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August 11, 2019

For the future

Opinion

August 11, 2019

With every passing day, Pakistan will regret its failure in not improving its human development indices or its embarrassingly high population growth. These losses subsume its successes. The country may still ride out the storm, though more likely we would be wayward poor stragglers in the company of Sudan, Nigeria and Afghanistan.

Here are some statistics. Nearly half the population is denied bare living requirements. Human dignity, even more than poverty alleviation, remains compromised. With the current fertility rate of 3.3 children per couple in Pakistan the population will double in thirty years to nearly 400,000,000. That would compound our misfortune.

The choice is stark. Either the country steps into the twenty-first century of the prosperous or remains mired in the poverty and stagnation of the nineteen century albeit with a population ten times greater. Meaningful economic growth and human development would only be possible when the fertility rate is reduced to population replacement levels of 2.1 children per couple. We may only be a decade away from being swamped. Can the leadership salvage our future?

Since 1951, Pakistan’s population grew six times compared to Bangladesh’s four-fold growth. To remain relevant in the mid twenty-first century, Pakistan must focus on the priority concerns of primary education-literacy; health-hygiene and drinking water-sanitation. (The country stands on a low 147th position on the Human Development Index). A focused social development programme incorporating the following ingredients needs to be implemented immediately: i) it must be community-driven, holistic to cover the essential needs and undertaken by the provincial governments; ii) it should be low cost, with lower overheads and lowest needs for buildings construction so that the maximum money is provided for essential supplies and services; and iii) it would need to be monitored regularly and rigorously at the community, union council and sub-divisional levels.

The literacy ratio as acknowledged by the government is 58 percent having fallen nearly two percent from a year earlier. Primary school completion rate is a dismal 61 percent; in Bangladesh and Sri Lanka it is almost 100 percent. Out-of-school children in Pakistan number 22.6 million which means that almost 44 percent of all children will in time be illiterate. Compulsory primary-level literacy classes for all out-of-school children must be ensured.

The state of health of the poorer sections of society remains depressing. Over 50 percent families cannot afford two meals a day. For women and children conditions are even more severe. Only 69 percent use iodized salt while moderate to severe stunting reaches 45 percent of all children. The infant mortality average is 61/1000 (under one year) and 75/1000 (under 5 years). Clearly, the United Nations Millennial Developmental Goal of reducing global infant mortality by two-thirds has fallen short in Pakistan. The maternal mortality rate is very high at 276/ 100,000 (Baluchistan reportedly even touched 780/100,000). About 34 percent of mothers are underweight while nearly 65 percent are anemic.

The one bright hope is the presence of 110,000 Lady Health Workers in the country working around the Basic Health Unit/Rural Health Centres and a few thousand Family Health Workers. Yet the unmet family planning needs are around 25 percent while 22 percent of births are unplanned. (PDHS 2006-7). There are over two million risky abortions reported in the country annually because of the state’s failure in reaching out to all with unmet needs.

Today almost 80 percent people are denied safe drinking water and the urban and rural areas are both deficient. Piped water use is confined to only 39 percent and non-piped to 52 percent. Only 64 percent of the populace get very basic sanitation services while 13 percent use open defecation and 14 percent unimproved sanitation. A phased programme, jointly developed by the affected people and the local government, is needed urgently.

In the past, inadequate financial resources were provided for these priorities. Most governments diverted scarce funds towards concrete structures like highways, motorways, metros and grand public buildings. Secondly, even within the sector emphasis was on brick and mortar with little money left for ‘software’ such as qualified teachers and health personnel, furniture and books, equipment and medicines. The local community was generally denied ownership.

The programme activities mentioned need to be coordinated and monitored by the provincial governments with the sub-divisional assistant commissioner as the focal point. The union councils along with the education, health and local government officials should be made responsible for all public needs.

Awareness creation through community organisations would persuade parents and elders to send children to the nearest public, private or mosque school. If there is none within a radius of two kilometers, a community school may be established in accommodation provided by the village for up to four hours a day on rent. For the community school an endowment fund of Rs5,00,000 be created in the nearest bank; the profits from this endowment (Rs75,000 annually) would cover basic costs and salary of the teacher of the community school who may be selected by the village itself with relaxed educational qualifications.

The community school teacher would also assist the village community in matters relating to health care and sanitation. (During 1993-94, similar community schools were successfully organized in Gilgit-Baltistan with an endowment fund of Rs100,000 per school, later increased to Rs200,000 by the World Bank. Ultimately, nearly 700 such community schools were established most of which were later incorporated into formal government schools).

All told, the annual costs would be about Rs100 billion plus. The families of these children would need to abide by the health and other components of the programme.

The existing allocations by the provincial governments for primary education, basic health and drinking water are higher than this amount. Others financiers like BISP, donors, philanthropists and local beneficiaries would complement it. The Pakistan Poverty Alleviation Programme, funded by the World Bank, needs to set well-defined targets and rationalize its overhead costs. The government’s recently announced Ehsaas programme’s poverty reduction strategy would fund part of the requirements. BISP has the competence and the provincial governments the commitment to succeed.

The writer has served as the chief secretary of GB, AJK, KP and Sindh and was the chairman of Wapda and the Pakistan Railways.

Email: [email protected]