Last week the UNDP released its Human Development Report, which highlighted the abysmally low levels of improvement achieved by Pakistan in this critical area, wherein progress in South Asian countries was helping drive a historic shift in global dynamics.
The SBP Annual Report 2011-12 had earlier shown that, in 2011-12, outlay on health fell to 0.3 percent of the GDP compared to 1.1 percent in 2007-08, and on education from 1.8 percent of the GDP in 2007-08 to 0.9 percent in 2011-12. Both trends reflect poorly on the outgoing government.
Although, we lived through a full 5-year term of democracy, according to the UNDP report, Congo – one of the poorest and civil war-ridden African states – performed far better than Pakistan; it spent 1.2 percent of its GDP on health and 6.2 percent on education.
While Pakistan’s longest lasting tragedy has been its neglect of the education sector – mother of all evils – our conduct has been worse in the health sector. The Population Council in Pakistan has launched a commendable campaign to highlight this failure to build support for the sector’s rehabilitation.
While city dwellers (excluding their huge lower middle class section) have access to healthcare, how little was done to rehabilitate the basic health sector since July 2007, is shocking because it hurt millions of pregnant mothers and children in the vast rural population.
Even in cities, conditions didn’t improve at the required pace. During 2008-12, the number of hospital beds went up from 103,285 to 108,137 ie just 4.7 percent. Thus, city dwellers too are at risk because there are too few hospital beds compared to the rising city dweller population. Pakistan’s population growth rate – among the highest globally – is around 2.03 percent, or roughly 3.67 million per year. Official statistics claim a growth rate of 1.82 percent, or 3.3 million a year. Compared to this rise in population, growth of the health sector is abysmally low.
The consequences of this criminal neglect aren’t hard to visualise; infant mortality rate in Balochistan – the highest in Pakistan – is 104 per 100,000. Maternal mortality rate is worse; it is 276 per 100,000 compared to just 30 per 100,000 in neighbouring Iran.
Due to the economic miseries that worsened in the last five years, limiting the family size is now a priority of even the vast illiterate majority, but only a minority knows how to go about it courtesy the dearth of a professional class that can advise them.
Population Council survey results suggest that 7 out of 10 women want to space their pregnancies to limit child birth, but only 4 succeed in doing so. This lack of knowledge about options available for avoiding unintended pregnancies had lethal consequences.
A shocking disclosure by the Population Council is that abortions forced by unintended pregnancies and economic pressures could be as high as a million per year – the murderous consequence of not educating people about family planning.
Pakistan’s population growth rate is suicidal. If not checked now, in the worst case scenario, by 2050 population could touch 342 million. Even if you set aside everything else, water – accounting for the bulk of the human body – won’t be there to sustain life.
India’s intentions about diverting more of the Indus waters are visible; so are the dumb efforts by Pakistan to prevent this broad daylight theft. To make things worse, natural tragedies of the sort witnessed in 2005, 2010 and 2011 could significantly reduce food growth.
At present, almost 30 percent of the population (56 million) is in the 19 to 55 year (ie the working age) range, and over 10 percent thereof are jobless; by 2032, if unchecked population growth continues this age group may contain 80 million with a higher percentage of jobless.
Providing employment to this lot requires a consistent annual GDP growth of over 8 percent. Given the state wherein the outgoing government has left Pakistan, reaching this growth rate seems impossible, at least for the next five years even if efforts remain focused thereon. We all agree that unemployment is the biggest cause of worsening social chaos – petty and mega crime, and terrorism. Then shouldn’t we engage in family planning to slow down this trend (jobless youth) so that the future of the country and the nation is secured?
We have no choice. Population growth must slow down, which calls for rapid growth in rural health centres, family planning advisory services and, above all, a concerted, criticism-proof media campaign to highlight why, for religious and rational reasons, family planning is imperative.
The first Family Planning campaign was launched in 1965, and went on through the 1970s; its aim was to undo the myth that higher the number of males in a family, better the chances of its economic emancipation (ie earning wages). Undoing this myth was a tough ask.
But General Zia and the religious elite labelled it as sinful. Not surprisingly, since 1978 population growth has been high, averaging 3 million a year. Fortunately, now several religious leaders agree that even religious edicts specify a 2-year gap between consecutive pregnancies.
It is imperative that parents realise their religious and moral duty to give their children a reasonably secure future by equipping them with moral values, knowledgebase, and skills that they need to earn an honest living to living a satisfying and economically secure life.
In the days to come, courtesy the unchecked greenhouse effect and population rise, resources essential for healthy human existence will become scarce. In that setting, it would be irresponsible to have more children who would have to struggle for survival.
In our region, the best performer in the context of population growth and human development is the Islamic Republic of Iran where, without compromising on religious edicts, emphasis has been on parents’ obligations in ensuring a secure future for their children.
We too need to quickly adopt a similar responsible approach to family planning so that no Pakistani child has to struggle for survival. Ensuring this is an undeniable obligation of every parent. Family planning is not nuclear science anymore, and specialised institutions have developed ethical and secure ways of going about family planning based on the hopes and wishes of the parents, and improving their capacity for nourishing and nurturing children. Family planning isn’t just about having fewer children; it is about nourishing a nation that can exist respectably and hold its head high instead of being dependent on others. For its success, this effort requires the backing of the state, institutions, professionals, religious leaders and, above all, the media.
A. B. Shahid, "Population rise: the big challenge," Business recorder. 2013-04-02.Keywords: