Daily Times

Pakistan was amongst the few countries in the region to begin a full-fledged population welfare programme as early as the mid-1960s. The impetus for starting the programme originated in large part from the economic agenda being pursued by the government of the day. The programme’s raison d’être was simple: ensure that the economic benefits accruing from industrialisation, the process of which had just started, would not be diluted by a fast growing population. If Pakistan was to prosper, planners reasoned, the rate of population growth had to be lowered.
To achieve this end, the message conveyed to people was that, in order to attain national prosperity, couples should produce fewer children. However, the relevance of this message, since it was not properly explained, was lost among poorer families, whose only hope to raise their income was through more earning hands. Moreover, arguments conveyed through the media, through images of overcrowded parks and hospitals overflowing with patients, were never quite internalised by the common people, who could not understand why the government could not simply build more parks and hospitals rather than asking them to have no more than two children. By and large, the advice from the population welfare programme was seen as a direct infringement of peoples’ private decision-making space and it became an uphill task to convince people to change. This was in the late 1960s and 1970s. The 1980s saw Pakistan witnessing an ‘Islamisation’ of society. The two children slogan disappeared and, suddenly, family planning became a taboo subject with all programme activities coming to a standstill. Programme activities did re-commence later but without any publicity or media coverage.
It was in the 1990s that couples began to realise for themselves the advantages of having a smaller family. This was mainly due to economic compulsions and, more importantly, because the differences in the standards of living of small and large families residing within the same community became very stark. It was in this period that couples began to opt for family planning and the trend continued into the new millennium. As the demand for family planning began to grow, another reality became apparent through a number of research studies. While couples wanted to adopt family planning, they were unable to do so as access to services, especially in the rural areas, was limited. This problem of unmet demands for family planning persists to this date.
Unfortunately, only lukewarm efforts have been undertaken by successive governments to redress this predicament. In recent years, the only notable interventions were the launch of the internationally recognised Lady Health Workers (LHWs) Programme in 1994 that reaches out to homebound women across the country with family planning services, and the announcement of the country’s first explicit population policy in 2002. With these exceptions, all other governments have fallen short of declaring the population issue a priority that has to be tackled urgently. With each passing year and increasing numbers, we are losing opportunities and moving towards a disastrous implosion.
Currently, all major political parties of the country endorse the need for lowering the population growth rate and have included this within their respective party manifestoes. Yet the issue is still not being discussed, debated or recognised as a central element of most of the problems that confront us today. There could be a number of reasons for this. First, there is a growing sense of conservatism enveloping our society, which raises the fear of societal backlash that the political leadership would not like to confront. There is also ambiguity regarding whether the electorate really wants to adopt family planning or not. Furthermore, there is a genuine lack of clarity in the minds of certain policymakers, bureaucrats, politicians and even healthcare providers as to whether family planning is permissible in Islam. The reasons for these reservations are mainly embedded in misconceptions. The economic arguments for family planning, which extol economic growth and poverty alleviation as key benefits of a small family, have not been well received by the religious community as they are perceived to question the Almighty’s design for provision of sustenance.
The advice to have fewer children has also been incorrectly perceived as part of a western agenda to reduce the size of the Muslim ummah (although increasing the ummah is envisaged through tableegh and not procreation). These experiences indicate a need to change the family planning narrative, to shift the focus from economic and demographic concerns, and express the need for planned families in a new paradigm that is socio-culturally and religiously acceptable, and that people can easily relate to. One of the most influential mediums that can help change the narrative is the country’s vast network of religious leaders. The words of religious leaders count; they influence the views and behaviour of the general public as well as political opinions. Recognising this reality, most Muslim countries obtained religious support right at the start of their respective family planning programmes that helped in sustaining political commitment. However, Pakistan has not made a serious effort to bring religious leaders on board. This has been one reason that has contributed to Pakistan’s lagging behind most regional countries in terms of family planning uptake.
In view of this situation, the Population Council has launched a national campaign with the support of the United Nations Fund for Population (UNFPA) to raise awareness about the importance of the population issue and give it the due importance that it deserves. An important feature of this campaign is to involve and consult religious leaders of major schools of thought by informing them about the prevailing health situation of mothers and children, and the high numbers of maternal deaths taking place in the country as a result of repeated and closely spaced pregnancies. In a number of interactions with religious leaders, the council has presented empirical evidence laying out the nexus between the number and spacing of pregnancies and their impact on the health of mothers and their infants, as well as cogent arguments to counter common misconceptions regarding family planning. In these exchanges, we focused on the health benefits of spacing births as a means to save the lives of mothers and their children, and to spare fathers the extra burden of caring for their families.
The response from religious leaders and scholars (ulema) has been highly encouraging. Convinced by the evidence, religious leaders have not only come out unequivocally in support of birth spacing as a means to regulate fertility but have also stressed upon the need to give due attention to providing proper care, attention, nutrition and education to girls. Their position is that, according to the Holy Quran, the foundation of a harmonious family is laid upon love and care. Therefore, the imposition of any hardship that could jeopardise the health and wellbeing of any member of the family is contrary to the principles of Islam. The ulema appreciate the shift in the rationale for family planning advocacy from the economic emphasis of the past to the more human and relatable objective of improving family health and wellbeing, and saving mothers and children from premature, pregnancy-related deaths.
The most important outcome of these focused engagements has been the assurance provided by the ulema that they are ready to work with the concerned government departments to fully disseminate religiously acceptable messages on birth spacing. For this purpose, they are prepared to make themselves available at any forum, be it the pulpit of a mosque or an appearance on the electronic media, to help bring a change in public opinion on birth spacing and improving family health and wellbeing. This unique opportunity must be taken up by policymakers to remove the impasses on public thinking on population issues.

The writer is the director programmes at the Population Council’s Pakistan office