KARACHI: Seventy-two per cent women and 62pc men in the reproductive age group in Sindh either want to stop childbearing or desire birth spacing, but they have no access to reproductive health services. Forty-three per cent pregnancies in the province are unintended, a speaker said at a programme held in a local hotel on Tuesday.

The discussion on the challenges of population and family planning was organised by USAID in collaboration with the JSI Research and Training Institute. The aim was to take Sindh parliamentarians on board on the issue. However, only four of the more than 150 MPAs could make it to the event.

According to experts, the fast growing population is a vital challenge Pakistan faces today that would turn more serious in the coming years if nothing was done to address the issue, a major stumbling block to economic growth and the dream to have a peaceful and prosperous society.

The solution, they said, was not difficult: integrate health and family planning services and focus on couples who were already convinced to seek reproductive health services.

Citing a recent survey, Dr Arshad Mahmood, representing the JSI Research and Training Institute, said Sindh had 1.75m pregnancies annually of which more than 700,000 (43.3pc) were unintended. The number of unintended births in the province stood at 387,000.

Abortion, he said, was often opted for as a solution to unwanted pregnancies and the number of reported abortions was found to be 269,000 in a year.

“Of every four children, one baby is unwanted. Such children mostly born to the poorest of the poor are likely to be deprived of the care and facilities required to make a productive individual.

“A high number of unwanted, illiterate and unskilled children mean a large group of vulnerable individuals that can turn to criminal activities and act as a threat to the peaceful existence of a society,” he said.

The fact that a large group of couples in the province wanted to opt for reproductive health service offered the government an opportunity to increase the dismally low contraceptive rate in a short period of time, he said.

Giving a presentation on population changes, Dr Tauseef Ahmed of Pathfinder, an international non-governmental organisation working in the area of sexual and reproductive health, said the Sindh government needed to take advantage of the falling fertility rate that, in his opinion, was a positive sign but, at the same time, presented the challenge of having and managing a large population of young people.

“You can earn demographic dividend only if you invest in health (that included reproductive health and family planning), education, employment opportunities and good governance,” he said, adding that governance based on merit-based decisions and accountability was the backbone of the process.

Sindh’s present population (45m) would double in 36 years for which the government had to take policy decisions now. The province had a high maternal and infant mortality rate as compared to Punjab and Khyer Pakhtunkhwa and had shown no significant progress in these areas.

“In rural Sindh, 86pc of married women are of reproductive age and 53pc of men are illiterate. Lack of education plays a big negative role in every aspect of life. Right now, it’s acting like a killer for Sindh’s children, greatly minimising their potential to have a better life,” he said.

Dr Sania Nishtar of Heartfile, another non-governmental organisation, lamented that though Pakistan was the first in the region to allocate budget for family planning and initiate relevant programmes, the country had achieved little in this sector in 60 years.

“We are all part of the failure. We should have built on these pilot projects,” she remarked.

Begum Shehnaz Wazir Ali (technical adviser to the Sindh government for oversight and coordination of primary health and family planning), Dr Farid Mihet, Dr Nabila Ali, Dr Yasmeen Qazi and Dr Moeed Pirzada also spoke.

Published in Dawn, October 1st, 2014