Doubling Ehsaas?

September 30, 2019

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The writer is country director, Population Council, Islamabad.
The writer is country director, Population Council, Islamabad.

PRIME MINISTER Imran Khan’s heartfelt statements about eliminating poverty in Pakistan are loud and clear. However, his analysis of how China managed to bring 700 million out of poverty is blind to one of the most obvious levers of change — reduction in population growth rates. The Chinese model is not appropriate for Pakistan; however, the experience of other countries in promoting a locally responsive narrative about the balance between population size and resources for families and for the country is surely relevant. And it is missing in Mr Khan’s and economic policymakers’ possible top list of how to change this country’s destiny.

Read: Pakistan, eight other countries to account for half of population growth by 2050

Last year, Bangladesh’s GDP per capita income caught up with and surpassed that of Pakistan. Reaching around $1700 per capita, this is impressive growth, considering that when the split occurred in 1971, Bangladesh was considered the poorer part. Many economists have written that a major contributor in Bangladesh’s economic growth is its strong and well-implemented population policy that has kept its population growth rate low. Bangladesh was able to achieve many of its MDGs by 2015, whereas Pakistan fell seriously behind in meeting almost all of them MDGs.

Pakistan can claim some progress in lowering poverty, despite low economic development. It has experienced some spurts of growth in per capita income and an associated decline in poverty. Income distribution has remained fairly stable and the influence of income disparities on poverty has at least not worsened. We have had some fortunate breaks, such as the rapid growth in workers’ remittances which contributed greatly to poverty reduction. But the truth is that we would have seen a much more pronounced reduction in poverty and much better progress in many of our development outcomes if our population growth had been slower. In fact, if our population growth rates had declined on the same lines as Bangladesh since 1980, we would have had 40 million fewer persons in the poverty head count in 2017.

But is our population growing so fast because we are poor or, are we poor because of our high birth rates? A recently released study by the Population Council and Guttmacher Institute, Adding it Up, shows that the poorest women have almost one more child than they want during their lifetime. This shatters the myth that the poor do not want to reduce family size; they certainly do. There is unwanted fertility among all classes of Pakistani women, the study shows, but it is highest among the poorest women.

We would have seen much better progress had our population growth been slower.

It is easy to see that women from the poorest families experience a three-fold disadvantage compared to richer women when it comes to managing the size of their families: they are more likely to be uneducated; they are less empowered within the family, especially in monetary terms; and they definitely face more issues of access to information and services for family planning. True, they want relatively more children — four children as compared to half that number (2.2) among the wealthiest — but the gap between desired and actual fertility is also greatest among them. Another distressing reality, evident from other studies, is that the poorest women experience more unwanted pregnancies and abortions on average, with associated financial and health costs.

Against this backdrop, it is encouraging to note a recent innovation being implemented by four partner organisations — the Benazir Income Support Programme, Punjab Population Innovations Fund, Population Council, and UNFPA — that specifically aims to reduce poor women’s barriers to accessing family planning services. This intervention is among the recommendations of the Council of Common Interests 2018 meeting to address alarming population growth in Pakistan. The large majority of the 5m women BISP seeks to support are currently married, and at risk of repeated, including unwanted, pregnancies. The intervention will help provide the resources they lack for paying transport costs and fees to access family planning services.

Much more is needed. But among many of Pakistan’s higher echelons of decision-making, it appears that promoting lower population growth is considered a high-risk venture. A common explanation given for high population growth rates and continued high fertility rates is that larger families may be inevitable, that poor parents ‘need’ to or expect to benefit from having many children — that in fact is their only means of maximising income. This may have held some truth if parents could expect children to pull the family out of poverty. However, this strategy is flawed in an economy that is generating inadequate opportunities for employment, even for those young people who do have education and skills, and where real wages are dwindling. Poorer families, even if they maximise income, barely have enough resources available for necessities like food, and little if any investment in the education and skills of children, especially girls. In the current economic environment, poor households with higher fertility are more likely to experience an inter-generational spiralling of the poverty cycle.

On the other hand lower fertility, apart from alleviating huge health and mental stress issues for the poorest women, is a major mechanism by which their families can lift themselves out of poverty. Fewer children and greater numbers of productive adult members generate higher levels of per capita income and savings. Lower dependency ratios are kicking in for the richest and the middle-class families in Pakistan that are having fewer children. But such savings remain beyond the realm of possibility for the poorest families who teeter precariously on the slippery slope of poverty and tend to spend all their income on meeting the most basic of needs.

No doubt much of poverty alleviation must be addressed through economic reforms, planning, and generation of growth-led development. But at the same time, a great deal of distress can be alleviated and the unequal risks of transferring poverty to the next generation reduced, by enabling poorer couples to have the numbers of children that they truly want and can afford to raise well. Not doing so will only continue to add to the pool of the destitute and poor, who desperately require social safety nets. If Imran Khan and his advisers do not take this simple reality seriously, they would soon be planning to double the outlay for and efforts towards the already ambitious Ehsaas programme.

The writer is country director, Population Council, Islamabad.

Published in Dawn, September 30th, 2019