s employment to population ratio has increased from 27.1% to 30.9% and malnutrition has
decreased from 40% to 31.5% during the period 2001‐11
Even though, current trend in primary enrollment is upward, the country will not meet the goal of
universal primary education.
Literacy rate is 58% against the set target of 88%during 2011/12, while the primary school enrollment
rate and survival rate in primary schools were 57% and 50%, respectively, against the target of 100%.
Many initiatives have been taken which improved the Gender parity but the current level is still far
below the MDG 2015 target.
The country will not be able to meet the MDG target since there has been slow profess. Pakistan is
marking lowest figures (2.32% women representation and in employment).
The country will not be able to meet the MDG target since there has been slow progress on reducing
increase child mortality rate.
Under‐five mortality fell from 117 deaths to 89 deaths per 1000 live births during the period 1990‐2013
which is still lagging behind the set target of 52 deaths per 1000 live births.
Maternal mortality has declined by nearly half, but falls far short of the MDG target due to
insufficient measures.
National MMR remained high at 276 against the setartget of 140 per 100,000 while the situation in
Baluchistan is severe where MMR is 758.
The incidence of HIV is declining steadily in the country; however, there is growth in TB cases
marking the worst faring indicator
Incidence of TB cases have increased up to 230 cases/10,000 population however, prevalence of
malaria remains under control vis‐à‐vis effective prevention and treatment measures.
Access to Sanitation remained at 72% which is far b elow the set target of 90% while forest cover is
slightly below the set target of 6%.
Overall, with four out of seven indicators on track, Pakistan is likely to achieve MDG 7 with continued
efforts
For Pakistan, efforts to improve market access regionally and globally achieved mixed results marked
by security concerns and mistrust.
Total ODA fluctuated between US$ 732 million to US$ 3.5 billion during this period
Source: MDG Report 2013, Planning and Development
30
T
Award.
he 18th Constitutional Amendment of Pakistan was passed in the National Assembly on the 8th
April 2010 devolving more functions and responsibilities in 17 areas to the provinces from
federal government to ensure Provincial autonomy and empowerment along with the 7th NFC
th
Post 2010, the 18 amendment to the Constitution List of Key Ministries Devolved after
devolved the powers of social development from a 18th Amendment
federal mandate to the provinces creating a chasm
1 Education
of knowledge and expertise with respect to the
MDGs. Moreover, simultaneous devolution of 2 Health
many ministries without a prior addressal of the 3 Environment
provinces' lack of implementation capacities, 4 Human Rights
accentuated the decade old administrative and 5 Labor and Human Resource
technical capacity vacuum to carry out programs
6 Minority Affairs
and interventions in the provinces
7 Population Welfare
Although this is a recent development in the 8 Sports
political landscape of Pakistan, it continues to face 9 Youth Affairs
teething problems in defining jurisdictions,
10 Women Development
legalities and provincial rights and responsibilities
with regard to economic and social subjects. 11 Tourism
The ministries of education, health, environment, labor and social welfare were completely devolved
to the provinces, thus shifting the functional responsibilities of the MDGs to the provinces.
Role of Federal and Provincial Governments in Mainstreaming Human and Social

Development
The 18th Amendment devolves functions and responsibilities to the sub national governments and is a
step to ensure provincial autonomy. It has spurred comprehensive institutional and administrative
reforms to guide and redefine the nature of governance in Pakistan.
Parliamentary Oversight on the MDG Targets in Pakistan

The MDGs including health, education, poverty reduction, women and children, environmental
conservation and other related areas fall under the direct administration and legislative control of the
Provinces. Therefore Federal and Provincial Task Forces on MDGs are convened in the respective
th
legislatures, to address the challenges in the post‐18 Amendment scenario and to strengthen the
legislative, oversight, and representation at role of the Federal and Provincial Legislature.
31
Provincial Task Force

Provincial Task Forces are convened considering that after the 18th amendment, key subjects of the
MDGs fall under the direct administration and legislative control of the Provinces and the 7th NFC
Award has led to allocation of more resources to provinces. It is therefore critically important for the
provincial legislatures to play a pro‐active role in accelerating the pace in achieving the agreed and
committed targets for post 2015 development agenda. The suggested Terms of Reference of the
National and Provincial Task Force are given below for the provincial and national legislatures:
centrates on the future. It is a source of inspiration. It provides clear decision‐making criteria.
Provincial Task Force Proposed Interventions and TORs

