Unplanned, untimely and unintended pregnancies directly impacts on health of whole family. Unfortunately, a major part of our society still considers family planning immoral and against religious norms which is not correct. By repositioning family planning as a health intervention, introducing the concept of “Birth Spacing” we can convey message to Religious Community that contraceptive methods to space births are in no way contrary to Islamic teachings
Concerned about high levels of neonatal mortality, the Khyber Pakhtunkhwa district government in Pakistan expressed a need to adapt and test a new approach—commonly referred to as the “Made-In/Made-For” (MIMF) method—that uses community-based informants to estimate the number of maternal deaths. The current pilot study in Nowshera was commissioned by the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH and conducted by the Population Council to test the feasibility of using the method, and community-based informant networks that had been used to measure maternal mortality, for estimating neonatal deaths. This study clearly shows that, in addition to identifying maternal deaths, informant networks can be utilized for collecting other health and surveillance-related information, and for sensitizing and mobilizing communities to raise awareness of safeguards for avoidable deaths. Because of their influential positions, the community networks identified by this study can play an important role in creating community awareness for issues related to birth preparedness and newborn care. The report concludes with major health sector interventions recommended for reducing neonatal mortality in Nowshera.
Recommended Citation
Mir, Ali M., Saleem Shaikh, Mumraiz Khan, Irfan Masood, Mansoor Qaisar, Sabahat Hussain, and Rehan M. Niazi. 2016. “Using the community informant-based (MADE-IN and MADE-FOR) methodology to estimate the neonatal mortality rate (NMR) in Nowshera, Khyber Pakhtunkhwa: A feasibility study,” Final report. Islamabad: Population Council.
Like many other women health related issues, abortion is another which is neither discussed openly nor gets the attention or focus that it merits. Experts say the reasons behind this scenario are both religious and social. As per several media reports, majority of doctors don’t do abortion operations citing religious teachings, social norms and personal beliefs. And this is leading to severe health issues for women.
Although abortion is allowed in Pakistan under specific circumstances, first if the women’s life is in danger and secondly, before the formation of the organs of the fetus, but despite that doctors largely refuse to do abortions. This forces the women to consult quacks, midwifes and illegal clinics.
As per a 2012 report by New York-based Population Council, Pakistan has the highest abortion rate i.e., 50 abortions for every 1,000 women aged between 15 and 44. This is four times high than the U.S. Commenting on the situation Guttmacher Institute said: “The procedure is legal only in very limited circumstances.”
According to Pakistan Population Council head, Zeba Sather, abortion is allowed at the time of need. “However, the law doesn’t elaborate the term need,” she said.
According to Sather’s research, most of the women are married and belonged to unprivileged section, hence, without any medical information and access to contraceptives. “We found to our surprise that most of the women had more than three children, maybe as many as five,” she said.
According to Dr. Tariq, who works at a reproductive clinic in Rawalpindi, most female patients don’t have access to long-term birth control methods. And the reason behind is no permission from mother-in law or husband. As per latest state-sponsored survey, “just 34 percent of married Pakistani women use contraception and only 25 percent rely on modern methods.” Dr. Tariq further said that many of these women have seven to eight children and don’t have access to family planning services. “The result? Unwanted pregnancies.”
Noting the abovementioned statistics, observers reiterate that family planning program of Pakistan is in shambles. They say that it is due to lack of knowledge, religious beliefs and cultural norms that the country is now among top five most populated countries in the world. It has led to shortage of land, water, low space in schools, congested streets and unemployment.
Director General of Pakistan’s Population Program, Abdul Ghaffar Khan said, “Pakistan’s high abortion and low contraception rates reflect a family planning policy in shambles.” Khan added that the whole project is bureaucratic mess as family planning is the job of federal government, but national policy approval this program had languished for years. In 2011, the program was passed to provincial governments, but family planning is not part of provincial health ministry. “Instead, it is part of a different office, which has long been underfunded and neglected.” Khan asserted.
