By: Amb. Salahuddin Choudhry
World Population Day seeks to focus attention on the urgency and importance of population issues, enhance awareness of population issues, including their relations to the environment and development, and commemorate the Day in partnership with governments and civil society.
UNSG tells us: “While the world’s population overall continues to increase, this growth is uneven. For many of the world’s least developed countries, the challenges to sustainable development are compounded by rapid population growth as well as vulnerability to climate change. The 2030 Agenda for Sustainable Development is the world’s blueprint for a better future for all on a healthy planet. On World Population Day, we recognize that this mission is closely interrelated with demographic trends including population growth, ageing, migration and urbanization”.
We remain unprepared for rising challenges of uncontrolled growth in population that raises poverty, leaves strain on resources, increases unemployment and terrorism.
As estimated, roughly 83 million people are being added to the world’s population every year. Even assuming that fertility levels will continue to decline, the global population is expected to reach 8.6 billion in 2030, 9.8 billion in 2050 and 11.2 billion in 2100, according to the medium-variant projection.
UNFPA works to support family planning by ensuring a steady, reliable supply of quality contraceptives; strengthening national health systems; advocating for policies supportive of family planning; and gathering data to support this work. UNFPA also provides global leadership in increasing access to family planning, by convening partners – including governments – to develop evidence and policies, and by offering programmatic, technical and financial assistance to developing countries.
The countries with older populations are facing the major impact of COVID-19. The UNFPA supports the participation of elderly people in political issues and the hearing of their voices in the preparation and response to a crisis that affects them most.
The pandemic is hitting marginalized communities particularly hard, deepening inequalities and threatening to set us back in our efforts to leave no one behind. Our response to COVID-19 in every country is critical and will determine how fast the world recovers and whether we achieve Sustainable Development Goals or not.
The crisis has taken a staggering toll on people, communities and economies everywhere. But, not everyone is affected equally. Women, who account for the largest share of front-line health workers, for example, are disproportionately exposed to the coronavirus. Supply chains around the world are being disrupted, impacting the availability of contraceptives and heightening the risk of unintended pregnancy. As countries are on lockdown and health systems struggle to cope, sexual and reproductive health services are being sidelined and gender-based violence is on the rise. And other population problems such as the importance of family planning, gender equality, hunger, maternal health, child marriage, human rights, right to health, baby’s health, etc.
Population Policy Development in Pakistan
We have had no explicit population policy till very recently, although population was implicitly mentioned in all of the 5 year developmental plans. These plans voiced concerns over the population growth as an impediment to development. Pakistan started one of the earliest population programs in Asia. Family planning activities began as early as the 1950’s through the auspices of the family planning association of Pakistan, a Non-governmental organization (NGO) which originated in 1953.
The National Health Policy, including the 1990, 1997, and especially the 2001 policy, was set for the next 10 years to implement. However, none of these policies were implemented entirely in stipulated time.
Since its independence, we have had to grapple with many problems. The country currently ranks sixth among the world’s countries after China, India, the USA, and Indonesia, with a population growth rate of 3.1 per cent per year. The population is expected to rise from 210 million people to 240 million by 2030. Its population was 33 million in 1950 and its rank was 14th in the world, but now it has alarmingly increased.
Women here continue to have an average of four children. Not enough is being done to bring down the birth rate. One of the main causes really is ineffective family planning and population control programs over many years – as a result of which our population growth has continued more or less unabated. Consequence of fertility rates remained high and contraceptive needs have largely remained unmet. People in Pakistan regard continuing contraceptive practices as a bigger threat to their health than an occasional induced abortion. Men and women are reluctant to visit government family planning clinics because of a lack of infrastructure and information.
Successive governments have paid no attention towards family planning and the apathy led to rapid population growth that outstrips development gains. If we had had the same population as at independence, we would be much more prosperous now.