1 Promote discussion through provincial assemblies’ debates and questions to obtain information, raise
awareness, to hold provincial governments to account and to draw attention to the post 2015 debate
2 Conduct committee hearings that investigate provincial priorities in greater depth and give
opportunities to hear testimony from independent experts and civil society representatives
3 Convene constituency meetings and public forums to establish dialogue with members of the public to
inform them of the issues and ensure that their voices are heard
4 Engage with local and relevant authorities, civil society organizations, media and the private sector by
sharing information and supporting their participation in decision making
5 Provide representation to all sectors of society by ensu ring that citizens, different stakeholders and civil
society groups have a voice at the national level and are able to participate in the decision making process.
6 Influence the formulation of the new development goals by en gaging with the intergovernmental
negotiations and policy discussion at provincial Level.
7 Introduce, scrutinize and review legislation.
32
Millennium Acceleration Framework (MAF)
T he UNDP experts reviewed the progress of MDGs in 2010 and

highlighted the critical importance for accelerating progress
on selected MDGs. One of the strategies proposed is the
MDGs Acceleration Framework (MAF), an approach that identified
and prioritized bottlenecks to progress and helped formulate
The plan aims to achieve:
1 Enrolment of 100% of out‐
of‐school children in primary
school
2 In‐school retention of all
pragmatic indigenous national visions and policy priorities and enrolled children, and
solution by respective countries' on selected MDGs. The MAF is now completion of their primary
adopted by over 50 developing countries to accelerate progress on education
3 Improvement in quality of
selected MDGs with regular time bound action plans with along with
primary education
monitoring plan embedded with progress.
The MDG Acceleration Framework (MAF) provides a systematic way for countries to develop their
own action plan based on existing plans and processes to pursue their MDG priorities. It is an
immediate and focused effort to obtain success on an off track goal. It also helps governments to
focus on disparities and inequalities.
MAF on Education in Pakistan

To initiate an in‐country dialogue on education a multi‐stakeholder consultation was held to develop
the acceleration framework to achieve the MDG target on Education. In Pakistan, a National Action
Plan 2013‐2016 on Education has been designed to accelerate implementation of MDG for education
in the next three years. The development of the MAF on education in Pakistan is built upon existing
country knowledge and experiences and policy and planning processes making it a concentrated
effort to reach the MDGs by 2015.
Net Enrolments and Planned Additional Enrolments Targets for MAF for Education of
Pakistan
Province/Area 2011-2012 Benchmark 2013-2014 2014-2015 2015-2016

2012-2013
Pakistan 68% 70% 77% 84% 91%
Balochistan 51% 51% 54% 57% 60%
FATA 60% 62% 63% 64% 65%
GB 63% 65% 70% 74% 79%
ICT 70% 72% 80% 90% 98%
KP 81% 82% 86% 91% 95%
Punjab 70% 72% 81% 91% 100%
Sindh 63% 65% 70% 75% 80%
AJ&K 58% 60% 65% 69% 75%
33
The Table below elaborates on the situation analysis of the education sector across the country by
identifying key areas of focus and priorities. For more information on respective provincial education
scenario, refer to Pakistan MAF Report 2013.
ACCESS
In School Factors Strategies/Interventions
− Shortage of teachers − Hiring of more teachers
− Teacher absenteeism − Strict monitoring of teachers
− Missing basic facilities − Provision of basic facilities
− Lack of friendly environment − No Corporal Punishment
− Teachers' harsh attitude − Incentives to retain students (free books, food,
uniforms, etc.)
Out‐of‐school Factors Strategies/Interventions
− Shortage of Schools − More schools to be established
− Distance especially for females − New schools established nearer to communities
− Insecurity − NFE/Community/Feeder Schools to be established
− Poverty − Enforcement of security and law and order
− Cultural norms − Free education
− Parents are reluctant − Awareness campaigns on importance of education
− Parents lack awareness − Community involvement in education
QUALITY
In School Factors Strategies/Interventions
− Poorly trained Teachers − Training of Teachers/refresher courses
− Outdated Teaching Methods − Teaching methods to be revised
− Missing facilities − Provision of basic facilities
− Lack of Monitoring/Supervision − Involve community members to monitor schools
Out‐of‐school Factors Strategies/Interventions
− Poor Governance − Effective monitoring and supervision
− Political Pressure − Rewards and punishments
− Involve community members to monitor schools
− End undue political interference and ensure merit
based appointment
Source: National Plan of Action 2013‐16, Achieving Universal Primary Education in Pakistan: MDG
ACCELERATION FRAMEWORK
34
30
Provincial and Federal Oversight of MAF for Education

