With continuing political turmoil, emergency rule declared, and concerns about how free and fair January elections will be, Pakistan has been under the spotlight recently. But the political arena isn't the only area where challenges persist.

Beneath the surface, more problems are brewing in the sixth most populous country in the world. Some of the challenges are fueled by the country's rapidly growing population, which is making increasing demands on social services, especially the health care system.

A comparison of population pyramids reflects how Pakistan has grown and how its needs will multiply (see below). Between 1970 and 2000, Pakistan more than doubled in population to 144 million from 60 million. Its population ages 15 to 49 more than tripled to 68 million from 14 million. As the number of people in that age group rose, so did demand for maternal and child health care. And health care needs are likely to grow as the 2025 projection for those ages 15 to 49 rises to 121 million, nearly double the 2000 estimate.1