Further, the family planning program in Pakistan largely runs with the fund from United States. Experts noted that the Trump administration caused a major hit to the program, when it put a gag on the funds. Although the current Biden government has reinstated the funds, but still the organisations in Pakistan are facing serious issues in this regard.
Like a lot of other issues, a lack of common sense is the main problem here too, observers maintain. Activists urge the people, especially the men, to understand that a woman is not a baby producing machine, and realise that giving birth leaves a very heavy toll on women’s body and it needs rest and break to rehabilitate.
Observers also point towards the patriarchal wish of having a son in our society, which to many experts is the most basic and vital reason behind unwanted pregnancies and illegal abortions. Observers reiterate that because most want a son not a daughter, hence if a couple already has daughters and fear with another, they will go for abortion, illegally.
Activists and rights advocates maintain that all we need is common sense, an understanding of the economic condition, and wellbeing of wives and the issue can be resolved. It might appear straightforward, but the ongoing ground realities push analysts to be less optimistic about overcoming the resistance to much needed change in how the society views and prioritizes women’s health.
The coronavirus pandemic has taken millions of lives worldwide. There was a time with no hope, but eventually humanity saw hope in the form of the vaccine.
However, there has been some misinformation regarding the Covid-19 vaccine formulations, uses, side effects, and effectiveness.
Unfortunately, myths and misconceptions and conspiracy theories related to the vaccine have abounded in the country. According to a report published by Gallup Pakistan, 49 percent of the population is reluctant to get vaccinated even if the vaccine is offered free of cost. Experts say that misinformation and religious beliefs are responsible for people’s mistrust of the vaccine.
Many people in the country believe the pandemic does not exist. Rumors are also widespread that Western countries want to insert a ‘surveillance microchip’ in the human body through vaccine shots. Therefore, most people don’t trust the vaccine. They also believe that the mass vaccination drive could be an attempt by global powers to spy on the world population. People are also concerned about the vaccine’s side-effects. Some Pakistanis say the vaccine is haram due to false claims that it contains pig gelatin and human fetal tissues.
There are certain myths about the Covid-19 vaccine which need some clarification. First of all, it is common thinking that the vaccine has been developed in less time and is still in phase three trials so it might be unsafe for clinical use. This is not true; the fact is that Covid-19 vaccine has gone through all the essential steps of vaccine formation and the same food and drug administration processes have been ensured for its safety and efficacy too.
There are other myths too that the vaccine contains a tracking device and it might change human DNA. Again, there is no truth in it. Similarly, it is also a common perception that wearing a mask is no longer needed once you are vaccinated. Wearing a mask, hand washing, and social distancing are required not only for Covid-19 protection but also to protect us from many other communicable diseases too.
Another myth suggests that certain blood groups are less likely to develop severe symptoms of the diseases hence vaccines are not essential for such people. Again, no evidence is available that supports this myth.
The main source of misinformation about Covid vaccines is WhatsApp, which is used by 39 percent of the country’s population. Unproven claims about vaccines are also circulating on YouTube and Facebook.
These myths and misconceptions about the Covid19 vaccine pose a challenge to health officials in educating people about the vaccines. It is now imperative that the myths and misconceptions of the people be dispelled with a solid strategy. It would be best to use all media tools, in particular social media platforms.
In this regard, it has become essential to take scholars, religious leaders, and Ulema of all schools of thought on board. They should be made fully aware of the corona vaccine and be asked to persuade the public in their Friday sermons to get the corona vaccine so that not only their lives will be saved but also others as well.
There were also conspiracy theories about the polio vaccine in the country. But it is a proven fact that the involvement of clerics and religious leaders has helped alleviate public fears and misinformation. The government should also include religious scholars of all schools of thought to eliminate misconceptions and conspiracy theories about the corona vaccine.
The writer is a freelance columnist based in Islamabad.
