The Interim Population Sector Perspective Plan 2012 is a response to Pakistan’s national commitment. It contains the National Population Policy and Population Sector Perspective Plan 2012.
The content strategies, objectives and programmes of this document are indicative of the strong political commitment of the government to population-related issues. The document cover some of the important areas which are detailed below;
Population Poverty and Development
Population and development are intrinsically interrelated and progress in any component can catalyze improvement in others. In recognition of this awareness the 1994 Population Conference was explicitly given a broader man -date than before on development issues establishing the connectivity of population with poverty, status of women and sustainable development.
It also recognized the linkage of slowing population growth, reducing poverty and achieving economic progress.
Pakistan’s GDP growth rate was 6% in the 1980s, with population growing around 3%, there was more, than 2% increase in the per capita income.
However, during the period from 1981 to 2000 it is recognized that population has eroded 2/3rd of the growth in income. It is generally stated that whilst poverty is the root cause of high fertility, the common outcome of the latter is poverty.
Therefore, the population growth rate has to fall sharply in order to significantly increase the growth in per capital income and also to decrease the level of poverty which has increased from 17.3 per cent in 1987-88 to 33.5 per cent in 1999-2000.
We are witnessing a rapid increase in the growth of slums in the urban areas. Most of these lack basic amenities such as water supply, electricity and adequate social services.
The rise in poverty can be attributed to low rate of economic growth, implying a slow increase in per capita income, rising unemployment, stagnant/decline in real wages. Furthermore, low savings and a low investment environment has strong linkage with lower employment generation. At the same time low savings has resulted in high national borrowing, which has raised the debt burden to an unmanageable level.
This has set the various cycles of borrowing and debt servicing which consumes a majors chunk of the available resources thus leaving negligible amounts for investment in social sectors.
Pakistan, a semi-arid country with only one-third of the area being arable, faces the problem of land fragmentation due to an increasing population along with a decline in productivity. Rapid population growth also contributes to environmental degradation and depletion of natural resources.
At the micro-level, the impact of poverty is more obvious. Poverty leads to pressures of food consumption, which adversely affect caloric intakes and increases malnutrition in poorer families thereby contributing to high levels of infant maternal morbidity and mortality. It is estimated that 40 per cent of Pakistani’s children being undernourished and underweight, their ability to actively contribute to socio-economic development is compromised.
Similarly, 45 per cent women of child being age (15-49) suffer from malnutrition. All these factors reinforce which in turn perpetuate poverty.
The flip side of the coin is a look at Pakistan s economy for a number of reasons is in a slate of stagnation. In FY 2001-2002 GDP was reported 2.6 per cent and the population growth rate for the same period was 2.2 percent. The two numbers means that income per head of the population increased by 0.4 per cent.
One consequence of such a small increase is the known sharp rise in poverty and the silver lining is that Pakistans agenda for sustained economic growth outlined by the government seeks through a number of measures to meet the pressures of expected population growth and facilitate the demographic transition.
The government has succeeded in doing in 2001. It had been able to do that is being to successful completion a programme of reforms funded by IMF.
By achieving a 1,9 percent growth rate by the year 2003-2004, the saving would be Rs. 328 billion or an annual saving of Rs 109.3 billion with the cost per birth averted being Rs. 2139.00 only, voluntary practice of family planning is a current demand and the unmet need for family planning is in the range of 33 per cent.
A contribution every Pakistan can make to economic growth this is well within reach and merits the highest political commitment and administrative priority.
As has been proposed, government through the poverty reduction strategy programmed (PRSP) is pursuing a two pronged strategy in order to address the issue. On the one hand the government has to introduce policies that increases economic opportunities for the poor, their empowerment provide access to physical assets and social facilities – education health water supply and sanitation and a system to protect the vulnerable segments of the society.
On the other hand an effective fertility moderation programmed has to be pursued and sustained for a period of time to achieve replacement level fertility, which ultimately leads to population stabilization.
Population Stabilization
Excessive population growth is one of the most serious concern. The message is loud and clear that the center piece of the national population programme must be the attainment of population stabilization.
In demographic terms this calls for a look at the two main factors fertility and mortality. The scenario is that according to the high variant population projection, if in 1998, the total fertility rate (TFR) of 5.0 children per woman declines to 2.6, by the year 2023. Pakistan’s population is estimated to reach 21.7 million and growth rate will be 1.5 percent.
Understandably this situation is unacceptable. In the medium variant projection, Pakistan’s population will reach 21.2 million with a growth rate of 1.4 per cent per annum and TFR of 2.4 children by the year 2023).
This is the most likely scenario to occur if our current progress in the field of family planning and socio-economic development is sustained. However, we should aim to achieve replacement level fertility, that is, 2.1 children per family by the year 2023, through strong family planning and socio-economic development programmes.
