FAMILY PLANNING
According to a projection of the United Nations, the population of Pakistan could reach to an uncontrollable 403 million by 2050. It is unimaginable to think how the government would be able to provide employment, water, public transport and food to so many people in the country, when the provision of these basic necessities is a challenge even today with a population of 207 million.
In the 2017 census, the population of the country, which had been projected to be 198 million, turned out to be 207 million. Concerned by such a high growth rate in the population, the then chief justice of Pakistan, Saqib Nisar, took a suo moto notice of it as a human rights case. He formed a committee with representatives from the federal government and civil society and directed it to give recommendations on the issue.
Dr Ali Mir, of the Population Council, a non-government organisation that carries out technical research for government agencies regarding population, states that after those recommendations, were drafted by the committee, the Council of Common Interests (CCI) approved them in January 2019.
One of the recommendations was to constitute separate federal and provincial task forces to monitor the population growth and take critical decisions to reduce it by lowering the fertility rate and increasing the contraceptive prevalence rate (CPR), which is a measure of the use of contraceptives.
The national task force is supposed to be chaired by the prime minister and comprise the chief ministers of all the provinces, provincial ministers of population, health, education, finance and planning, and representatives of civil society. The provincial task forces are to be chaired by the respective chief ministers and include their cabinet members.
Demographer, and senior associate and country director of the Population Council Zeba Sathar, who is also a member of the committee formed by the Supreme Court, stresses the need for building a new national narrative to bring a balance in the population growth. Rather than controlling the population, she says the state needs to manage it. Due to high unwanted pregnancies and number of children, the public, she believes, is ready to get engaged with the state in its efforts to manage the population.
The committee had come up with a total of four recommendations. One of them was the Family Planning and Reproductive Health (FP&RH) Rights Bill which was supposed to ensure mandatory FP&RH services at all the general health care facilities in the public and private sector. It was recommended that the National and provincial assemblies approve the bill by March 31, 2019 but it is yet to be passed by the assemblies, except that of Sindh.
Likewise, the Early Child Marriage Restraint Act has also only been passed by the Sindh Assembly, whereas, it was supposed to be passed by all the assemblies by March 31, this year.
The third legal recommendation was about the pre-marital counselling on family planning, for which some work has been carried out by the provinces. The committee recommended that such counselling be made mandatory for the Nikah (marriage) registration.
She also shares the idea of a post-marital counselling. “It can be done immediately after the marriage,” she says and adds that it will have to be across the board for everyone.
In its fourth legal recommendation, the committee called for declaring the right to promotive and primary health care for mother and child a fundamental right by including it in the constitution.
Regarding the religious sensibilities involved in the matter, Dr Sathar believes there’s already a consensus of religious scholars being built over the need of managing the population. She also particularly praises Sindh for taking the legal framework regarding the population issue very seriously.
The federal government, according to one of the recommendations, should also release every year a non-lapsable amount of Rs10 billion under the Pakistan Population Fund to the provinces in order to help them control the population growth.
The real situation
For a family of six members, which includes four children and two adults, having a monthly income of Rs25,000 is below the poverty line in Pakistan. According to this criterion, 76 million people are living below the poverty line in Pakistan as per the last census. This situation is further compounded by the fact that these low income group families reproduce even more and thus the ranks of the most marginalised continues to increase.
Currently, Pakistan has the highest population growth in the region, about 2.4 per cent. When Bangladesh was East Pakistan, its population growth rate was higher than that of West Pakistan. Today, it manages to maintain its population growth at a rate of 1.6 per cent.
India, being the second largest populated country of the world after China, has its population growth projected at 1.8 per cent. According to the World Bank, China’s growth rate was 0.7 per cent in 2017. The population growth rate in Iran is 1.1 percent.
In a country like Bangladesh, where successive governments were able to control population growth, they are now able to provide better education and health facilities, and economic opportunities to the population.
Mass migration
The director of the University of Karachi’s (KU) Applied Economic Research Centre, Dr Samina Khalil, points out that high unemployment, leads to migration of population from rural areas towards urban centres.
The population growth rate in the urban areas of Pakistan is 2.7 per cent, whereas it is 2.4 per cent in the rural areas. On the national scale, the average population growth rate has declined in Pakistan from 2.6 per cent in 1998 to 2.4 per cent in 2017; however, it is still very high.
The capital territory of Islamabad has registered the highest population growth rate of 4.91 per cent. Punjab and Sindh have, however, seen a decline in their population growth rates, which have been recorded at 2.13 per cent and 2.47 per cent, respectively.
Meanwhile, Khyber-Pakhtunkhwa (KP) and Balochistan have also witnessed an increase in their population growth. Currently, the population growth rate of KP is 2.9 per cent and that of Balochistan stands at 3.37 per cent.
Immediate steps are needed to control the population growth. The state has to indeed play its role, but parents are also a key stakeholder, alongside the state, and they need to understand the seriousness of the issue.
State’s role in population control
The state is not only responsible for the provision of health facilities, education, economic opportunities and infrastructure to the people, but in the context of the population growth, it is also supposed to develop such policies which would create a balance in the population growth.
A professor at the Karachi University’s department of sociology, Dr Nabeel Zuberi, who has specialised in human behavior, also underscores the need for carrying out research on the population living below the poverty line to determine factors which make them reproduce more. “The population living under the poverty line cannot be educated by force but with incentives,” he says and shares that there are fears and shame attached with ensuring a gap between births among the poor communities in Pakistan.
He recalls that in 1955, Pakistan was the first country in the Islamic world which started a population welfare programme, but today it had quite unsatisfactory indicators regarding the people’s welfare. Citing the example of Iran, which is a religious country, he says that their CPR is 78 per cent. In Pakistan, this ratio is around only 30 per cent.
Biostatistician Zahid Mehmood also praises Iran’s model and explains how they have made it compulsory to have segregated seminars for male and female students of universities on family planning. They have also opened small institutions across the country to educate the adults about family life and planning and it is now mandatory for Iranians to obtain a certificate from those institutions before solemnising marriage. The CCI’s approved recommendations also tasked the provincial and federal governments to include life skills based education and population studies in secondary and higher secondary schools.
Renowned economist Dr Kaiser Bengali is of the opinion that the government also needs to bring all religious leaders on board. He proposes holding an Islamic conference on family planning after inviting religious leaders from all Muslim countries. If these religious leaders share their countries’ strategies to control population growth, it will result in a breakthrough, he remarks.
Pending bills in Punjab, KP, and Balochistan
Family Planning and Reproductive Health (FP&RH) Rights Bill
Early Child Marriage Restraint Act
Bills were to be passed by March 31, 2019
Regional Population Growth Rate
• 76 million people live below poverty line in Pakistan as per last census
• Pakistan’s population can reach an uncontrollable 403 million by 2050
• Average growth rate declined from 2.6 per cent in 1998 to 2.4 per cent in 2017
• Urban population growth rate is 2.7 percent, whereas rural rate is 2.4 percent
• In 1955, Pakistan was first in the Islamic world to start a population welfare programme
As for the second stakeholder, parents, Dr Zuberi recalls the United Nations’ International Conference on Population and Development (ICPD) in Cairo in 1994, in which gender roles were defined. “In our country, women are only considered as child-producing machines,” he says and suggests that if the gender perceptions are addressed properly from the birth, there can be greater balance in societies due to less mismatch between scarce resources and ever growing consumers.
Good and responsible parenting, according to Dr Zuberi, is in itself a science. “It is easy to become parents biologically, but there is social, political, religious and psychological parenting which we aren’t aware of.”
The writer is a staff member