How we grow

By Zubeida Mustafa

IS the world really waking up to the population crisis that received a lot of international publicity at the London Summit on Family Planning last week? One wishes it were. But all the noise seems to be emanating from the developed states which have managed their own demographic affairs very well while generously supporting the Third World countries’ population programmes. Their success is to be attributed mainly to their strategy of working honestly within a holistic socioeconomic framework.

Unfortunately, developing countries, which are the biggest contributors to the galloping global population growth and that have restricted resources, have shown a poor record. According to the UN, the current world population stands at 7.6 billion and is expected to be 8.6bn by 2030 and 9.8bn in 2050. The world has roughly 83 million new mouths to feed every year.

Take our case. With a population of about 200m — we still await the recent census results — Pakistan is the sixth most populous country in the world and a major contributor to the annual global population growth. It has failed to meet its demographic goals.

The Punjab finance minister, who attended the London summit, can hardly be credited with high intelligence when she stated the obvious that Pakistan had no time to lose to reduce its fertility rates. With every woman producing an average of 3.8 children in her reproductive years, a contraceptive prevalence rate (CPR) as low as 35.5 per cent and the population growing at 1.86pc per annum, the country still has a long way to go. In the last three years, Pakistan has managed to reduce its growth rate marginally by a measly 0.06 percentage point by the official reckoning.

Is population planning following the same path as education?

What was most disturbing was the minister’s statement that “a definite political will had been translated into budgetary allocations by the provincial governments”. One should normally have welcomed this move. But a look at some facts and figures pointed out by an Islamabad-based NGO called Research and Development Solutions tells another story. It says government budgets across all provinces have reportedly exceeded Rs10bn — 2.5 fold in one year between 2012 and 2013. But it is doubtful if this has translated itself into a proportionate increase in the CPR or reduction in the total fertility rate. Only a survey, whenever it is held, will tell.

Where is all this funding going? It is revealing to dig into the information given in various documents released by the government agencies annually and the two demographic surveys of 2006 and 2012. Here is my assessment, which should give some food for thought to those who care.

First, the population programme, like our education projects, is receiving heavy funding from various foreign sources and a lot of it is going into increasing manpower at the population department and to build infrastructure. Thus family welfare centres, reproductive service centres, mobile reproductive units, registered practitioners have grown (on paper?) requiring funds but not necessarily producing results. It is calculated that 96.5pc of the funds pay for salaries and overheads. More significantly, since 2013, the supply of contraceptives has actually gone down. As for the contraceptive users only a third receive their supplies from a public-sector facility with the remaining two-thirds being served by NGOs or procuring their own supplies after paying for them in the market.

All this doesn’t inspire much hope. Is population planning following the same path as education with its main goal being job creation? One would have to obtain the manpower strength at the Population Welfare Department and its performance to assess the effectiveness of the programme.

One would like to believe that the population staff is serving as motivators to create the demand for family planning services and the desire for small families. But creating demand without providing the services can be a frustrating exercise. Empirical evidence does not suggest that much has changed on the demographic front. Look at what demographers call unmet need (UMN), meaning there are women who do not want more children but who have no access to contraceptives. This has not grown substantially and the UMN has stagnated at 20pc in the last decade.

The emphasis appears to be on supply side strategies. The reason stated by the NGO for this failure is plausible. There is little effort on retaining users, young couples (especially girls) are systematically ignored and little research has been done on the demand factors such as reasons for refusal, clearing up misconceptions and devising ingenious counselling techniques. There is also the need to focus on the growing urbanisation. Health and educational facilities in our urban slums are badly neglected. These aspects must be looked into seriously if the population growth rate is to be slowed down.

Source: Dawn