Even so high fertility and young age structure if the past would contribute to a momentum that would lead to growth in our population for many years to come. Regrettably there being even more young people than ever before. Even after 2023 Pakistans population will continue to grow for another 3-4 decades.
Hence it will take almost 40-50 years from now onwards to attain the much needed and sought stabilization of population in Pakistan. It is, therefore, exigent on the government to address the issue in a priority and sustained basis.
Accounting for that already born replacement level fertility is not attainable till 2023 and population stabilization will be within reach a few decades later.
The reason for this alarming state of affairs is the cumulative effect of decades of neglect tragically our country’ s leadership with the exception of president Ayub Khan failed to accord sufficient level of priority to the crucial issue of the population study of the situation.
In Indonesia makes one realize how a leader’s vision and political will, in this case, President Suharto can propel even a large widely dispersed third world nation towards effecting a successful family planning programme to improve the quality of life of its people.
In Iran ruled by so-called Islamic fundamentalists, a visionary approach has helped launch a truly effective population programme with family planning even being propagated in mosques by the imams. In the process the population growth rate in Iran which used to be significantly higher is now well below, Pakistan a comparison drawn with Bangladesh is also depressing.
The strategy of the Plan
Multi-Sector Approach
The National Population Welfare programme being structured in consonance with the ICPD multi-sectoral paradigm seeks to integrate issues and concerns relating to population stabilization into the activities of Federal Ministries and Provincial Line Departments, Interalia, most social sector activities being provincial subjects, it remains at the federal level for MoPW to coordinate activities through Federal Ministries in the Province.
In this regard, the Ministries of Health, Education and Women’s Development are referred to in this document as they have an essential role to play. The national programme interfaces with the Ministry of Health in taking forward the initiative under the M/O Health titled Family Planning in Primary Health Care Programme. In the case of the M/O Education, over the years a sustained population/family life education programme has been undertaken whereby presently the subject has been included in the curriculum from class-I to XII.
Activities are in hand to translate the curriculum into action through substantive teacher training and preparation of text book materials. Regarding M/o Women’s Development, the empowerment of women and girls is crucial for inculcating the small family norm in Pakistan. Improvement in the current status of women is, therefore, being addressed whereby political, economic, social and individual well being issues of women are outlined.
Amongst other, in education, focal attention is being given to girls education & women literacy; in health to safe motherhood, family planning and nutrition; under social and individual well being focus is on the family as the basic social unit and physical security of women and girls is being addressed and in the economic sector, skill training relating to microcredit is on the anvil.
The National Population Welfare Programme is enabling the Ministry of Women’s Development to set up a Management Information System, which would serve as a database for gender mainstreaming in the planning or programming process.
In addition, in the Advocacy and IEC component of the population programme there is centrality in reaching the minds of men with the women’s rights agenda.
The Population Welfare Programme on a sustained basis will initiate and strengthen multi-sectoral projects as described above with Federal Ministries. At the provincial level, the Ministry of Population Welfare has a structure in place whereby the programme, with fiscal and administrative transfers, has been given to the provinces and thereon devolved to the district government. This mechanism will be used by the Ministry in developing Provincial Line Department Programmes.
Two examples furnish the potential Provincial Line Department’s contribution to the Population Welfare Programme: these are the Department of Health and Department of Labor/Social Security Institutions.
As is to be seen from these two examples, integration of the message and delivery of family planning has enormous potential not only in these two line departments but clearly in and through the infrastructure of Departments such as Local Government and Education.
Common and Advocacy Strategies
Pakistan with its rapid population growth, and concomitant pressure on the distribution of resources and development, has long been trying to promote family planning for a balance between population and resources. The government is aware of the serious implications of high fertility and population growth and aims to accelerate the pace of fertility decline, lower the rate of population growth, reduce infant, child and maternal mortality, and improve the health status of the people of Pakistan.
The goals of the Population Welfare Programme in Pakistan, since its inception in mid 1960s, has been to increase public awareness about the adverse consequences of unchecked population growth, generate demand and satisfy unmet need for family planning services.
Three major initiatives in the early 1990s contributed significantly to an in- coverage, accessibility and choice of family planning services. These are (i) an accelerated population welfare programme, which inter-alia involved strengthening provincial, divisional and tehsil management setups, (ii) introduction of community-based workers by both the Ministry of Health and Ministry of Population Welfare and (iii) expansion of static Reproductive Health Centres and Mobile Service Units.
Additionally, the outlets of the Department of Health, having female staff also provided family planning services in collaboration with the Ministry of Population Welfare. Private sector involvement received a major boost from donors and the government facilitating in expanding their role in enhancing accessibility and choice of methods to users especially in urban and per-urban areas.
The GOP institutionalized the involvement of NGOs by establishing NATPOW (National Trust for Population Welfare) through an endowment from the government and assistance form the donors.