Since 1998, the David and Lucile Packard Foundation’s Population and Reproductive Health (PRH) program has granted more than $52 million to improve family planning and reproductive health services in Pakistan. Over the course of its engagement in Pakistan, PRH has supported a diverse set of grantees and engaged in a variety of beyond-the-check activities to build momentum around family planning and reproductive health issues, ensure critical sexual and reproductive health services are provided to those in need, and empower local actors to continue this work into the future.

The Foundation’s efforts have focused largely on Punjab and Sindh provinces, where the majority of Pakistan’s population lives, and have also included advocacy activities at the national and provincial levels. From 2014 onward, the Foundation consolidated its grantmaking to Karachi. In 2017, PRH commissioned Mathematica Policy Research to conduct an in-depth review of key achievements and lessons learned from the Foundation’s two decades of grantmaking in Pakistan. This report summarizes the results of those efforts and details the Foundation’s strategy and interventions in Pakistan and how they evolved over time. The report also summarizes efforts to institutionalize gains prior to the Foundation’s final transition out of the country in 2020.