COVID-19 Not Only A Global Health Crisis; An Emerging Crisis In Learning
The worldwide closure of schools due to Coronavirus pandemic is unprecedented–affecting more than 1.5 billion children, according to a United Nations policy brief. In countries like Pakistan, the situation poses a high risk of students, especially girls, dropping out and not returning to schools when educational institutions finally reopen.
COVID-19 is an emergency of enormous scale and extremely unusual in nature. It has derailed socio-economic progress and pushed many countries further back in their quest to achieve Sustainable Development Goals, especially SDG 4.
The COVID-19 pandemic has not only created a global health crisis but has also twisted a learning crisis across the world for children and adolescents of school-going age. During the first and second waves of COVID-19, education systems in most countries including Pakistan were adversely affected as the pandemic prompted country-wide closures of almost all institutions.
Education is the right of every child and is the bedrock of a just society. Pakistan has some of the world’s worst education indicators with 40 percent of children not attending any form of formal education. The COVID-19 crisis has further aggravated the situation. It is time to ask what measures government needs to take in order to make the education sector more sustainable, equitable, inclusive, and resilient in the face of crisis.
Meanwhile, educational technology has been rapidly advancing smartphones, tablets, virtual reality, and high-speed Internet–4G and 5G connectivity. All of this makes online learning more productive, adaptive, and accessible. In fact, the e-learning industry is currently valued at more than $200 billion and is expected to top $375 billion by 2026. Even so, Pakistan has some of the world’s worst educational outcomes. For example, it has the world’s second-highest number of children not in school: 22.8 million children aged 5 to 16, making upto 40 percent of school-age children.
Children lack basic facilities and tools of formal education
In an unfortunate twist, the onset of the pandemic coincided with Pakistan’s struggle to implement a uniform curriculum across all provinces. As Coronavirus control measures spread throughout South Asia, departments of education and higher-level universities found themselves poorly or, in most cases, completely unprepared for online learning and delivering distance learning. In the past, Pakistan had closed educational institutes due to terrorist attacks and political threats, but there was still no official policy regarding online education.
Coronavirus has fundamentally transformed learning mechanisms
Meanwhile, Pakistan has an emerging mobile phone-user market and currently, 75 percent of the population uses mobile phones. But out of a population of 220 million, making it the fifth most populous country in the world, there are only 76.38 million internet users. That’s only 35 percent of the population, with only 17 percent using social media. Facts on the ground show that accessibility to the Internet is the major hurdle to adopting an e-learning system. Resistance to adopting technology or new learning pedagogy and being used to the classroom environment also play a negative role in resistance to online learning policy.
Therefore, provinces need to take the lead. They should develop and promote localized, free, and open digital tools for education to make large-scale remote learning possible. There is a dire need to develop, print, and distribute learning materials where there is limited access to the Internet and online resources.
A post-Coronavirus scenario will require provincial governments to monitor the drop-out rate, especially for girls and children from impoverished or marginalized households. It can be done through databases maintained by the incumbent government’s EHSAS program (Former BISP). It is also high time to revisit the budget for education to ensure equitable allocation of funds and introduce game-changing investments for digital and online learning to become available to all.
The federal government along with international organizations, civil society, and private sector partners should join hands to prevent the current crisis from widening Pakistan’s already huge educational inequality, and promote science, technology, engineering, and mathematics (STEM) education at all levels.
In the backdrop of a global decline in population growth rates, Pakistan stands out as a country with a youthful demographic profile. With more than 65 million young people between 10 and 24 years old, Pakistan has one of the largest young populations in South Asia.
Adolescents and youth represent the economic future of Pakistan and research shows how critical it is to continue investing in them so they can achieve their full potential. We need to take advantage of the youth dividend to support economic and social growth, close the gender gap, and reduce exclusion and inequalities.
