KARACHI, July 11: A paucity of funds hinders the public sector family planning programme from promoting and achieving any plausible rate of contraceptive practice among the married couples across Sindh, sources privy to the birth-spacing initiatives said on Wednesday.
While observing the World Population Day on Wednesday, the facts and figures related to the population control efforts caused concerns among health workers, demographers, etc, again.
According to the Population Reference Bureau’s data sheet-2011, Pakistan’s total population was around 177 million, with a fertility rate of 3.6 and contraceptive use rate at 27 per cent among married women (15-49 years). Sindh’s population was estimated around 42 million, with a fertility rate of 4.3 and contraceptive use rate of 27 per cent, said a source in the provincial population welfare department.
Under the millennium development goals, the rate of contraceptive use among married women needs to go up to 55 per cent by 2015. Pakistan is projected to be the fifth populous country with a total population of 314 million by 2050.
The family planning initiatives introduced in the country under a federally managed association in the 1950s and various slogans were coined from time to time to increase its acceptability equally in all the segments of the society.
It is learnt that the field activities and provision of services were transferred to the provincial governments during a period of 1983-88 (sixth five-year plan of the government), while finances and policymaking affairs, which were left with the federal government, were likely to be handed over to the provinces till the end of financial year 2014-15.
In order to improve the family planning indicators, the provincial population department changed its strategies and slogans and decided to generate participation of the adolescent and the married couples in its programme by stressing the role of reproductive health of a mother in the development and sustainability of a family. One of its latest promotional slogans said: healthy mother-healthy family.
“Efforts are being made, but without pumping required money in the family planning programme how can we ensure our contribution to the population checking,” another source said, adding that about 30 per cent of the couples seeking family planning interventions, including contraception, could not be reached at present across the province.
A source in the population welfare department said that there were about 630 family welfare centres (FWCs), about 100 mobile service units and 75 reproductive health services (RHS) centres in the province for creating an awareness about and provide family planning services, including the spacing-counselling for married couples, supply of contraceptives, awareness and treatment about the sexually-transmitted infections including HIV, minor interventions in the infertility cases and otherwise referral to nearest public health centre.
Although the authorities felt the gaps and necessity of expanding the network, but it was the available budget which restrained them even from increasing the number of FWCs, particularly in the rural areas where population is less educated, poverty ridden and unable to approach any other private or public facilities but they desired to seek reproductive health related guidance and interventions.
“Finance is needed to induct more doctors and paramedical staffs for the expansion of the family planning network,” said the source, adding that things were worsening so much that staffs were not being paid their monthly salary on time.
An expert said that Sindh needed to double the number of its existing FWCs in order to make it possible for the poor population to access the family planning facilities.
The expert said that an FWC had the capacity of meeting the need of a population of 7,000 available within seven kilometres only.
Therefore, many of the people were being deprived of contraceptive and condoms and other surgical interventions despite all their willingness to practice family planning in their life, the expert added.
Dr Azmat Waseem, an additional secretary of the Sindh population welfare department, told Dawn that the need of about 452,000 contraceptive users were met by the department across the province, while about 120,000 could not be reached.
Replying to a question, she said that the rates of clinical/surgical sterilisation in men had increased at the government RHS in 2011.
The number of women undergoing tubectomy remained about 3,000 last year, while the men undergoing vasectomy ranged 110-120 per month, she said, adding that if relevant funds were made available for onwards payment to people volunteering for the surgical options the figures of men and women in question could increase further in the province.
Dr Waseem said that the population department’s reproductive health centres were not only creating awareness but also facilitating the visitors in regard to the reproductive process and better opportunities of health to mother and child. “At our welfare service centres we provide services in the fields of family planning, health of mother and child and treatment of common diseases as well.”
She said that there was a need to facilitate the mothers seeking abortion on health ground and other measures to reduce the infant and maternal mortality rates, which were higher in Sindh.
Talking about the funding, she said that the federal funding had been capped around Rs885 million per year, but the provincial government had provided Rs500 million in the last year.