By Zubeida Mustafa
In a recent study on family planning in 95 Third World countries, the Washington-based Population Crisis Committee ranked Pakistan 43rd in availability of modern birth control methods, service related activities, information and outreach and government commitment to population in terms of budget and policy. Out of a total score of 100, Pakistan received a lowly 29 and was rated as “poor”.
It compared most unfavourably with Taiwan which scored 92 and was ranked first. In fact Pakistan was also way behind other South Asian countries such as Sri Lanka, India and Bangladesh which scored 76,64 and 64 respectively. Even Nepal was better off with a rating of 30.
What emerged significantly from the survey was the close relationship between family planning programmes, the decline in fertility rate and the level of economic development. Higher decline in total fertility rate (TFR) between 1970 and 1985 occurred in countries with “excellent” scores on access to birth control. It is no coincidence that these are also countries which have recorded good progress in the economic field such as Taiwan, Singapore, South Korea, Hong Kong and China. Pakistan’s TFR fell by only 18 per cent when China’s recorded a decline of 55 per cent. The TFR in India and Bangladesh fell by 32 and 21 per cent respectively.
Pakistan’s poor showing in this context has serious implications for the country’s social and economic progress as well as the status of women. Failure to provide contraceptive facilities and information and education on fertility control has, on the one hand, adversely affected the pace of national development. A high population growth rate of three per cent has strained economic resources and neutralised the little progress made in different sectors.
On the other hand women who are trapped in a cycle of child-bearing and child-rearing through the most productive years of their lives are left with little scope for the enrichment of their personalities, economic emancipation and intellectual uplift, not to speak of the improvement in the quality of their lives.
The weaknesses in the clinical aspect of the population programme as underscored by the low ratings for availability of different contraceptives account for its failure to make an impact on the demographic scene. Pakistan’s score is behind that of other South Asian countries in terms of birth control services available.
But what is equally if not more significant is Pakistan’s low rating in the column on information and outreach. This reflects poorly on the communication strategy adopted. It is not only in the narrow term of the message sought to be conveyed and the mode used to transmit it that the authorities have not succeeded. Their entire approach has been wrong.
One major factor to be taken note of is that the population programme has been isolated from the social and cultural milieu. It has not tackled directly the religious and cultural constraints that have prevented the small family norm from gaining universal acceptance in the country. For instance no effort has been made to enlist the cooperation of religious leaders in the matter. No fatwa has ever been obtained giving religious sanction to family planning as in other Muslim countries.
As a result religious belief continues to be a restraining force in Pakistan’s population programme. In a survey, Dr. Samia Altaf and Dr Mir Anjum Altaf found 72 per cent of the respondents saying that they felt that contraceptive practices were against their religious beliefs. Other countries, including Islamic states, have demonstrated their capacity to overcome such barriers through conscious efforts.
The population planning programme has failed to make a headway because its communication strategy is misdirected in another way. The motivation campaign adresses the women predominantly. But ours is a patriarchal society where men are the key decision-makers. The woman’s role in decision-making even at the family level is minimal. Hence the family planning message fails to create in impact because the men are largely by-passed while the women who are the main target group have very little say in the matter.
Most importantly, population planning in Pakistan has not been integrated with a movement to improve the status of women. Whatever the planners might claim their strategy to be—some population projects are linked with income generating schemes for women and others provide simple healthcare — the fact is that there is no concerted drive at the national level to change social attitudes towards women. Age-long prejudices against women continue to determine people’s perception of women. Thus daughters are regarded as a liability and sons an asset. While girls are brought up as commodities which have to be transferred to others through matrimonial arrangements, boys are regarded as the mainstay of the family.
To seek behavioural changes in men and women without modifying the social environment has proved counter-productive. Given the parental discrimination between sons and daughters and their preference for boys, it is not strange that most couples do not become acceptors until they have produced a male offspring or two. This approach defeats the basic purpose of the population programme and does not have a beneficial effect on the fertility rate. These are some of the aspects population planners will be expected to look into if Pakistan’s high fertility rate is to be brought down.
Source: Dawn 23-12-1988