KARACHI – Ninety-eight percent of Pakistanis are aware of the need for family planning but the unavailability of contraceptives has led to a population explosion, experts say.
Ahead of World Population day which is observed on July 11, experts told The News that contraceptives are expensive and the government should provide them free of cost.
According to the Population Council, Pakistan, 17% of married couples in Pakistan want to use contraceptives but cannot due to various reasons, including affordability and accessibility of the contraceptives.
“The awareness of the need for family planning in Pakistan is 98 percent – almost universal,” said Syeda Rabia Zafar, director of research and survey at National Institute of Population Studies.
“What is important is that you provide quality services of family planning at affordable prices.
Women lack the knowledge of methods for family planning and then which method to use. When a woman goes to a health center and says, ‘I want this method,’ if it is not available, she gets confused and ends up not using any method at all,” said Rabia.
“A lot of work has been done, now people are aware enough but the stock is not available. People have to go far away for contraceptive methods. If they are provided services at their doorstep, they will definitely do it,” said Rabia.
Population experts say Pakistan should learn from Indonesia and Bangladesh. “In Bangladesh, religious leaders at the community level helped the government implement its policies,” said Ikram ul Ahad, deputy manager communications, at Population Council Pakistan.
Baqar Abbas Zaidi, a religious scholar, said that keeping the population of Muslim countries low is an imperialist policy of western nations. “Poverty is not a result of population increase. It is a result of unjust distribution of wealth.
“If the population of Muslim countries goes up, it will help us produce more minds that can come up with ideas of technological advancement,” said Baqar.
“Family planning should be left to people. If people think they cannot raise children because their financial means are limited then they can choose not to have children by using contraceptives. But it shouldn’t be a national policy.
“China had a one-child family policy for a long time. What happened to them? Although they have done away with that policy now, their young generation doesn’t want to have children. As a result, the percentage of young people in their population is decreasing fast,” said Baqar. “In the coming years, they will have a huge crisis. They will have to take care of a very large number of old people with a fast decreasing number of working-age people,” he added.
Ikram said political will is the most important factor in managing population. “In Bangladesh, Sheikh Mujeeb ur Rehman decided to plan the population and that policy was maintained by succeeding rulers. As a result they have managed to plan their population. Their fertility rate is a little above 2. Mujeeb said if they continued to increase in numbers they would turn into cannibals,” he said.
Experts say the lower literacy rate of women in Pakistan is also a factor behind the fast rising population. “Data collected by us shows that the more a woman is educated the more she is inclined to use contraceptives,” said Ikram. “Similarly, the increase in the number of working women has helped Bangladesh manage its population. In Pakistan the number of women working is much lower than Bangladesh,” he added.
“Besides, easy availability of microfinance helped a large number of women in Bangladesh open their own businesses. That also helped Bangladesh in planning its population.”
Pakistan’s fertility rate – the average number of children a woman bears in her lifetime – is 3.6, the highest in the region excluding Afghanistan. “It is more than India, it is more than Iran,” Ikram said.
He said continuity of policies in Indonesia helped it manage its population. “From the reign of President Suharto till now the political leadership has maintained the population management policies,” said Ikram. “In Pakistan, there was emphasis on population plan in the 1990s when we used to see campaigns urging people to have only two children but now there is no such effort. We in Pakistan should have a high-powered commission as Indonesia did. There is no central policy of planning population now because of devolution of powers to provinces.”
Ikram said there is a lot of misperception about the use of contraceptives. “Many people are misled into thinking that contraceptives are injurious to health although only one in a million women develops health problems because of contraceptives and that occurs because of the negligence of the healthcare provider, not because of contraceptives,” he said.
According to the Population Council, on average, 11,000 maternal deaths occur annually. It says that if contraceptive use rises from 34% to 52%, 3,800 mothers will be saved.
Around 40% children under the age of five are stunted while 29% are underweight.
Moreover, 62 infants per 1000 live births die before reaching one year of age. The council says that 140,000 infants will be saved if contraceptive use rises from the current rate of 34% to 52%.