It is time to defuse Pakistan’s ticking time bomb. Various surveys show Pakistan as having the highest population growth in South Asia. All efforts in the past to tackle the issue have failed, undermining the socio-economic progress of the country. According to the latest count, our population has already crossed an estimated figure of over 207 million. There are many complex factors behind the failure of continuing national efforts to reduce the population growth rate. These range from lack of a holistic approach to a regular follow-up, and at times the complete sidelining of campaigns of the population welfare departments by the government of the day.
The PTI government also committed itself to tackle the population issue with a firm hand. Its election manifesto said: “We will ensure the adequate availability of contraception to all married women of reproductive age (MWRA) through the population welfare and healthcare network of Basic Health Units, Lady Health Workers and Community Midwives.” This is the party vision which has yet to be translated into action. No visible measures have been taken to upgrade various government facilities, like rural dispensaries, which are an important link to disseminate the message of family welfare, especially through female teachers or midwives posted at the health units throughout the province.
The toughest resistance to population welfare plans comes from the conservative section of society, which needs to be addressed by enlisting the support of religious scholars. In rural Pakistan, the mosque can be used as an effective platform to spread the message of birth spacing. But to use the methodology, the state has to ensure that those leading prayers across the country are qualified enough to perform the task of convincing the common people to have fewer children. Referring to this aspect of the matter, the PTI manifesto says: “We will build on the existing consensus from religious leaders of all major schools of jurisprudence on using temporary birth spacing methods and publicly use their endorsement at the community and household level.” But the necessary follow-up measures have yet to be taken.
The taskforce, which was set up in November 2018 in a meeting chaired by Prime Minister Imran Khan, and attended by four chief ministers, had decided to reduce the population growth rate from the current 2.4 per annum to 1.5 per cent. The Ministry of Health had chalked out an action plan entitled “Pakistan Population Vision 2018-30,” which aimed at reducing the growth to 2.1 per cent and taking the contraceptive prevalence from 35 to 70 per cent while making efforts to reduce the child mortality rate as well. Both federal and provincial governments have also set apart substantial amounts to accelerate the population welfare programmes but the situation has shown little improvement so far on the ground.
Needless to say, population planning is closely linked to food security, achievement of the country’s economic goals and tackling the serious issue of undernourished children. So it has to be made a success. At present, Pakistan has an acute global child malnutrition rate of over 17 per cent. The services being provided at the Family Health Clinics of the provincial governments look impressive on paper. But the question is how many people access these facilities? How strong are the efforts to persuade couples to visit the centres? Is there any system of monitoring and collecting data and conducting an analysis every year to know if the set targets have been achieved? Unfortunately, if one looks at the figures a dismal picture emerges. It is necessary to ensure that Pakistan’s future generations are saved from malnourishment. As things stand, millions of Pakistani children are facing stunted growth.
Last year’s UN report projected that Pakistan’s population will reach 403 million by 2050, which ought to set off alarm bells for economic planners in a country already grappling with energy and potable water issues. Pakistan’s population doubled in size from 1990 to 2019, which means whatever steps were taken to curb the growth rate did not produce the desired results. This shows something is seriously wrong that despite phenomenal growth in the means of information, the message of population welfare did not either reach the target audience or was simply ignored by the majority of the population.
What is the way forward? The PTI government must implement what it promised in its manifesto to check the burgeoning population growth rate. The entire population control campaign needs to be restrategised. A new massive awareness raising campaign needs to be accompanied by strengthening the network of family welfare centres and refurbishing them to work as community health clinics. Secondly, we need to retrain family health visitors, who should not only work as carriers of the message but also provide family planning tools, medicines, etc, on the spot to willing couples.