Won`t we be counted?

January 11, 2012

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ACCORDING to Pakistan's Population Census Organisation's website, enumeration of the population should have been completed on Sept 27, 2011. This has not been done.

Even the house-listing operation that precedes the head count has run into road blocks. One can therefore only make wild guesses about the size of our population. According to the government, the population of Pakistan today stands at 177.1 million. The growth rate, as claimed by the Pakistan Economic Survey 2010-11 , stands at 2.05 per cent per annum.

This is cause for serious concern as last year's Survey had quoted the population growth rate to be 1.51 per cent.

Compared with some of our neighbours who have done well in checking their demographic explosion Asia's average population growth rate is 1.1 per cent Pakistan's record is dismal.

Every year there are 3.53 million new mouths to feed.

Considering that these children also have to be provided nourishment, healthcare, schooling and shelter, and at a time when the economy is in the doldrums, Pakistan's population burden is becoming heavier and unbearable. True a more equitable distribution of resources may ease the problem somewhat but it would still drain the national resources and not provide satisfactory facilities for all.

There is another way of looking at the issue as is the proverbial case of a glass viewed as being half empty or half full. Dr Adnan Khan, director of Research and Development Solutions, takes a more positive view of Pakistan's population statistics.In a report that he is preparing on the basis of his analysis of the data given in the Pakistan Demographic and Health Survey of 1991 and 2007 he feels that 'there has been success all around, gains in family planning in rural locations far outpaced any progress in urban locations.

Whereas urban contraception rates doubled, rural rates increased over six-fold with traditional methods increasing nearly 10-fold. It is our feeling the magnitude of this change has been under-appreciated by public health providers.There is also a great unmet need for contraception in Pakistan, particularly in the rural areas where many couples would adopt family planning if services and contraceptives were made available to them. Therefore, Dr Adnan Khan suggests that policymakers should address the supply side of contraceptives more comprehensively.

He is correct on this score. With an unmet need of 25 per cent (six million users) Pakistan has plenty of scope to convert these people into adopters. This simply calls for making contraceptives easily accessible and affordable. The success of this approach has been proved before. In 1970-77, the contraceptive inundation scheme had created quite an impact on the population growth rate. Dr Adnan Khan also cites a survey held in 1991 when supply side programming caused the CPR to go up by as much as 25 per cent in some selected areas.

This analysis so eruditely done should explode certain myths which are actually promoted by vested interests. It should also alert us to a mixed trend both positive and negative in the status of women in Pakistan. The PDHS had made it quite plain five years ago and it has been confirmed by this analysis that religion, especially the brand preached from the pulpit, does not really determine the decision of people on the number of children they want. The gender balance of the family is more decisive for the family size.

The fact is that many women in the reproductive age group are now taking matters into their own hands and opting f or contraceptives to space their children. In fact, the non-availability of contraceptives is a major constraining factor in Pakistan's population growth rate. It also accounts for the high recourse to abortion. It is not surprising that the methods used by women female sterilisation, IUDs. Implants, pills which account for 3.42 million women users as against 1.6 million condom users are now more popular though their use requires medical supervision of some kind. Women are now beginning to realise that they have to turn to family planning if they want to change their lives.

It is a pity that they have to rely preponderantly on the pathetic services provided by the government. I wouldn't attach the same importance that Dr Adnan Khan gives to the traditional methods for which there is no way of authenticating the surveys which are notorious for their inaccuracy. The data for the modern methods can to an extent be validated by ascertaining the quantum of contraceptives dispensed. The exodus from the countryside and the growing urbanisation in Pakistan accounts for the lower population growth rate in the rural areas.

But there is a need for the government to spruce up its performance in contraceptive delivery as this analyst demands.

The allocation for population projects is not traditionally fully utilised. In 2010-11 of the Rs2151.5m allocated to this sector under the capped PSDP only Rs692.34m was actually utilised.

How well it was spent, one cannot say.

With its wasteful overheads, the government spends nearly Rs14,000 on every user to provide contraceptive cover for a year to reach only four per cent of married women of 15-49 years of age. The NGOs are more frugal with their funds and their corresponding expenditure is only Rs300-3500 per head.

It is time it was realised that this is not an exclusively women's issue. Overpopulation has implications for the national economy as well as the social and political well being of the country.

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