YOUSAF and his wife wanted at least a son, preferably two. They now have two. But they also have four daughters. One of the daughters is physically challenged.

Yousaf works as a driver. His salary is not enough to ensure a decent standard of living for 10 people (including his old parents). He is the only breadwinner of the family. And he keeps running from pillar to post, trying to do two jobs when he can, to earn a bit extra. Even with the running around he is always worried and stressed out and almost always in debt.

Yousaf cannot afford to have his children educated. So he is making choices under severe constraints. He sends his older son to the best school he can afford: a low-fee private school that advertises itself as an English-medium school. He sends three of his daughters to a public school while the child who is physically challenged does not go to school. The other son is too young for school. Yousaf knows he will not be able to send him to the same private school unless his income goes up by Rs500 a month.

Though it is hard for Yousaf (and his wife) to articulate why he wanted sons, he feels strongly that sons are an important legacy and they are an essential means for ensuring that his old age will be well taken care of. Whether he is right in his perceptions or not, he feels strongly enough about this to have had six children even when he had a good idea of his income level.

Five poorly educated and one uneducated child. Have Yousaf and his wife made the right choice? Whatever the answer, he has definitely imposed a cost on society. If these children remain uneducated, they are not likely to contribute to the ‘demographic dividend’ story that has been so popular in some development policy circles in Pakistan for the last few years.

If Yousaf and his wife cannot get their children educated, society has to allocate the resources for them to do so. Currently there are, by some estimates, 20 million-plus school-age children who are out of school. Clearly society is not doing a good job of allocating resources for educating children who are not being educated by their parents.

Sakina, who works as a maid in three households to make around Rs9,000 a month, has eight children. She only wanted a couple but her husband, who is a junkie and does not work, was not in favour of using contraceptives. He did not care about the number of children and his approach resulted in more than eight pregnancies for Sakina and eight surviving children.

Despite her 10-hour workday and six-day work week, she is not able to even provide proper nutrition to her children. Though some of her children go to public schools, on and off, since there is no one at home to supervise or manage them, even the ones who go to school are not learning anything.

Though fertility rates have come down significantly in Pakistan, they are still high by international standards and it is estimated that by 2050 Pakistan will have a population of 275 million (some estimates go as high as 350 million). If a lot of these people survived malnutrition in the early part of their lives and are uneducated we will have a demographic nightmare on our hands as the dividend.

‘Do bachay khushal gharana’ and catchphrases about a minimum three-year interval between children were common in the media at one time and quite well known. At some point in time, maybe due to the decline of fertility rates, family planning issues went off the radar of society and the government. Though fertility did decline, the drop was not steep enough to warrant the complacency that developed and continues. This has to change, and urgently.

If Yousaf and his wife’s perceptions about the value of sons are true, the underlying factors have to be addressed to change these perceptions. If Yousaf’s perceptions are wrong, his misperceptions need to be corrected. Sakina’s preferences need to have more weight. And all of them need to have options, as a matter of right, and with easy access and at affordable prices, relating to reproductive services. Surveys show there is significant demand for such services but the state is not providing them right now. This too needs to change and urgently.

Nadeem, who works as a cook, has stopped at three children. This despite the fact that he lost another child to illness. His brothers and sisters have five or six children each. He thinks he can only provide for three children. He wants to educate his children well. He is investing in quality rather than quantity. If we could provide the same assurance and environment to Yousaf and his wife maybe their choices would have been different too.

There cannot be any element of coercion here. People make the best choices they can, given their choice sets. Changing choices requires changing their choice sets. Yousaf and Sakina are not being irrational or even sub-optimal. They are doing the best they can given what they face and what they believe to be the case. If society wants different outcomes, the underlying factors behind the choices need to change. But if we are not able or willing to address these issues, we should prepare for the nightmare that we will face in a few decades.

The writer is senior adviser, Pakistan, at Open Society Foundations, associate professor of economics, LUMS, and a visiting fellow at IDEAS, Lahore.