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Much of the global burden of disease is due to sexual and reproductive ill health.
"A combination of factors like non-availability of services, baseless traditional beliefs and misconception play a big role. Everything depends on population: the economy, security, progress, values, culture.
Most of classic Economist as well as subsequent theorist based their theories on Malthusians theory .According to theory pressure of population brought down the wages to subsistence level and there was a constant fear of positive checks(faimine,war,and epidemics) .If preventive checks(celibacy,abstinence,and later marriage) were not applied.
Pakistan population grew from nearly 33 million in 1947 to about 180.8 million to date--an increase of over five times since the year of independence. Continued rapid growth in population has ranked Pakistan seventh in world and the third biggest contributor to world population growthIt was estimated as 146 million in mid-2002, (Source: Population Census Organization, 1998 Census Report of Pakistan and Economic Survey 2001-02).
In 1950 Pakistan had a population of 37 million and was the world's 13th largest country. By 2007 it was the sixth largest country with 164 million people. Pakistan population was 144 million people in 2000.In 2008 PAKISTAN population is 180.8 million ,In 2020 -336 million, 2040-446 million, 2060-550 million populations will be expecting by Pakistan. Is population boom is crisis or a blessing as a result of economy growth?
Pakistan is the worlds seventh-most populous country, with a population density of over 226 people/ km². Most of the population is concentrated in the plains surrounding the Indus River and its tributaries. The country has a moderate youth bulge; the average age is 21 and over 37% of Pakistanis are under 15 years of age.
Sexuality and reproduction are fundamental to personal identity and fulfillment, and to Family and social relationships. Sexual and reproductive health services help individuals
And societies achieve a range of social and economic goals.
32% of girls are married before 18 years of age from 1998-2007 (UNICEF), 33% Unmet need for family planning (PRB), Current total fertility rate: 4.0 (PRB) Pakistans total fertility rate (average number of children born by a woman in her lifetime) has declined in the past few decades. UNICEF estimated the total fertility rate at 6.3 in 1990 and 3.5 in 2007. The Population Reference Bureau estimates the current TFR at 4.0 (2009).
The TFR in rural areas (4.5 births) is considerably higher than the rate in urban areas (3.3 births). despite the decline in fertility rate, women in Pakistan have more children than those in the neighbouring countries like India where TFR is 2.7, Bangladesh 3.0 and Nepal 3.1.
Each year almost 400,000 infants and 16,500 mothers die from pregnancy- related causes. The infant mortality rate (75 deaths per 1,000 live births) is way above the world average of 52 deaths, and in more developed countries this rate is around 6 deaths (PRB, Pakistan Still Falls Short of Millennium Development Goals ).
Pakistan launched one of the first population control programmes in the 1950s, yet has lagged far behind other countries in effectively implementing or developing its understanding of population programmes. When Pakistan launched its national population programme in 1965 it was one of the first countries to take this ambitious step. Yet 46 years later, the programme is remarkable for its lack of impact on contraceptive Prevalence and fertility reduction, not for its achievements.
Government economists and academics from Harvard University, who assisted the Planning Commission in designing both the First (1955-60) and Second (1960-65) Five Year Plans, urged the government to recognize that even a 1.4% rate of population growth was a threat to economic progress. Ayub Khan took serious note of these early warnings but found him frustrated in his search for a quick solution.
The population sector has suffered because of this problem, more so since 1976 when the Programme was fully federalized. In 1979 UNFPA suggested provincialization as the first step in the transition towards the full integration of population with health, which was already the responsibility of the provinces
The Muslim world has one of the world's highest rates of population growth if not the highest. This is causing increasing human pressures upon a region of the globe that has suffered from millennia of abuse and degradation. Perhaps for this region, the Muslim world has been involved in more armed conflicts (mainly along the interface between the Muslim and non-Muslim worlds) than any other region of the world. (Africa has a similar rate of population growth and a similar number of armed conflicts.). Of the 10 countries that achieved the fastest reduction in the total fertility rate between 1980 and 1999, eight were Islamic countries
There is a well-known story about how a society stabilizes its population. As a country transitions from poverty to affluence, birthrates plungefrom six or eight children per woman to just about two. Population growth levels off. Prosperity and education, the story goes, are just about the best form of birth control there is. But this tale gets it backward. Low birthrates arent a consequence of national wealth; rather, theyre needed to create it. Soaring unemployment, endemic poverty, and flailing schools are quite simply impossible to combat when every year adds more and more people.
