By Zubeida Mustafa

Pakistan is heading for a demographic disaster. And if we need to be reminded of it,, the recently published report of the National Institute of Population Studies (NIPS) in Islamabad should serve the purpose. It very bluntly states the implications of a runaway population growth rate for the socio-economic development of the country.

The State of Population in Pakistan graphically describes the impact of a high population growth rate (2.8 – 3.1 per cent by current guesstimate) on various sectors in the last four decades. It also projects future growth at a constant rate and how it will affect the socio-economic situation in the year 2000. In mid-1987 Pakistan’s population was estimated to be 102 million. At the turn of the century it will be 150 million if it continues to grow at the rate of 2.8 per cent per annum.

Take the case of literacy and education. In the period 1951-81 the increase in the number of literates was quite remarkable — from 4.2 million to 15.1 million. But during the same period the number of illiterates almost doubled from 22.1 million to 42.7 million because the increase in the annual literacy rate failed to keep pace with the population growth rate.

The same pattern emerges in the primary school enrolment of children. In 1951 only 20 per cent of the children aged 5-9 years were enrolled in school. In 1981 this rate had improved and was 40.7 per cent. But the number of children denied schooling had doubled from four million to eight million in 1981.

Looking into the future, the NIPS report estimates that even if Pakistan were to attain a literacy rate of 80 per cent by the turn of the century (a most unlikely scenario) it would still have 19.8 million illiterates on its hand at the current population growth rate. And if all primary age children are to go to school there will be 23.6 million of them to educate in the year 2000 compared to the 6.1 million attending school in 1981. The country will need 241,323 primary schools and 643,200 teachers to provide education to all these children — a big jump from the 63,000 primary schools and 168,000 teachers in 1981. Will these targets ever be attainable?

NIPS’ findings in respect of healthcare, housing, labour force, food and nutrition are no different: a high population growth rate has neutralised whatever little progress has been made in the last four decades. In the coming years massive new demands will be created on account of the fast growing population leading to a deterioration in conditions.

How have our policy-maker responded to this demographic challenge? While admitting the failure of the Sixth Five-Year Plan to achieve the population goals, the Seventh Plan laid down fresh targets which were less ambitious than before. It aims at reducing the crude birth rate from 42.3 to 38 per 1000, raising the level of contraceptive use from 12.9 per cent of married couples to 23.4 per cent and thus avert 3.1 million births in five years. What is strange is that no radical change in strategy has been envisaged though the earlier policy was acknowledged to have been a failure. Technically speaking there is nothing to be faulted in the various components of the population programme. The thrust is towards a multi-sectoral approach which gives recognition to the interrelationship between population, resources, environment and development. The government has promised a concerted effort towards increasing the practice of breastfeeding, improving maternal health and reducing infant mortality.

Another important aspect of the population policy is the communication, information and education strategy. The Government plans to design and implement a more effective mobilisation compaign directed towards clearly defined target groups.

On the delivery side the emphasis is on expanding the outreach and making contraceptives easily available. In view of the findings of the Pakistan Contraceptive Prevalence Survey of 1984 which indicated a high potential demand of 59 per cent tpr family planning services and a very large unmet need, it has been decided to address the issue of accessibility of contraceptives seriously.

The present government has so far not spelt out in very clear terms precisely what population strategy it plans to adopt. The only hint of a change comes in the Peoples’ Party election manifesto which promises to make family planning an effective part of the healthcare programme and provide mobile services for it.

In keeping with the manifesto, the Finance Minister of State in his budget speech in June spoke of making family planning services available from all health outlets. This will certainly be lauded as a sensible move. It would enable the government to enlist the services of physicians as motivators and communicators and expand the contraceptive delivery system enormously. But some basic weaknesses in the government’s population programme cannot be overlooked. They will have to be tackled if the small family norm is to be made generally acceptable.

Pakistan’s population programme has no major achievement to its credit. For one, the infrastructure to tackle a problem of this dimension has not been created in the three decades that the programme has been in operation. For another, the social environment necessary to bring about behavioural changes in the people has not been shaped.

As a result the government has not been able to utilise fully the funds available for its population programme. Foreign donors have been all too willing to finance population projects and the availability of funds has not posed a problem. In the Sixth Plan period only 76 per cent of the funds allocated could be used. Consequently, in the first two years of the Seventh Plan, the allocations have been scaled down and are 36 per cent less than what was targeted.

While the inadequacy of the birth control services is an important factor, the socio-economic milieu which is a key determinant of family size has also been neglected. In this context, the most significant issue is the status of women. The link between female education, infant mortality, the employment of women and population growth rate is universally recognised. Thus the UNFPA’s State of the World Population report for 1989 emphatically points out why the condition of women in a society has a profound bearing on its demography.

“Many women, especially in developing countries, have few choices in life outside marriage and children. They tend to have large families because that is expected of them,” the report states. By investing in women, especially socially, a government can provide them the opportunity to explore their full potential and develop as equal members of society. Thus the focus will not be on them as wives and mothers alone.

Better education, health and employment facilities could raise their status giving women’s life a new dimension in the family and outside. It has been adequately demonstrated that female education, improvement in maternal health, lowering of infant mortality and a higher female enrolment in the organised work force can help reduce fertility rates in a country.

One reason why Pakistan’s population programme has yet to make a. headway is that women continue to be a disadvantaged and oppressed segment of society. Returning to the NIPS report, its chapter on” women makes depressing reading.

What emerges clearly is that in all spheres of life women are treated as being inferior to men.

The standards of female literacy, education, health and employment are dismally lower than those of men. They are discriminated against before the law. Social prejudices handicap them. Only 16 per cent of them are literate while even less are educated. Though a large number of them are economically active, very few of them (two per cent) are shown as being members of the labour force, which excludes them from the development process. Healthwise, the inferior status of women shows in their higher mortality rate which in turn is reflected in the adverse sex ratio of 111 men to 100 women in Pakistan. While all this needs to be changed it is also necessary that social attitude are modified. So long as women are not given their due status and are not included in decision-making at all levels, the demographic picture will not change. – The status of women affects the population growth rate in two ways. First, they have very little influence over family decisions, including those relating to family size. And yet the family planning campaigns are mostly directed at them on the assumption that they can be more easily motivated since child bearing and child rearing affects them more directly.

Secondly, what statistics fail to reveal is that most married women do not become acceptors unless .they have given birth to at least one or even two sons. Their clear preference is for the male child. That . would explain why the family size continues to be so big when so many women profess the desire for fewer children.

The present government has the credentials to initiate a movement for social change. Being a political government with access to the people at the grassroots level it can seek to educate, motivate and mobilise the masses to get them to change their attitudes.

The government needs to demonstrate a strong and overt political commitment to an effective population programme. The underpinning of the population programme must be an active campaign to better the status of women. This could be launched with the announcement of a Women’s Policy on the same lines’ as the Youth Policy. Now is also the time for a pronouncement on the government’s population programme. There is need to remind our people again and again what implications the seven children born every minute in Pakistan have for the socio-economic progress of the country.    

Source: Dawn 14 July 1989