According to the Census 2017, the total population of Pakistan is 208 million of which 49 percent are women; an estimated 29 percent of the total population in the age group 15-29 years, half of which are women. Currently with 63 percent of Pakistan’s population in rural areas, the majority is of female youth. While all youth needs to be mobilized and provided opportunities for a robust, dynamic, and progressive Pakistan, there is an urgency to focus on young women.
Meanwhile, the country is experiencing the phenomenon of unemployed educated people, particularly jobless graduates. The unemployment rate among degree-holders is almost three times higher than the other overall unemployed people. The reason given for this is a mismatch between the education being imparted and the need of the economy to sufficiently absorb fresh graduates.
Additionally, Pakistan’s economy has badly suffered from the outbreak of the Covid-19 pandemic. This adverse economic impact of the pandemic has translated through various channels, including the decline of domestic demand, decrease in business activities, a decline in import and export, and reduction in production due to supply chain disruption. One of the very obvious effects is a decrease in employment, particularly among youth.
Given the above situation, it would be very disappointing to look at the current government’s youth policy. If it is said, PTI used the youth and did not take any significant steps for them after coming into power.
The PTI is the same party, which fully relied on the young population of the country before the 2018 elections. Simultaneously, the youth also supported the PTI with the hope that it was going to prove itself to be a better alternative to the PPP and the PML-N.
The previous confidence of the youth has now started to shake because of both the public ridicule of their choices as well as the failure of the PTI to deliver on its promises. Now there lies a real danger that the political participation of the youth may start to dwindle even if the democratic transition continues in the country.
It is important to mention here that in such a situation, the Pakistani youth will not believe in any political party or leader in the future. It is unfortunate that despite having such a large number of young people, country is unable to take advantage of youth bulge due to incompetency of the rulers.
Therefore due to the youth bulge, approximately 1.5 to 2 million youth are annually being added to the job market in Pakistan, and providing jobs to such a huge number every year is the most challenging task in such an unstable economy of the country. However, this is also alarming that still; the PTI government has not taken any serious measure to provide job opportunities to the youth. Contrarily, the government had cut 40 percent educational budget, and a huge number of employed persons were kicked off from their jobs due to such a miserable economic condition of the country which shows a complete failure of the incumbent government in terms of what promises it had made with the youth before elections.
It is vital to listen to young people’s needs and offer them tangible opportunities to contribute to peace, progress, and prosperity. The road ahead will be challenging, given Pakistan’s limited fiscal space and governance systems that have historically struggled to ensure efficient spending.
Education plays a very critical role in deciding the growth of a nation. Educated citizens of a country bring it fame, wealth and prosperity, which in turn help in the development of a country. And all this helps in nation-building.
People who are educated are aware of what is right and what is wrong. According to the recently launched Annual Status of Education Report (ASER) 2018, improvement was recorded in the education sector last year but a lot more still needs to be done. It is alarming that only 47 percent of surveyed fifth graders could not do two-digit division. In the rural districts of the country, 48 percent of surveyed fifth graders in public and private schools could not read a sentence in English and 44 percent could not read a story in Urdu, Sindhi or Pashto.
The report also shows that 83 percent of all children of schoolgoing age, six to 16 years, are enrolled in school. of them 77 percent go to government schools and 23 percent to private schools – 20 percent in formal education and three percent in madressahs.
The report says that Azad Jammu and Kashmir is at the top with a 95 percent enrolment rate for children between the ages of six and 16, followed by Gilgit-Baltistan and Islamabad with an enrolment rate of 91 percent each. In Punjab, 89 percent students are enrolled in schools, 86 percent in Sindh, 87 percent in Khyber Pakhtunkhwa, 28 percent in Balochistan and 72 percent in the (former) tribal areas.
The report says that 32 percent of government schools and 11 percent of private schools do not have useable water facilities and that 42 percent of government schools do not have toilet facilities. It also says that 13 percent of surveyed private schools do not have toilet facilities. It points out that 30 percent of public schools and 20 percent private schools do not have boundary walls.
