Anxieties and Possibilities of Pakistan’s Population

Author: Dr Rakhshinda Perveen

Population Day was first celebrated in 1990. Since then, each year, the day is assigned a specific theme. For the current year, 2023, the theme given by the UN is “Unleashing the power of gender equality: Uplifting the voices of women and girls to unlock our world’s infinite possibilities.”

This day evokes mixed feelings and brings back memories for me. I remember towering Pakistani demographers such as the late Dr Sultan Hashmi, Dr Zeba Sathar, Dr Nawab Naqvi, the late Dr Saleem Jillani, and feminist leaders like Dr Attiya Inayatullah, Kishwar Naheed, Khawar Mumtaz, late Prof. Altaf Bashir, the late Imtiaz Kamal, the late Dr Nafees Sadiq, Hilda Saeed, Tahira Abdullah, the late Zeba Zubair, and the late Husaina Moeen, among many others who laid a strong foundation for family planning through research-based advocacy, media, and communications.

I recall the controversy generated in the mainstream media during the famous Cairo conference (International Conference on Population and Development) and the speculations surrounding it. I also remember the visit of our Prime Minister Benazir Bhutto to this conference. This day, also reminds me of my younger self, transitioning from clinical cardiology due to a combination of professional and personal circumstances, and destiny leading me to become the first trainer on social marketing of contraceptives through a project that has now become a success story. I recall the myths, hate, resistance, and much more at the community and policy levels. While acknowledging the hard work of many unsung heroes and sheroes from the pre-18th Amendment era’s Federal Ministry of Population Welfare, I cannot forget those who missed opportunities for transformative changes and callously wasted resources. Where does the country stand in terms of population and related domains? Some eye-opening statistics, readily available on the internet, repeatedly fail to serve as a wake-up call for our successive governments. At present, Pakistan’s population accounts for approximately 2.83 per cent of the global population, placing it as the fifth-most populous country in the world, including its dependencies.

Pakistan’s population accounts for approximately 2.83 per cent of the global population; placing it as the fifth-most populous country in the world.

The three biggest issues related to population are the unmet need for family planning, preventable maternal deaths, and gender-based violence in general, including violence against women and girls and the endorsement of harmful practices in the name of twisted interpretations of faith, religion, honour, and traditions. Among South Asian countries, Pakistan is performing better than Afghanistan in terms of the contraceptive prevalence rate (CPR), which is the percentage of married women ages 15-49 using any method of contraception, standing at 34%. However, Pakistan’s population is growing at a rate of 2.4% annually. Despite considerable political will, including a national commitment endorsed by the president to raise the CPR to 50% by 2025, it has stagnated at around 30-35%, according to reliable documents. A recent report by the UNFPA states that Pakistan will be one of the eight countries accounting for half of the projected global population growth by 2050, alongside the Democratic Republic of the Congo, Egypt, Ethiopia, India, Nigeria, the Philippines, and the USA. Currently estimated at 240.5 million, Pakistan’s population is projected to reach 403 million by 2050.

What is hindering Pakistan from addressing these challenges? Where is the problem? Why are policymakers and those in power failing to implement urgent mechanisms regarding age-appropriate awareness, education on health (including sexual and reproductive health), hassle-free over-the-counter sales of contraceptives, and specific services for adolescents and youth? Sadly, such concerns are often debated in conferences, and become subjects of PhD dissertations and reports funded by international partners, but practical actions are rarely taken. As a result, despite the presence of a considerable number of committed professionals in the field of population and related specialities, tangible changes at the grassroots level are not visible. What is the visualization of a success story in population?

Drawing from my years of experience in this field, I can propose that the key to success lies in the empowerment of women, girls, and youth, enabling them to make decisions about their own bodies and reproductive health without requiring the consent of their spouses and without the fear of social stigma. Unfortunately, stigma-based violence has yet to receive significant attention in all interventions related to “population control.” Real success will come when our country focuses on the needs of all people, including the most marginalized, and stops chasing numbers to meet unrealistic targets. One may wonder who truly cares about malnourished, illiterate and opportunity-deprived people of Pakistan.

The writer is Public Health, Gender Equality and Inclusion Expert.

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