Economic Development in Low-Income Countries. It argued that population control would allow families to accumulate more money for investment and thereby solve the problem of insufficient capital in poor countries
Family Planning Scheme for Pakistan during Third Five-Year Plan, 1965-1970 Prevent 5-6 million births in next 5 years. Reduce annual birth rate from 50 to 40 per 1000 by 1970.Cover all 20 million fertile couples with services by 1970.main objective was, Maintain present and planned level of increase in per capita income. Obtain self-sufficiency in food, avoid imbalance in age structure of population. . Full-time staff included 1392 Family Planning Officers, 1200 Lady Family Planning Visitors, and 1209 Family Planning Assistants. Among the part-time staff were 25 000 traditional birth attendants, village 'dais' (Traditional Birth Attendants) were employed (one 'dai' for two villages), who earned referral fees for clients they brought in (Ministry of Health 1965). Usa aid it had spent over $30 million on Pakistan's population programme; during 1965-75 US AID provided 40% of total programme inputs.
In 1965 The annual crude birth rate was around 45 per thousand and death rate was around about 18 per thousand and net growth rate was 2.7% per annum. Annual crude birth rate was around 45 per thousand and death rate was around about 18 per thousand and net growth rate was 2.7% per annum.
Family Planning Scheme for Pakistan during (1970-1977) Reduce birth rate from 45/1000 to 40/1000 (in original Fourth Plan, 1970-1975) 34% of married women will practice effective contraception by 1975. 9.6 million births prevented.Main Objective was Maintain a growth rate in GNP higher than population growth.Rapidly reduce fertility. 1972 Census were made public; they revealed that Pakistan's poulation had grown from 43 million in 1961 to 65 million, and fertility levels remained Unchanged. In late December 1971, the population was estimated at 65.2 million.
Following Zia ul-Haq's coup d'état in 1977, government population planning efforts were almost halted. In 1980 the Population Division, formerly under the direction of a minister of state, was renamed the Population Welfare Division and transferred to the Ministry of Planning and Economic Development. This agency was charged with the delivery of both family planning services and maternal and child health care. The population by 1980 had exceeded 84 million
Family Planning Scheme for Pakistan during (1983-1987) Zia froze the population programme when he first assumed power in 1977. One stated reason for his decision stemmed from the widespread belief that Bhutto had used PPP workers as field motivators. Reduce birth rate from 40.3 to 37.3/1000 by 1987.Increase contraceptive
prevalence rate from 9.5% to 18.6% by 1988.Reduce rate of growth from 2.87 to 2.69 by 1987.If above achieved, then 0.5 million births will be prevented per year by 1987-88 (Sixth Plan)
In preparing the Sixth Five-Year Plan (1983-88), the government projected a national population of 147 million in the year 2000 if the growth rate were to be a constant at 2.8 percent per year, and of 134 million if the rate were to decline to the desired 2.1 percent per year by then
By the Seventh Five-Year Plan (1988-93) period, the multipronged approach initiated in the 1980s had increased international donor assistance and had begun to enlist local NGOs.
Modifications of the multi-sectoral approach during Seventh and Eighth Five-Year Plans1988-1998). Seventh Plan 1987-1993 Lower crude birth rate from 42.3 to 38/1000 ncrease contraceptive prevalence rate (CPR) from 12.9% to 23.5% .Prevent 3.17 million births Accelerated Programme 1991: Eighth Plan 1993-1998 Raise CPR from 14% to 9%.Reduce total fertility from 5.9 to 5.4. Reduce crude birth rate from 39 to 35/1000 revent 4.66 million births Reduce population growth rate from 2.9% to 2.6%.
Objectives Increase in child survival will help reduce fertility Overcome inadequacies in service availability and involvement of other Government sectors. two child polices was introduced in that plan.
8th plan 1998-2003 aims at reducing Growth Rate from 2.4% to 1.9%, Total Fertility Rate from 5.2% to 4.2% and to increase Contraceptive Prevalence Rate from 24.4% to 40.3%. Total population 146 m 2002 Economic Survey, 2001-2002,
Budgetary allocation and expenditure on Family Planning Programme by Five-Year Plan Period, 1955-2011.
(1)1955-60, Allocation 0.5 million, Expenditure (in Millions rupees), % foreign ssistance to expenditure o, Utilization % -
(2)1960-65, 30.5, Expenditure (in Millions rupees) 19 , % foreign assistance to expenditure 60, Utilization % 62.29
(3) 1965-1970 , Allocation 284 million, Expenditure (in Millions rupees) 356 % foreign Assistance to expenditure 18, Utilization % -125
(4) 1970-1978, Allocation 1028.8 million, Expenditure (in Millions rupees) 833.9, % foreign Assistance to expenditure 51.3, Utilization % -81.1.
(5) 1978-83, Allocation 1800 million, Expenditure (in Millions rupees) 617, % foreign ssistance to expenditure 18.8, Utilization % 75.