It is very important to know that Pakistan is the second country of the world with more than 60 percent of its population between the ages of 15 and 35 years, a great human resource that the Almighty has bestowed us with. Unfortunately, Pakistan’s vision of an enlightened and empowered process of nation-building was hijacked by vested interests in its initial 20 years. Excluding the first few years of its creation, in the major part of its initial phase, Pakistan did not have the required focused priority on education.
What is most important is an understanding of history. It is the most powerful core of education that sets the path for future generations. But we have played havoc with this fundamental subject. After the 18th Amendment, education became provincial responsibility in the country. Interestingly though, the provincial governments are in the control of the same rich and powerful lot that have been the main obstructing factor causing the poverty of education. It is hoped that a continuous democratic process will weed out the obstruction.
The current government should take serious and many steps to bring about a visible improvement in the education sector, such as launching a uniform education system in the country. This is so because a uniform curriculum and education system is imperative for providing equal opportunities to all students.
It is clear that the economic progress that a quality education brings delivers better jobs and more jobs which in turn offer the citizens of a country more choice in what they do with their lives and indeed the lives of their children. It is also clear to me that the belief that we have choices in our lives builds contentment.
It is very important for the current government to realize that quality education is an important precursor to nation-building. The goal must be clear: the inputs, processes and outputs measured and individual and collective accountability should be taken to deliver education which is of a quality and quantity that builds the Pakistan we want to live and work in.
Last but not the least, we must urgently re-examine the goal of Pakistan’s education system. Should our education system create blind followers of dominant powers, both at home and in the world? Or does Pakistan need to create its own reference points, and put an end to the global exploitation of our youth, our resources, and our intellect?
The writer is associated with thedevelopment sector.
Family planning is not only a fundamental human right that empowers individuals – especially women and girls – and helps save the lives of women and newborns, but it is also vital to economic prosperity and nation-building in the Asia-Pacific region and other parts of the world.
Modern contraceptive use has nearly doubled worldwide – from 36 percent in 1970 to 64 percent in 2016. Yet, some 214 million women in developing countries who want to avoid pregnancy are not using safe and effective family-planning methods.
Most women who lack access to contraceptives live in 69 of the poorest countries on earth. Around 70 million of these women hail from South Asia. Around 308,000 women, including 85,000 women who hail from Asia-Pacific alone, die every year from causes that are linked to pregnancy or child birth. In addition, an estimated 2.7 million babies, including 1.3 million in Asia-Pacific alone, die within the first month of their lives.
Pakistan is the fifth most populous country in the world, with 208 million people and a population growth rate of 2.4 percent per year. The rising population numbers are likely to outstrip development gains and continue to adversely affect the economy, our environment, health, education and the quality of life for all citizens.
It is important to realise that every woman has the right to exercise her reproductive rights and seek protection from violence and harmful practices in both the development and humanitarian contexts. The Pakistan Vision 2025 has embedded five components of women’s empowerment into its objectives: activities that promote women’s self-worth; the right to determine their choices; access to opportunities and resources; the right and power to control their lives – both within and outside the home – and the ability to influence social change. However, these rights still remain beyond the reach of most women in Pakistan.
Meeting the demands for family planning can also fuel large-scale economic growth by creating a demographic dividend, which emerges when a country’s population shifts from being composed of mostly very young children and adolescents to comprising a majority of working-age adults. This scenario reduces the overall costs of educating children and keeping them healthy, and increases a country’s collective financial outputs and, ultimately, its GDP.
Moreover, the economic, environmental, and social strain of high fertility rates and rapid population growth can threaten the stability and security of an already fragile state. Family planning can reduce this stress at the familial, community, and national levels, contributing to more peaceful societies where the needs of all citizens are met more routinely.
Gaps in empowerment are seen at the earliest stages of a girl’s life. At every step, girls and women face challenges and obstacles in making their own choices and determining their own path.