The country, arguably, is no more agrarian. And, this has happened for all the wrong reasons. While it did not have any policy to control exploding rates of population, a majority of the lands that are now being turned into villages, towns, and housing societies were once part of the country’s vibrant agricultural landscape. If the population rise continues to take place with the current pace, in a few decades, the country will face food insecurity.
UNESCO indicates that in the present scenario, one in four Pakistani children will not be finishing primary school by the deadline of 2030. It is a pathetic situation – educational facilities are growing, but not fast enough to cope up with population growth.
Major factors responsible for high population growth are high fertility, low contraceptive prevalence ratio, high unmet need of family planning, decreasing mortality, customs of early marriages, son preference, illiteracy especially of women and lack of women empowerment, religious restrictions, beliefs, customs, traditions and lack of recreational activities.
We remain unprepared for rising challenges of uncontrolled growth in population that raises poverty, leaves strain on resources, increases unemployment and terrorism.
Family Planning Programs in countries in SE Asia were pretty successful: the best results byJAPAN followed by China, Korea, Taiwan, Indonesia. The most important factor has been the strong political will to curb population growth. First country to experience a revolution in reproductive behavior was Japan with below replacement level fertility by 1960. This was accomplished by massive postponement in age of marriage and rapid reduction in marital fertility.
That high fertility was bad for our country and for the family. In Asia, such programs did not
fully develop or succeed where they met religious opposition (as in the Philippines), politically expressed ethnic opposition (as in MALAYSIA), or feudal social structures (as in PAKISTAN). Similar programs were later developed in much of North Africa, in Egypt, Morocco and Tunisia.
Majority of countries made dramatic economic breakthroughs in the past 30 years drastically reducing the average fertility rate. Iran made it from 6.53 to 1.96 in a span of 30 years, Bangladesh down from 6.92 to 2.1 during a span of forty years, while Korea (1.21), China (1.65), Hong Kong (1.23) and Taiwan (1.1) made similar impressive reductions. Regrettably, Pakistan has a very high fertility rate of 3.73 for only for the past four years. If not immediately addressed, this single factor could negate every effort Pakistan may make to break away from poverty, hunger, disease and illiteracy.
In the late 1980s, Iran’s supreme leader issued fatwas (religious edicts) making birth control widely available and acceptable to conservative Muslims. Under the new decrees, contraceptives could be obtained for free at government clinics, including thousands of new rural health centres. Health workers promoted contraception to increase the gap between births and to reduce maternal and child mortality. Between 1996 and 2016, the average age of marriage for Iranian females increased from 19.8 to 23 and from 23.6 to 27.4 years for males.
Interestingly, in case of Bangladesh, it adopted a community-based approach to population planning. It was based on recruiting married, literate village women trained in basic community health and family planning going door-to-door dispensing contraceptive pills and condoms. Local villages had credibility among suspicious and very religious population. Importantly, giving high priority to girls’ education delayed marriages and gave women higher control in their lives.
According to a Bangladeshi expert, some effective ways to control population boom:
- reform in education system, especially in relation to family planning;
- lift ban on TV and print ads of condoms and pills to affect family planning initiatives. Good educational ads need not be erotic and obscene. Creative or symbolic ads of condoms will contribute to population control and STD prevention.
- promote tolerance like in a secular society.
- don’t give power to religious groups to decide on government policy about family planning.
Pakistan’s population predicament
(Pakistan has been firmly saddled with a very high fertility rate of 3.73 for the past few years.)
We in Pakistan could not benefit from religion as a vehicle for change and action. We failed to create population control policies to integrate communities. There was neither easy free access to contraceptives, nor was the media utilized for public awareness and guidance. There were no innovative incentives created for those who adhered to a two-child policy. Most importantly, no steps were taken to raise the marriage age for girls to ensure 16 years of education as provided for in the Constitution.
Our much-needed break from poverty and disease is critically dependent on the ability to bring down fertility rate to and educating girls. Failure to implement the measures would be a sure recipe for a continued addiction to the IMF besides keeping our children vulnerable to stunted growth, crippling impacts of polio, acquiring HIV by reused syringes and remaining illiterate.