(6) 1983-88 Allocation ,2300 million, Expenditure (in Millions rupees) 1686.3, % foreign
Assistance to expenditure 52.6, Utilization % 82.
(7)1988-93, Allocation 3555 million, Expenditure (in Millions rupees) 3172.485, % foreignAssistance to expenditure 38.6, Utilization % 104.
(8)1993-1998, Allocation 9000 million, Expenditure (in Millions rupees) 8400, % foreign ssistance to expenditure 26, Utilization % 92.
(9) An amount of Rs.8140 million has been so far allocated for Population Welfare Program during 1998-2002 as against plan provision of Rs.15625 million. The allocation against plan provision comes to 52% only. An amount of Rs.4182 million has been proposed for the year 2002-2003 to establish the service delivery infrastructure which could not be established during the years of the 9th Plan.
(10) PSDP 2002-2003, 3200.0 allocation, propsed-4200 millions rupees.
(11) PSDP 2003-2004 ,Allocation,3700 million,Propsed-4809 millions rupees.
(12) 2004-2011-allocation,29680.1,Propsed-61207.1 million rupees.
(13)PSDP2001-2011 Funds allocation 71941-5,Propsed-71941.4 millions rupees, Resource Gap-32760.9 million rupees.
The largest amount earmarked for family planning since the 1994 International Conference on Population and Development in Cairo was in 1995, with US$723 million committed, remaining above $600 million for all but one year to 1999. The latest estimate, for 2007, is about $338 million
Poverty Trends in Pakistan and Urban-Rural Areas:1990-91 to 1998-2008.
1992-93 total , 24.9,Urban 19.8 ,Rural,27.0. 1993-94,total, 27.7,urban,15.2,rural,33.0
1996-97,total,24.5,Urban14.8,rural,28.7.1998-99-total,30.6,urban,20.9.rural,34.7,1999-2000,Total,35.2,urban,31.7,rural,39.2.
Percentage of population living below the poverty line has fallen from 34.46 percent in 2001 to 23.9 percent in 2004-05, a decline of 10.6 percentage points. In absolute numbers the count of poor persons has fallen from 49.23 million in 2001 to 36.45 million in 2004-05. The percentage of population living below the poverty line in rural areas has declined from 39.26 percent to 28.10 percent while those in urban areas, has declined from 22.69 percent 14.9 percent. In other words, rural poverty has declined by 11.16 percentage points and urban poverty is reduced by 7.79 percentage points
The WB validated the decline in poverty from 22.3 per cent in 2005-06 to 17.2 per cent on the basis of the data collected in 2007-8 under the Household Income Expenditure Survey (HIES). The latest survey found that poverty in the urban areas stood at 10.10 per cent and in the rural areas, it stood at 20.60 per cent. PCs own panel of economists, led by renowned economist Dr Hafeez A Pasha, had estimated poverty in the range of 37.5 per cent just a few months back.
Almost 74% of the population lives below $2 per day (UNDP,Human Development Report) with 31% below the poverty line of $1 per day (PRB). Due to increased food prices and poor access to affordable health care, progress in reducing poverty has been set back seven years (WHO, Impact of Food Crisis on Health).
Rural poor, Agricultural Laborers 5%, Farmers ,Baluchistan 2%, Farmers WFP 6%, Farmers Sindh 11%, Farmers Punjab 24%, Non-farm elf-Employed 17%, Non-farm Other 35%. Access to land is highly skewed: only 37 percent of rural households own land; 61 percent of these own less than 5 (15 percent of total land).
Pakistan has the highest number of out-of-school children in South Asia, with over 8 million of the almost 20 million school-age children out of school (UNESCO, Children out of School). Literacy rates in Pakistan have increased gradually over the past decades from 18.4 percent in 1961 to about 44 percent according to the 1998 population census results. This percentage increased from 27 to 55 for males, and for females from as low as 8 to 32 during the same period
Government of Pakistan spent about Rs.1332 billion to reduce the poverty. And as a result poverty reduced from 39.26 to 28.10 percent (rural) and from 22.69 to 14.9 percent (urban). By having a close look at the facts it is revealed that although a heavy amount has been spent on poverty reduction but the attained results are not up to the mark as poverty percentage stands quite high.
If humanity acted with resolution it is still possible to stabilise global population around 8.5 billion by the middle of the century. China and Iran are the two most conspicuous cases of successful population policies, and instead of criticising China for its somewhat brutal one-child policy, we should praise it for its courage to have done so. Imagine China with a population of 2 billion towards of this century.