While most of the other Muslim countries can encourage the practice of family planning and birth control and bring down the population growth to manageable levels, Pakistan can’t even afford to tackle the burden of a high population growth rate of 2.4 percent. With a growth rate of between three percent and four percent, and an annual increase of 2.4 percent in population, a majority of the population cannot even visualise a modest improvement in their standards of living in the decades to come.
It may be argued that Pakistan had to face a high cost of inaction in the past by not keeping a check on population growth. Pakistan has the slowest demographic transition in the region as the use of contraceptives had dropped to 33 percent as compared with 77 percent in Iran, 68 percent in Sri Lanka and 62 percent in Bangladesh. The continuation of this trend and further apathy on the matter could be damaging in many ways and tear apart the socio-economic fabric of society.
The prime minister and the chief justice also spoke in favour of family planning a few weeks ago. This seems to be the right time for all the provinces to be on the same page to check population growth and deal with the ticking population bomb.
The writer is a freelance writer and isassociated with the development sector.
Over 90pc Disasters In Pakistan During Last 40 Years Due To Changes In Climate, Indicates WHO Data
Over the last 50 years, human activities – particularly the burning of fossil fuels – have released sufficient quantities of carbon dioxide and other greenhouse gases to trap additional heat in the lower atmosphere and affect the global climate. According to World Health Organization, in the last 130 years, the world has warmed by approximately 0.85oC.
It’s the first time that each of the last three decades has been successively warmer than any preceding decade since 1850. Sea levels are rising, glaciers are melting and precipitation patterns are changing. Extreme weather events are becoming more intense and frequent.
Extreme high air temperatures contribute directly to deaths from cardiovascular and respiratory disease, particularly among elderly people. In the heat wave of summer 2003 in Europe for example, more than 70,000 excess deaths were recorded. High temperatures also raise the levels of ozone and other pollutants in the air that exacerbate cardiovascular and respiratory disease. Pollen and other aeroallergen levels are also higher in extreme heat. These can trigger asthma, which affects around 300 million people. Ongoing temperature increases are expected to increase this burden.
Globally, the number of reported weather-related natural disasters has more than tripled since the 1960s. Every year, these disasters result in over 60,000 deaths, mainly in developing countries. Rising sea levels and increasingly extreme weathers will destroy homes, medical facilities, and other essential services.
More than half of the world’s population lives within 60 km of the sea. People may be forced to move, which in turn heightens the risk of a range of health effects, from mental disorders to communicable diseases. Increasingly variable rainfall patterns are likely to affect the supply of fresh water. A lack of safe water can compromise hygiene and increase the risk of diarrheal disease, which kills over 500,000 children aged under 5 years, every year. In extreme cases, water scarcity leads to drought and famine. By the late 21st century, climate change is likely to increase the frequency and intensity of drought at regional and global scale.
WHO data indicates that in the last 40 years more than 90% of the disasters that have taken place in Pakistan have been triggered by changes in the climate. It is predicted that there will be an increase in the frequency and severity of climate-related events, such as floods, droughts, cyclones, heat, and cold waves, in the coming years.
Climatic changes could also affect human health, (e.g. increasing the number of cases of avian influenza, malaria, cholera, dengue fever) animals and have an impact eco-system. Weather and climate effects are key determinants of health. They also influence the transmission of infectious diseases.
Climate change has deleterious impacts on sustainable development and economic growth. In addition, policies to mitigate climate change (e.g. in energy, transport, urban planning sector) have a direct and important influence on health, e.g. through effects on local air pollution. There is a need to focus on generating evidence on health and climate change, develop evidence-based policies to reduce emissions, slow down global warming, and increase the resilience of health systems in order to minimize the impact on health as a result of climate change.
It is critical to build the institutional capacity of the health sector (at provincial, district and local levels) in relation to extreme weather events to reinforce surveillance, early detection, and response in the areas of infectious diseases, nutrition, respiratory diseases, water, and food safety.
