Modern contraceptive uptake patterns in public sector family planning centres: a 6-month mapping study from Rawalpindi, Pakistan

Abstract Background Expanding access to modern contraceptives, particularly long-acting reversible contraceptives (LARCs), is crucial for reducing unmet need, unintended pregnancies, and maternal mortality in Pakistan. Despite availability, the uptake of modern contraceptives, especially LARC, remains low, with short-term methods dominating contraceptive use. This baseline study was conducted as part of a larger research project evaluating client-centered counseling interventions to improve modern contraceptive uptake in Rawalpindi. Methods We conducted a descriptive cross-sectional study across three Family Health Centers (FHCs) and their affiliated Family Welfare Centers (FWCs) in Rawalpindi district over 6 months (September 2024–February 2025). Aggregate facility records were reviewed using standardized extraction templates to compile data on modern contraceptive uptake by method type. Descriptive statistics and comparative analyses were performed using SPSS v26 to identify method mix patterns and assess baseline differences across centers. Results A total of 199,491 clients were served across the study sites. Condom use dominated (≥ 85%), with combined oral contraceptives as the next most common method (6–8%). LARC use was consistently low (1.5–2%), with notable facility-level variation but no statistically significant differences in modern contraceptive uptake across hospital groups (p > 0.05). These findings indicate a predominance of short-term method use, with minimal uptake of long-acting methods across facilities. Conclusion The study underscores critical gaps in method mix and informed choice, providing a strong baseline for evaluating counseling interventions aimed at increasing modern contraceptive, especially LARC, uptake in Pakistan’s public sector.