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Exploding population: choice not destiny - capturing Pakistan’s demographic dividend

Inaam Ul Haq's picture

 

Blog in Urdu

Family planning in Pakistan
This blog is certainly not about exploding mangoes but about the exploding Pakistani populace. The recent reactions of surprise on results of the census seems bewildering. Pakistan’s population is now over 207 million with a growth rate of 2.4 percent per year since the last census in 1998. The results were predictable and expected, as Pakistan has not implemented any large-scale population related interventions for over a decade. We should not be expecting results because inaction does not usually deliver them.
 
Pakistan’s efforts to reduce fertility and population growth were transformed during the 1990s. The period between 1990-2006 saw effective policy making under the Social Action Program with multiple interventions e.g. expansion of public sector provision, large scale private sector participation including social marketing innovations, improving access to women through community based providers. All the right things that delivered huge results. Fertility declined from around seven to four children per woman, and contraceptives use increased from 10% to over 30% - a 300% increase. Appropriate actions delivered results and some still can be photocopied and expanded on scale for making progress.

Much more remains to be done in terms of Pakistan's family planning
The actions started to wane after 2006 and was followed by a decade of inaction. Public and private sector interventions stagnated, community based service delivery given a deadly blow, and with no new ideas, resources started to dry up.  Results duly stagnated and the population continued to explode.  Pakistan is on a dangerous trajectory with a stagnant fertility decline and contraceptive use. What is worrying, and to some degree scary that the country has the largest ever cohort of adolescent youth going into active reproductive age. Without decisive action, the population explosion is likely to continue and could easily double by 2047, when Pakistan will be 100 years old, putting enormous strain on the country’s ability to deliver basic services to its population despite economic growth.
 
Pakistan GDP is growing and is expected to grow further in future. The real GDP per capita (constant US$ in 2007) is projected to grow from $1,000 in 2015 to $2,283 in 2050. At the present trend of fertility decline, it’s estimated that its population will be about 345 million in 2050 (at 2.8 children per woman).
 
However, Pakistan could grow much faster to a per capita GDP of $3,414 in 2050 if it achieves the South Asian average fertility reduction rate, with a population of 276 million in 2050 (based on 1.84 children per woman), if appropriate actions are effectively implemented. The cost of inaction will be a forgone GDP estimated to be $2.3 trillion between 2020 and 2050, which means a loss of $76 billion per year. This will have serious economic and social implications for the people and the country. 
 
There is greater realization that Pakistan cannot afford procrastination. There have been positive actions recently, especially at the provincial level both in Punjab, Sindh and KP focusing on girl education, maternal and child health, nutrition, procurement and supply of contraceptives, introduction of new contraceptives, targeting the poor, etc. However, these actions need to be significantly and exponentially enhanced in all provinces. The large youth bulge can be turned into a great opportunity (demographic dividend) but the dividend unfortunately, is not automatic. Policy action is needed now for rapid acceleration of fertility reduction.

Pakistan needs to position its policy and strategic narrative around “family planning plus” as a priority development agenda with an enhanced scope of interventions and innovative “out of the box” thinking. It also needs to have commensurate financing to transform and boost the reproductive market for family planning products and services. This requires sustained political leadership; scale-up evidence-based interventions using multi-sectoral approach and increased investments predominantly targeting the private sector. 
 
Essential interventions will need to include:

  1. Resolving the fragmentation of reproductive health service delivery and using branding/social marketing for public sector services;
  2. Continue to prioritize girl’s education increasing female enrolment, retention and quality in secondary schools with economic empowerment women/youth by scaling-up skills development, entrepreneurship and financial inclusion initiatives;
  3. Scaling-up public financing for private sector market shaping programs including subsidizing local manufacturing of family planning products to lower prices benefiting all providers and consumers;
  4. Financing an intensive behavior change communications campaign besides introducing life skills education in all higher secondary schools; and
  5. Leveraging social protection system to target the poor.
Pakistan's destiny is in its own hands, the time for decisive action is now. 

Comments

Submitted by Mahedi Hasan on

Thanks for sharing the marvelous info. It is an excellent article which helps me a lot. I expect we will get this type of informative article more and more.

Submitted by Jens Andersen on

Population Pakistan 2017: 197,164,669
Population Bangladesh 2017: 164,669,751
Total 2017: 362 millions
India 1951: 359 millions
As we can see Bangladesh and Pakistan together to day have the same populatione as India in 1951. It is a catastrophe

Thanks Andersen - completly agree that this is a huge challenge - but it can be managed and there are solutions by focusing on the youth educating skilling them and by increasing access to finance and the large population can be made productive members of the economy. 

Submitted by Mariam on

Isn’t the Karachi population underestimated by around 6-10million. What are the implications on health and education financing for the city/division? And what role is WB played to validate the population data it will use in programs?

Dear Mariam

The truth is that there is a disagreement on Karachi's numbers however as of now there is no evidence that it has been underestimated.  It is difficult to agree to statements that it has been nderstement.  There needs to be some evidence which one can rely on.  We need to wait for the results of reassessment as agreed by the government. 
Under estimation does have implication for good planning for provision of services.  We usually dont validate the data but for programs we undertake assessment definign size of popualtions.  As I said we will all need to wait for the result of reassessment. 
thanks and regards

Submitted by Shah Fahad Baigal on

Just think of the situation when women stopped having kids due to these birth control policies. Increasing or the exploding population can be handled because there are adequate resources but think of when women face the plague of infertility, is there any policy to control infertility just like policies of birth control? No. Some demographers predicted that in 2080 women will be infertile, babies per women will be very small and hence children will be rarities. This seems utopian now but it's happening and we don't set any policy when women will be biologically incapable of producing children.
2.1 babies per women is standard for maintaining population in industrialization countries. It is astonishing that in America it is below the standard which is 1.8 babies per women. The rate is also lower in Europe which is 1.6 babies per women and meanwhile in Japan, it is 1.4 babies per women.
So in the race of birth control and saving resources, population of world is getting smaller and smaller which is bigger threat than overpopulation. These abrupt policies may be very dangerous for human race as well. We need to keenly study these demographic transitions.

Dear Baigal thanks for your comments.  I would only like to point out that the population of the world is 7.6 billion and is still increasing and is estimate to increase to 11.2 billion by 2100. Therefor eI have to disagree that the proposed solutions are dangerous for human race.  It is quite contrary to that

regards

thanks

Submitted by Anonymous on

This article is so immature in its content and substance. The writer has failed to provide the solution how to control the increasing populations. Instead he uses the 'could be, would be, should be and intervention needs' to be etc. etc. It is a serious issue for the country. Mangoes do not explode rather rot but still smell great. Where has all the money millions of dollars WB loan gone.

Thanks for your comment - unfrotunately it did not come to your expectation.  Just would like to comment on one aspect - Pakistan has various options which the country needs to choose from - that is why terms like could be or would be used.

thanks

Submitted by Minh on

I enjoyed your blog a lot. Your insight shows how much love you have for your country.

Submitted by Mohammad Nadeem on

Many thanks for sharing this piece of information which indeed is an excellent reading. As you have proposed, so many choices are available and can be implemented especially girls education as a priority across the country. This needs however some attention and ownership at different levels including the stakeholders.

Submitted by Inaam on

Absolutely

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