LAHORE: With its high fertility rate, Punjab province has paid a high cost for neglecting population growth rate with its failure to achieve universal education, health, employment and maternal health.
With 110 million population, Punjab is equivalent to 12th most populous province in the world. Punjab’s population has grown five-fold since independence from 20.5 million to 110 million currently. At least 6,000 mothers die annually while infants’ death rate is higher than the national average, which must ring alarm bells for the provincial authorities. At least 50 per cent of maternal mortality in Pakistan occurs in Punjab, according to Pakistan Health and Demographic Survey-PDHS 2017-18.
The Population Council, while revealing the population statistics in Punjab, informed that besides deaths of 6,000 mothers annually in Punjab, another 75 infants out of every 1,000 live births die before reaching their first birthday, higher than the national average of 62 infant deaths. A high ratio of maternal and infant deaths is a clear indication that situation in the province is far from ideal.
It is pertinent to mention here that maternal mortality rate and infant mortality rate of Pakistan are amongst the highest in the world.
About 9 million children are out of school in Punjab while a majority of young people entering the workforce do not have secondary education. The working-age population will double (from 74 to 135 million) in Punjab by 2050 regardless of what actions we take today.
Currently, 74 per cent of women are not in the labour force. There is a dire need to make it attractive and possible for women to do paid work to reap the fruits of demographic dividend. With a rapidly growing population, by 2040 Punjab will need 10 million houses and 67 million jobs (given 2pc annual population growth rate).
According to the PDHS Survey 2017-18, the total fertility rate in Punjab is 3.4 and has considerably decreased since the last PDHS Survey 2012-13. However, the province still has 3.3 million women with an unmet need for family planning. Contraceptive use has declined in Punjab in the past five years, further aggravating an already higher fertility rate in the province. The contraceptive prevalence rate has dropped from 40.7pc to 38pc over the past five years. Unmet need of family planning results in 2.4 million unwanted or mistimed pregnancies in Punjab which leads to 1.2 million induced and unsafe abortions and 1.2 million unwanted births.
A clear link can be established between unmet needs of family planning and maternal deaths as increase in contraceptive use from current 41pc to 59pc can save 2,700 precious lives of mothers. Similarly, the above mentioned increase in contraceptives will save lives of 73,000 infants in Punjab. Infant mortality rates are higher in South (78pc) and Central Punjab (74pc) as compared to Northern Punjab (42pc). Similarly, percentage of delivery at a health facility is higher in Northern part of the province (86pc) compared to Central (74pc) and South (53pc) regions which is a clear indication of scarcity of health facilities in southern part and disparity among different regions of the same province. Failure of family planning service delivery can be gauged by analysing the unmet needs of family planning in the different parts of province as unmet need in the Northern and Southern Punjab are higher, 18.3pc and 17.5pc, respectively, while it stands at 14.7pc in Central Punjab.
This gap can be bridged by making sure that family planning services are available at all the health facilities of the province. Achieving sustainable population growth is crucial for Punjab to meet its development goals. Maintaining a balance between population and its resources is an utmost priority to achieve a sustainable population growth. Increased investment in family planning and ensuring universal access to contraception to meet unmet family planning needs can lead to reduced maternal and infant deaths, better prospects for education, strengthening women’s participation in economy, youth employment and reducing the pressure on natural resources in the province.