It is equally important that the provincial authorities are capable of generating and/or gathering intelligence and establishing early warning systems for climate-sensitive diseases, and integrating such intelligence into existing health information management systems.
Improving evidence-based policies will lead to greater protection for health from climate change and raise the awareness of the public about adaptation to climate change and adopt appropriate mitigation measures. Close coordination and cooperation between the Ministries of Health, Environment and Education and the Pakistan Department of Meteorology in issuing advisories and to handle the issue in a comprehensive way is essential.
The newly-released results of Pakistan Demographic and Health Survey (PDHS) 2017-18 showed major improvements in child survival and maternal health care, while progress has been slower in nutrition and family planning. This is the 4th DHS survey conducted in Pakistan since 1990-91. The survey findings describe that more children in Pakistan are surviving early childhood than ever before as under-5 mortality has sharply declined.
Currently, the under-5 mortality rate is 74 deaths per 1,000 live births, a decline from 89 deaths per 1,000 live births in 2012-13. This means that approximately 1 in every 14 children in Pakistan does not survive to their fifth birthday. Basic vaccination coverage has improved in Pakistan.
Meanwhile reproductive healthcare coverage among Pakistanis is also improving. Nearly 9 in 10 women aged 15-49 receive antenatal care from a skilled provider such as a doctor, nurse, midwife, or lady health visitor. Additionally, more than half of women have their first antenatal care visit in the first trimester, as recommended. Half of the women make four or more antenatal care visits, a notable increase from 37 percent in 2012-13. More births are delivered in a health facility, from 48 percent in 2012-13 to 66 percent in 2017-18. Yet, 1 in 3 births takes place at home.
The bad news is that unmet need for contraception remains high at 17%. There is dire need of political support for the family planning agenda, and the need for integration of family planning within health services immediately, to change the current non-curve in our demographic transition.
According to the United Nations Population Fund (UNFPA) 2.2 million abortions are carried out in Pakistan every year, thus the need to cater to a persisting unmet demand for contraceptives in the country becomes all the more important.
There can be no denying the difficulties a Pakistani woman faces as she’s forced to abort an unwanted pregnancy simply because of the failure of the authorities to provide her the contraceptives. It is important to know that Abortion is not a family planning method.
Almost half of all pregnancies in Pakistan, around 4.2 million each year, are unplanned and around 54 percent of those end in termination, according to a report by US research firms Population Council and Guttmacher Institute. Decades ago, a family planning campaign with the slogan “bache do hi ache,” or “two children is good,” was rejected by religious leaders as well as nationalists who wanted a bigger population to rival the 1.2 billion people in neighboring India.
Authorities have not yet been able to make this issue an emergency for Pakistan. However, Prime Minister Imran Khan in December acknowledged the lack of political will on the issue and promised pro-contraception campaigns using the media, cell phones, schools, and mosques.
The absence of women in decision making is one of the key reasons behind poor family planning. Many people do not even bother to plan their families due to the desire to have a male child. This was yet another cause cited of overpopulation. Besides, low-quality services and unavailability of stock of contraceptives also led to poor family planning.
Today with a population of around 207 million, Pakistan’s baby boom is stretching its resources beyond capacity and experts warn of trouble ahead. In order to meet its family planning commitments made at the London’s FP2020 Summit in 2017, Pakistan is required to raise the CPR to 50 percent by 2020, by committing additional resources, raising the per capita expenditure on family planning, and bringing in a programmatic refocus to address the information and services needed. There exists an unmet need for both the spacing and limiting of births, and the extent of each of these varies with women’s age, parity and education. The low levels of contraceptive use and the large numbers of unwanted pregnancies point to the need to provide quality accessible family planning services in the country. Access to family planning services is a fundamental right which is crucial to slowing and reversing unsustainable population growth.
In 2016, the Pakistan Council of Research in Water Resources (PCRWR) issued a report that suggested the country had touched the water-stress line in 1990 and crossed the water-scarcity line in 2005. The council delivered the grim warning that the country would run out of water by 2025 if positive action wasn’t taken.
“Despite having the world’s largest glaciers, Pakistan is among the world’s 36 most water-stressed countries. As the population rapidly increases, water demand is projected to far outstrip supply. Immediate coordinated planning and implementation is required to avert disaster”.
Without measures to save our rapidly-depleting water resources, climate change, coupled with rapid urbanisation and population growth, will further impact the availability of water. With a drought-like situation likely in the near future, the gravity of the problem can be illustrated from the fact that the per capita availability of water in 1947, which was over 5,000 cubic metres, has shrunk to just 1,000 cubic metres today.
Experts believe that population growth and urbanisation are the main reasons for this crisis. The issue has also been exacerbated by climate change, poor water management and lack of political will to deal with the crisis. Apart from the water-storage issue, experts suggest that water wastage is also a pressing issue in the country.
In Pakistan, the signs of water stress are ubiquitous in the form of water scarcity, resource depletion, and contamination. The catastrophe implicates the country’s incompetent leadership and their poor management of available natural water resources. This has made Pakistan vulnerable to long drought spells and extreme floods. The climate change-led water crisis has not only posed a threat to the summer cropping season, but has also adversely affected hydroelectricity generation.
Such a crisis is inevitable in a country where political leaders are busy slinging mud at each other in a lust for power and lack vision. These leaders also oppose the construction of new infrastructure to store water. The fact that the word ‘dam’ has been made highly controversial and that its use often spurs heated discussions between the provinces aptly highlights Pakistan’s predicament.
Pakistan ranks third among countries facing water shortage. One major reason is excessive use. Around 100 litres are wasted on washing a car with running tap water. Water shortage as well as the incidence of flashfloods could be dealt with by simply adopting the 3Rs to save the environment: reduce, recycle and reuse.
We must reduce water use at the household level by turning off taps when we brush our teeth and using a limited amount of water to flush toilets and bathe. Recycling at the household level can also help solve the problem. Instead of using the shower to take a bath, we should replace it with a simple water bucket. We should use simple rainwater barrels for gardening purposes as rainwater barrels are aboveground water-storage vessels that capture rain runoff from a building’s roof through the gutter and downspout system. In addition, a rain garden could be constructed to reuse water that would otherwise runoff into the sewage systems. The installation of a grey-water system would be beneficial in diverting water from your shower drain to flush the toilet.
The incumbent government is privileged to have the support of the country’s history. Imran Khan’s government should benefit from this and take concrete measures to overcome the water crisis as Pakistan’s National Water Policy has already been approved by the cabinet last year and all four provincial governments and the federal government also agreed on it. Such a consensus on a national policy document is unusual.
This water policy must be implemented in letter and spirit for efficient water-resource management. Furthermore, commissions must be set up to monitor the efficient water-resource management at all levels and offer timely recommendations.
Given the limited capacity of state institutions to manage the water sector and because repeated attempts and investments to fix the existing infrastructure have failed, the country must think outside the box. Innovation, particularly the participation of the private sector, could be useful in managing water resources efficiently. Debundling services and encouraging the private sector to manage water resources can be an excellent initiative to address these issues. The agriculture department ought to keep facilitating farmers in shifting their focus towards modern and efficient irrigation technologies in lieu of outdated flooding methods.
Pakistan needs to learn from countries that have even fewer water resources but enjoy higher GDP growth rates and better quality-of-life indicators. For example, Israel has been able to reuse effluents to irrigate around 40 percent of its agricultural land.
It is a challenge for the state to save water, not only for agricultural purposes but also for human consumption and to meet rising water demands in other social and economic sectors. This demands improved water governance, management and investment in scientific knowledge – all of which require commitment and resources. It is time for decisive action.
The writer is a freelance journalist and is associated with the development sector.
Family Health & Well Being 