With the development of MAF for Education consistent efforts are being made to make progress on
the goal of Education indicators. The Parliamentarians and provincial Legislatures should play their
responsible oversight and strategic role to ensure the achievements on the agreed and committed
targets as the respective MAFs are in the phase of implementation in the provinces.
The objective of formation of these task forces is to maintain and sustain an enabling environment for
initiating an open, inclusive and transparent consultation process among all the stakeholders to
further the development agenda in Pakistan.
INTERNATIONAL
AGREEMENTS /COMMITMENTS
FEDERAL T ASKFORCE
Coordination Legislation
Representation Oversight
Consultation Policymaking and review
Implementation Recommendation
oversight
PROVINCIAL T ASKFORCE
Punjab Sindh KPK Balochistan
DISTRICTS
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Gaps, Challenges & Lessons learnt of MDGs
T he pursuit of MDGs however noble in retrospect was highly ambitious. These goals were
defined as a roadmap for world development by 2015 and provide a framework to measure
progress against time bound targets.
We all should be cognizant of the reality that the world has changed radically since the turn of the
millennium. New economic giants have emerged, new technologies are reshaping, the world
consumption patterns are changing, and our societies and new patterns and activity are heightening
the pressures on our planet.
The Strength Weakness Opportunities and Threats (SWOT) analysis is elaborated in the Figure below:
Strengths Weaknesses
• United International Agenda • Lack of indigenous national local planning
• Directed resources and coordinating • An international agency driven tap‐down
international action to achieve goals embraced initiative
by consensus • Lack of alignment between goals, targets and
• Established, time bound and concrete targets indicators
• Strengthened global partnership for • No explicit targets for global partnership in
development modern technology
• Provided benchmark for Post 2015 • Insufficient and highly uneven progress
development agenda • No mid term review
• Not a natural calamity inclusive agenda
Opportunities Threats
• Forming and utilizing potential of National and • Potential negative impact of new information
Provincial level task forces on MDGs technologies on traditional indigenous
• Establishment of dedicated MDGs desks in knowledge systems
Planning and Development • Eco‐systems maintained for maximum
• National level consultations and engagement productivity may lose their resilience in the
with all key stakeholders long run.
• Focus on strengthening of National Data • Increase population
Sources
Suggested Recommendations for Post 2015 to obtain Transformative Shift

1. Peace, Securities and Stability
2. Inclusive Social and Human Development: Take everyone along
3. Environmental Security and Sustainable development at the core
4. Transparency and accountability across at all levels
5. Transform economies for jobs and inclusive growth
6. Forge a new global partnership for trade and not aid
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Post 2015 Development Agenda
T he World's quest for dignity, peace, prosperity, justice, sustainability and an end to poverty
has reached an unprecedented moment of urgency (UN Secretary General Report 2013). As
the deadline for achieving the Millennium Development Goals (MDGs) expires in 2015, global
efforts to craft the Post‐2015 development agenda are accelerating. The Post 2015 development
agenda embodies a three dimensional nexus of Sustainable Development Goals (SDGs) with focus
Economic, Social and Environmental sustainability.
The role the Federal and Provincial MDGs Task force can play is not only oversight but also exchange
information, knowledge and examples of good practices with peers and international and
development research institutions build capacity of the relevant departments and ensure that good
governance, transparency and accountability is at the center of all the human and social reforms in
Pakistan.
National Scenario
The present government is fully committed to make a progress on MDGs and provide a
comprehensive input on new and inclusive Sustainable Development Goals (SDGs). Considering the
challenges of existing MDGs Framework following steps have been taken by the present Government
to have a more inclusive strategy by:
1. Formation of national and provincial MDGs task forces to have inputs of the provinces to set
national priorities post 2015
2. Establishment of dedicated MDGs desks in Ministry of Planning & Development for robust
stakeholder consultation at federal and provincial level
3. National level consultations and engagement with all key stakeholders including corporate sector
and media
4. Strengthening of national data sources by innovative and creative information technologies at all
levels.
With Particular focus on:

Peace Stability & Security, Human Rights, Equality Peace, Justice, democratic and good governance,
gender mainstreaming Data Revolution environmental sustainability, disaster preparedness and
response, aid trade off with more robust trade mechanism.
International Scenario
The report of the UN High Level Panel on Post 2015 Development Agenda recognizing both the
strengths and the weaknesses of the MDGs stresses on eradicating poverty and transforming
economies through sustainable development. It acknowledges the progress made towards achieving
the MDGs, which resulted in half a billion people graduating from poverty, a decline of 30% in child
death rates and a plunge in deaths from malaria by one quarter. However, at the same time, the report
is quite mindful of the weaknesses of the MDGs and urges to go beyond these goals. It asserts that
reaching out to the poorest people and addressing social exclusion in its extreme form did not
resonate strongly with the current goals. (Source: High Panel UN Report)
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Building Blocks for a Sustainable Development Agenda
F or such a sustainable development agenda to be effective, four building blocks need to be

agreed upon: a far‐reaching vision of the future firmly anchored in human rights and
universally accepted values and principles, including those encapsulated in the Charter, the
Universal Declaration of Human Rights and the Millennium Declaration; a set of concise goals and
targets aimed at realizing the priorities of the agenda; a global partnership for development to
mobilize means of implementation; and a participatory monitoring framework for tracking progress
and mutual accountability mechanisms for all stakeholders.
Stakeholder Ownership
Short-term and Long-term
M&E embedded in each Goal
Civil Society/Private Sector should be engaged
at the initial level
Invest in Capacity of the statistical Institution
Qualitative Vs Quantitative measurement
PAKISTAN'S NATIONAL AND PROVINCIAL PRIORITIES IN EMERGING VISION 2015

The key elements of the emerging vision for the development agenda beyond 2015 include:
1. Universality To mobilize all developed and developing countries and leave no

one behind.
2. Sustainable To tackle the interlinked challenges facing the world, including a
Development clear focus on ending extreme poverty in all its forms.
3. Inclusive Economic To ensuring decent jobs, backed by sustainable technologies, to shift
Transformations to sustainable patterns of consumption and production.
4. Peace and As key outcomes and enablers of development
Governance
5. A new global • To recognize shared interests, different needs and mutual
partnership responsibilities.
• To ensure commitment to and means of implementing the new
vision.
6. Being “fit for To ensure that the international community is equipped with the
purpose” right institutions and tools for addressing the challenges of
implementing the sustainable development agenda at the national
level.
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Regular monitoring and accountability will be a To move forward towards a universal Post‐2015
critical success factor for the sustainable Development Agenda Sustainable Development has to
implementation of the post‐2015 development be kept at its core with:
agenda. Governments, especially parliaments, will • Poverty eradication
play a central role. Data gathering, quality and • Inclusive growth targeting inequality,
analysis are the fundamental building blocks to • Protection and management of the natural resource
measure and evaluate the success of any social base of our planet within a rights‐based framework
• The nexus between peace and development being
development. Therefore the federal and provincial
the overarching objectives of sustainable
data collection centers should prioritize technical development.
infrastructure and capacity building coupled with a This would require a profound
logical framework. transformational shift from business as usual to
address the emerging challenges of sustainable
The provinces should formulate their human and development.
social development framework from inputs,
insights and actions from their respective districts.
Once agreed with all relevant stakeholders within the provinces the commitments in the form of
goals, indicators and targets will be shared with the concerned ministries at the federal level and
federal MDGs Task Force.
Suggested Interventions
LEGISLATION OVERSIGHT REPRESENTATION

