- Greater investment in family planning programs key to achieve sustainable development
- Over 11,000 mothers die annually in Pakistan due to pregnancy-related complications
By Hamid Khan Wazir
ISLAMABAD, Pakistan: Pakistan’s annual population growth of 2.04 percent poses serious challenges to the country’s development and impedes improving the quality of life and wellbeing of people. Therefore, the Civil Society Organization (CSOs) coalition on Population urged the federal government to increase the allocation of Rs 1 billion to the promised level of Rs 10 billion non-lapsable in the Special Fund for reducing Population Growth to sustainable levels.
The multifarious challenges of a rapidly growing population call for stronger political commitment and investment in family planning and reproductive health (FP&RH) programmes in Pakistan. As a large population has a profound, cross-sectoral impact on the country’s socioeconomic growth, Pakistan needs immediate transformative changes to boost the use of FP&RH services.
The present federal and provincial governments recognized the nexus between population growth and developmental challenges and committed to implement a plan of action endorsed by the Council of Common Interests (CCI) in 2018.
The federal government made a commitment to provide Rs 10 billion per annum non-lapsable fund to provinces for improving contraceptive supply and population coverage by Lady Health Workers who provide invaluable FP&RH services to married women at their doorsteps.
Additionally, these funds were to be spent by provinces on improving FP&RH services to poor and marginalised people by introducing innovative models to boost the uptake of these services.
However, the coalition expressed astonishing that this commitment was not honoured in the last two budgets and in the new budget only Rs 1 billion has been provided for this purpose, which is highly insufficient. The coalition, therefore, urges the federal government to increase the allocation to Rs. 10 billion so that measures approved at CCI could be effectively implemented.
A total of 19 Civil Society Organizations have joined hands to form a Coalition on Population to gauge the implementation of these commitments.
The Coalition during a meeting on Friday took stock of federal and provincial governments’ progress on the CCI commitments and advocated for key policy decisions to improve access to family planning and reproductive health services.
Pakistan rapid population growth rate undermines sustainable development and puts the lives of mothers and children at risk, as large segments of the population, especially young people, poor and marginalised communities are held back on social, economic, environmental, employment and health fronts due to lack of access to essential services and opportunities. Therefore, they said that greater investment in family planning programmes is essential for Pakistan to achieve sustainable development.
They also stated that mere allocation of financial resources is not enough, as the challenge is to spend these resources wisely, in a timely manner. The CCI gave the stewardship role for implementing their pledges to the federal and provincial Task Forces, headed by the President of Pakistan and Chief Ministers, respectively; however, they said that until now, these meetings have been highly irregular.
“We urge to hold these meetings at designated intervals of every six months for the federal Task Force and every quarter for the provincial Task Forces. We also urge the Task Forces to give clear targets to the line departments for improving FP&RH services and monitor progress regularly,” they added.
They said that after the 18th constitutional amendment, the responsibility for population welfare issues lies with the provincial governments; therefore engagement of provincial governments is essential to enhance the efficiency level in family planning service delivery.
They recommended that the provincial task forces must fix targets for the provincial population welfare departments and the provincial health departments and monitor their progress regularly to ensure the targets for family planning service delivery are met in the provinces.
Increased investment in family planning programme can ensure federal and provincial governments expand Lady Health Workers programmes, increase budgets for contraceptives supply, adapt innovative approaches for reaching poor and marginalized population to reduce population growth and CPR.
The CSOs coalition on Population urged the federal and provincial governments to take radical steps to promote delivery, access and uptake of family planning services to manage Pakistan’s high population growth rate. The Coalition also stresses ensuring universal education especially girls education, greater involvement of grass root religious leaders to maintain balance in family size and birth spacing in conformity with Islamic teachings and a large-scale national awareness campaign amongst citizens on keeping their family sizes small is need of the hour that builds on a national narrative of balance or tawazun between family size and resources.
The CSOs coalition reaffirms its commitment to drive public and political discourse on the population issue by regularly dedicating time to discuss its impact on the country’s development and work collectively to prioritize Pakistan’s population as a critical issue amongst policy makers, government and the general populace.
Ensuring universal access to family planning is not just critical but also a cost-effective intervention for attaining sustainable population growth. According to the Pakistan Demographic and Health Survey 2017-18, Pakistan has the lowest contraceptive prevalence rate (CPR) in the South Asian region, which has stagnated over the last few years at 34 percent.
Family Planning and birth spacing can save mother and children’s lives. Over 11,000 mothers die annually in Pakistan due to pregnancy-related complications. The latest Maternal Mortality Ratio Survey 2019 informs Pakistan’s maternal mortality rate (MMR) has declined to 186 per 100,000 live births over the last few years but is still one of the highest in the region, as much more still needs to be done by Pakistan to prepare its health systems to serve the needs of mothers and children and to achieve the Sustainable Development Goals’ target of reducing the MMR to 70.
The Guttmacher Institute reports investment in Family Planning reduces the burden on the health system. The cost of averting an unintended pregnancy through family planning is much lower than the cost of maternal and newborn health care required for that pregnancy.