ISLAMABAD, July 10: Population growth rate in Pakistan has declined to two per cent and total fertility rate to 4.5 births per women, however, the maternal mortality rate is still very high due to number of pregnancies per women and inadequate gap between births.
“We are still losing 30 to 35 women a day in Pakistan due to pregnancy related complications — a human disaster which can be prevented through improved service delivery and child spacing,” said Olivier Brasseur, the United Nations for Population Fund (UNFPA) representative in Pakistan.
He was speaking at the launch of the Pakistan Population Assessment Report 2003 at the United Nations Information Centre here on Thursday. Abdur Rashid Khan, secretary population welfare, also spoke on the occasion.
The most worrisome thing, Mr Brasseur said, was that the population in Pakistan was growing at a rate which was absorbing every additional expenditure made in sectors like health and population planning.
The maternal mortality rate of 350 to 700 deaths per 100,000 births is highest in the region, though Pakistan is still on the path of improvement.
However, he appreciated the commitment on part of President Pervez Musharraf, Prime Minister Mir Zafarullah Jamali, and both federal and provincial ministers in this regard. However, he mentioned the confusion prevailing in the society about population planning because of cultural, social and religion factors.
“Islam is not against the control of maternal mortality, still our biggest problem is to convince the people to avail the facilities offered by the government,” he said.
The service delivery in Pakistan still needs a major improvement, the UNFPA representative said.
While the number of employed people doubled between 1970 and 2002, the assessment report said, the number of unemployed people increased eight-fold during the same period. The investments made in social sectors like education, health, housing, water, sanitation and infrastructure had not kept pace with the rapidly growing population.
The report called for integrating population issues into economic and development strategies to achieve mutually reinforcing gains both for development and an improved quality of life in Pakistan.
Considering that people under 25 years of age constitute 63 per cent of the population, a comprehensive youth and adolescent health/reproductive health policy is urgently required in which the partnership of public as well as NGO sector should be ensured.
The development of a comprehensive national maternal health policy should also be pursued to reduce maternal mortality and morbidity.
The human development section of the poverty reduction strategy paper should look at fertility reduction as a first priority, to ensure that investments in other areas were not constantly undermined by an uncontrolled demand.
The report stressed the need for investing in capacity building to make the ministry of population welfare a leading department on policy issues, advocacy, information, education and monitoring of population aspects.
It also suggested to harness political commitment at a broad coalition for strategic integration of population issues. “This will be achieved through a nationwide advocacy and social mobilization programme at all levels involving elected leaders like MNAs, MPAs, Nazims, male and female councilors, political leaders, religious leaders and scholars, community leaders and members of communities.”
The report said the staffing at the primary health centre should comply with minimum standards, specially providing for women staff members, like two women obstetricians should be posted at each district headquarters hospital.
Appropriate infrastructure and facilities should be available at Tehsil and district level; delivery rooms should comply with basic standards like water and electricity supply, ventilation, stable room temperature etc. While compliance with these standards should be regularly monitored, the report said.
It said the community midwives, with adequate supervision and training, should provide antenatal and postnatal care including safe basic obstetric care.