A. Necessary laws to ensure the Community oversight and district
implementation of Article 25‐A, based reporting.
of the constitution guaranteeing
free and compulsory education.
Regular call‐attentions and
B. Home based workers Lady Health Workers‐Integration into questions, asking information
the health system. from the Executive on the
progress, pace and
C. Immunization and Community Implementation of 10% jobs quota. implementation of various
Health Integration projects concerning health,
Ghosts schools and curriculum education, poverty alleviation and
monitoring. livelihoods.
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Conclusion
To summarize, the provinces not only have immense opportunities but responsibility to begin a
journey alleviating social disparities and inequalities that Provinces themselves identify and
implement rather than those priorities being dictated. The legislatures at all levels need to take stock
of where they are and where they need to head; firstly in the time that remains until end of 2015, and
secondly, in the post 2015 period.
This prime task needs to be dispensed through esprit de corps by:

1. Coordinating and engaging with stakeholders across the country,
2. Identifying and prioritizing the critical social development agenda respective to their provinces,
3. Deploying and allocating appropriate resources with stringent oversight and monitoring
mechanisms that drive and promote transparency and good governance.
Pakistan is at a precipice where as a nation we carve out a path for ourselves, reducing direction and
dependency on the international community, to achieve peace, harmony economic independence
and social equality and justice in the pursuit of providing a better quality of life for all Pakistanis. The
end that needs to be kept in mind is the progress of the nation and it's citizens to a quality of life that
will be a model of transformation for the world.
Source: Building Blocks for a Sustainable Development Agenda taken from UN General Assembly Report 2013
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National Mdgs Orientation: For Parliamentary Task Forces

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National MDGs Orientation

for Parliamentary Task Forces

PAKISTAN INSTITUTE FOR

DEDICATED TO PARLIAMENTARY EXCELLENCE

Islamabad, May 22, 2014

Marriyum Aurengzeb. MNA

Islamabad, May 20, 2014

i. Promote discussion through provincial assemblies debates and questions to obtain

National and International Partners of the Inaugural

MDG 1: Eradicate Extreme Hunger & Poverty 2

MDG 2: Achieve Universal Primary Education 5

MDG 3: Promote Gender Equality & Empower Women 8

MDG 4: Reduce Child Mortality 11

MDG 5: Improve Maternal Health 14

MDG 6: Combat HIV/AIDS, Malaria & Other Diseases 17

MDG 7: Ensure Environmental Sustainability 20

MDG 8: Develop a Global Partnership for Develo pment 24

Social Development in Pakistan: Gaps & Challenges 29

Millennium Acceleration Framework (MAF) 33

Gaps, Challenges & Lessons Learnt of MDGs 36

Post 2015 Development Agenda 37

Building Blocks for a Sustainable Development A g e n da 38

Millennium Development Goals 2000-2015

What were the Objectives?

Goal 1: Eradicate extreme poverty and hunger

Status of Indicators – MDG 1

Initiatives in the Right Direction

MDG 2 aims endeavors to increase access to primary education and

Under Article 25a of the constitution of Pakistan two significant provisions

Status of Indicators – MDG 2

Initiatives in the Right Direction

Wage employment is also an important indicator of women's economic

Status of Indicators – MDG 3

Initiatives in the Right Direction

Progress on MDG 4 is measured against six indicators: under‐five child

Status of Indicators – MDG 4

Initiatives in the Right Direction

Status of Indicators – MDG 5

Initiatives in the Right Direction

Pakistan remains particularly vulnerable to viral, in particular water borne

Progress on MDG 6 is measured against five indicators: HIV prevalence

6.3 Proportion of population aged 15-24 years with

Status of Indicators – MDG 6

Initiatives in the Right Direction

Climate change is a grave threat to gains made in poverty reduction and

Status of Indicators – MDG 7

Initiatives in the Right Direction

The linkages between specific MDGs and strengthened global partnership

The inclusion of MDG 8 in the UN Agenda is a reflection of the commitment

Status of Indicators – MDG 8

Official Development Assistance (ODA) Indicators for Pakistan

2000 1.24 5.4 732

2002 2.9 14 2105

2003 1.2 7 1072

2004 1.4 9 1439

2005 1.4 10 1614

2006 1.7 14 2180

2007 1.6 14 2269

2008 0.9 9 1549

2009 1.7 16 2769

2010 1.6 17 3013

2011 1.6 20 3508

Source: World Development Indicators