Population explosion – a real threat to Pakistan
According to UN projections, the Pakistan population will grow to over 380 million by the year 2050, surpassing the United States, Indonesia, Brazil, and Russia to become the world’s third largest country behind India and China. At highest population growth rate for any large Asian nation, Pakistan will surely experience dramatic declines in per capita availability of arable land, water, and forest resources.
Pakistan, being one of the high-fertility countries with a large proportion of young adults and children, had a population of 33 million in 1950 and its rank was 14th in the world but today, its population has reached around 210 million making Pakistan 6th most populous country of the world, after China, India, USA, Indonesia, Brazil, and surpassed Japan, Bangladesh, Nigeria, South Korea, and Russia.
Due to a high increase in the population, Pakistan is facing serious challenges like shortage of water, electricity, jobs infrastructure, public transportation, health, education law and order, and other social issues are prevailing in the society. The population is a big threat for Pakistan.
Efforts in the past to introduce family planning schemes and greater access to contraceptives met with little success. Due to a lack of foresight and dilly-dallying in implementation process of policies by successive governments, along with societal stigma and resistance from right-wing sections each time the topic of birth control was brought up; and the problem carried on. Shockingly, about half of all married women in the country do not use modern contraceptive methods, resulting in 3.8m unintended pregnancies each year. Early marriages, and the lack of knowledge in contraception and birth spacing, have worsened the position.
From 1993 to 1998, Pakistan ran a successful family planning program which was instrumental in reducing fertility rates and increasing contraceptive prevalence. The key element of the program was the recruitment of trained Lady Health Workers (LHW) to provide primary health care and family planning services to women at community level. The LHW were pivotal in expanding family planning services to the poor and educating them on the available methods. However, from 2000 onwards, successive governments’ attention to family planning programs started to reduce.
POLICY FORMULATION & ACTION PLAN
Year before last, that is mid-2018, a population control and action plan was formulated which were to be presented at the National Task Force, established on the advice of the Supreme Court and as per directives of the Council of Common Interests (CCI).
The documents prepared then – as initiated during later part of the then Govt. – covered all four provinces, AJK and GB and were to be implemented throughout the country in consultation with UNFPA: the draft called the scheme “Pakistan Population Vision 2018-2030”.
The Targets were set in the Plan – wherein the process were to be started – which remains to be seen on the ground. According to the draft plan, the fertility rate or growth rate would be reduced from 3.6% births to 2.1%; the contraceptive prevalence rate increased to 70% and the child & maternity mortality rates substantially brought down; that is, decreasing population growth rate to 1.5 percent.
CONCLUSION
It is encouraging to see population and family planning again getting space on the government’s policy agenda. Yet the scenario as it stands is grim; we cannot afford to laze & lax and have to move forward. Issues relating to family planning and reproductive health services are complex and intertwined. Solutions also need to be comprehensive and integrated. The government of Pakistan along with UNFPA and a host of private NGOs are working on these issues and many others, to contain the population. Population stability may eventually be achieved. BUT, IT IS TIME GOVT. ACTED FAST with the set political will; It’s time we all acted as a nation. Curtailment & containment is the BIGGEST URGENCY.
The Task Force on Population and Family Planning has to embark on to develop a strategy for controlling population growth – nay, pop. explosion – and to guide its implementation. The Task Force, spearheaded by the Center, must act hand in hand with all provincial Chief Executives alongside the newly constituted governing bodies. Given the devolved governance structure in Pakistan, with the 18th Amendment in place, full force is to be applied by all & sundry concerned – no malice but friendship – to ACT IN UNISON WITH COURAGE AND DISCIPLINE toward comprehensive family planning …… the Task Force motto being “WE SHALL DO IT”; no shying away; else, ‘pop-boom’ is going to be like corona exploding without sound and eating away every fabric of our society !!!
The author is a Rotarian and former senior career diplomat. He is available on [email protected] and @SaladinCh