KARACHI, Oct 11: Pakistan’s population of over 142 million today is likely to reach 220 million by the year 2020, undermining all efforts for poverty reduction. In view of this grim scenario, the ministry of population welfare recently presented the first ever population policy that sets both short and long term targets. One of the short term targets is to reduce the population from the stated 2.1 per cent to 1.9 per cent by 2004, or attain four births per woman per annum.
How do population experts see the new population policy? Are the targets realistic? Dr Mehtab S. Karim, Professor of Demography and Head, Reproductive Health Programme, Aga Khan University, who has made a close study of the population policy, had several comments to make.
Firstly, the population policy focuses on reducing fertility; it is, in his words, “a family oriented policy”. However, Dr Karim is of the view that the high infant mortality rate in the country — one of the highest in the region — must also be addressed, as this has a direct bearing on family size. “Women have more children, as they fear all will not survive”.
Another area that has been disregarded is the large-scale migration within the country, which “impacts on the receiving end”. Sindh, for instance, which has 24 per cent of the country’s population “gets the highest per cent of migrants — i.e. 48 per cent”. This means that “Sindh’s population is growing faster than other provinces”, and this factor cannot be ignored. The government must “discourage” such large scale migration and deal with illegal immigrants.
According to the census, the population growth rate on average is 2.3 per cent, while the Federal Bureau of Statistics claims it is higher, at 2.6 per cent. “Both figures can’t be right,” points out Dr Karim. “Either the census has missed some people, or the estimate given by the Federal Bureau of Statistics is wrong.” Given the poor performance of the family planning programme in rural areas — a fact confirmed by the World Bank — the census figures could be questionable.
This can be confirmed by conducting a “post census enumeration survey”, as done in 1961, which found that six and a half per cent of the population was missed in the census. “It is important to verify the census figures, as the census is an important determinant of the National Finance Award (NFC) and the allocation of seats in the Assembly” he adds.
Dr Karim also questions whether we really have the 2.1 per cent population growth rate as being claimed today by the government. Assuming it is 2.1 per cent, can we really achieve the 1.9 per cent population growth rate by 2004, or the 1.3 per cent growth rate by 2020 — the targets set by the government. He points out that with better services, if the birth rate declines, so will the mortality rate of infants and adults. “It’s better then to set targets for the reduction in fertility, rather than the population growth rate, which includes the mortality rate.”
He stressed that for a faster decline in the birth rate in the rural areas, substantial effort have to be made in these areas. Studies in the Sindh interior indicate that the recruitment of women health workers — who should be educated and married — is not meeting the standards set. Dr Karim stresses that political commitment is essential — both at the top and at the district level — if the programme is to succeed.
He also stressed that monitoring is a must to understand where the problems lie, and where corrections need to be made.”This will also help us to learn from those districts that are doing well, and will give them an incentive to do better.”
Having made these observations, Dr Karim added that the population policy provides a good guideline, integrating the population issue with other sectors like education and health, unlike earlier programmes which were vertical in approach.
The policy is also an improvement to earlier programmes, as it provides community based services, with health workers going to the client rather than the client going to the health worker. Other positive factors of this policy are that it envisages a public-private partnership, and it sees birth “not only as a woman’s issue, but also stresses on male involvement”.
Dr Mohsina Bilgrami, who is the Managing Director of the Marie Stopes Society, commends the government for issuing a population policy and setting short and long term targets. However, Dr Bilgrami’s chief objection is that the policy statements are too generalized. Giving one example she says, that “the policy states: ‘reduce unmet need for family planning services by making available quality family planning services to all married couples’. But how will efforts being initiated differ from the past? This the policy does not specify.”
She also stresses the need for linkages between different ministries for a successful family planning policy. For instance, there is a need to link up with the education department and the ministry of religious affairs to educate people about planned families and the need to delay the age of marriage. However, there is no mention in the policy about such linkages.
Again, the policy sets a target of achieving four births per woman by 2004. But how will the government reach this target? What indicators will the planners use to learn whether the targets set have been met or not?
Dr Bilgrami also points out that the policy does not indicate the resources required to achieve the targets set; or what the government will do if the resource needs, which are dependent on foreign grants, are not met.
