In a comparative and empirical study of the state of social development in rural Pakistan, SPDC's latest Annual Review, the twelfth in the series, explains how the social sector has fared, particularly, after the promulgation of the 18th Amendment to the Constitution made the provinces primarily responsible for health and education. The report brings forward urban-rural differentials using development indicators such as population, demography, education and public health; profiles and quantifies the rural economy; provides latest estimates of poverty; and analyses the pattern and structure of employment in rural areas, access to education, the state of the health sector and the effectiveness of social safety nets. By shedding light on the social sector, and comparing and contrasting urban-rural disparities, the report reinforces the importance of a healthy, educated citizenry and its centrality to the prosperity of Pakistan.