In the last decade, however, In the last decade, however, contraceptive use has more than doubled, from 11.9% in 199091 (National Institute of Statistics and IRD/Macro International 1992) to 27.6% in200001 (Hakim et al. 2001), contraceptive use in 2001-2008 is 32% in Pakistan.and there are signs that fertility rates are also falling . Why is the contraceptive prevalence rate in Pakistan only 23.9, why arent the people of Pakistan using these methods when their immediate neighbours, India and Bangladesh are slowly and steadily increasing their contraceptive rates.
The Ministry of Healths programme the National Programme of Family Planning and Primary Health Care, commonly referred to as the Lady Health Worker Programme (LHWP) was launched under the Eighth Five-Year Plan (199398). In health sector People in Pakistan's health indicators are among the worst in the world.
As a result, Pakistan's population growth rate fell from 3.7%/ year in 1990 to 1.8% in 2006 .
Internal migration depicts significant relocation of the population mainly from rural to urban areas: about 32 percent of the rural population has moved to urban areas. This also affects interprovincial spatial relocation whereby 60 percent of internal migrants originated in the Punjab and 67 percent in the NWFP, and Sindh received the majority of these migrants. Pakistan is the most urban country in South Asia : 24% of the urban growth can be attributed to migration, while the overall natural increase in urban areas remains 2.6%. This trend poses daunting challenges for housing, environment and employment. International migration with influx of Bangladeshis, 2 to 3 million ther illegal entrants, and 7 million Afghan refugees, amounts to additional strains on overstretched resources.
There is an urgent need to educate women about emergency contraceptives with emphasis on available methods and correct timing of use. The Total Fertility Rates (TFRs) of some Arab countries, notably Tunisia, the United Arab Emirates, Bahrain, Kuwait and Lebanon are either below or very close to the stability level of 2.1 children per woman. Algeria and Morocco are at 2.4 and dropping fast. Some other Islamic countries are also in this zone of population stability or decline, including Turkey (2.1) and Indonesia (2.29)
Indonesia, with the largest Muslim population of any country in the world (190 million), has had one of the most successful population stabilisation programmes.In October 1983, almost 22 years ago, a national conference of the Ulama (local-level religious leaders), passed a resolution stating, "Islamic teachings justify family planning for the betterment of health conditions of mother and child, to make the child healthy, intelligent and devout".the annual population growth rate is a manageable 1.4% a year (India's is close to 2%)
In the Islamic Republic of Iran, after the overthrow of the Shah in 1979, the new fundamentalist leaders dismantled the country's earlier family planning programme and introduced pro-natalist policies. They soon realised their mistake, as the population rate soared, increasing by almost 40% in a decade. The sudden increase in the population led to a rethinking of policy: between 1976 and 1986 the population went up from 34 million to 49 million. In December 1989, the family planning programme was revived with the support of religious leaders. Population growth dropped from 3.2 per cent to 1.2 per cent by 2001 In the late 1980s, they made an abrupt about-turn, promoting modern methods of contraception, including the pill, IUDs and condoms.
Muslim country, sterilisation techniques are accepted forms of birth control. Reversal of vasectomy is also available and has a success rate of 80 per cent. The leaders of Iran have shown that it can take difficult decisions, reversing old traditions in matters that are beneficial to the people.
Tunisia, another almost wholly Islamic country, has a successful family planning programme which goes back to the mid-1970s. It is the only Islamic nation where polygamy - having more than one wife - is banned by law.
Morocco's Total Fertility Rates: 5.6 in 1979, 2.5 in 2003 In the last 10 years, Morocco's annual population growth rate has come down from 1.9% to 1.6% and the fertility rate of women (the average number of children women have) from almost four to under three"
Mexico has made. In 1970, a few years before Mexico initiated its national family planning program -- with significant assistance from the United States and the United Nations Population Fund (UNFPA) -- less than a quarter of women used contraceptives, average fertility rates were about seven children per woman, infant mortality rates were 69.0 per 1,000 live births, and average life expectancy was 62 years of age.
By contrast, today two-thirds of Mexican women use contraceptives, average fertility rates are 2.2 children per woman, infant mortality rates are 20.5 per 1,000 live births, and average life expectancy is 75 years of age.
Bangladesh, Turkey and Egypt are two others - where family planning is widely practised, using modern methods of contraception, including sterilisation. Abortion, admittedly, remains a controversial area, but some of these countries permit it if the health of the woman is in danger.
Investments in health care services, including those related to sexual and reproductive ealth, can make valuable contributions to wider development goals. The cost to avert an unwanted birth in a typical low-fertility Latin American country was estimated at $133, and savings at $1,600meaning that each dollar spent on family planning saved the government $12 in health and education costs alone.
A study in Vietnam found that over time every dollar invested infamily planning would save about $8 in health, education and other social services.
every dollar invested in Thailands family planning program saved the government more than $16-$21.Even more dramatic, an analysis in Egypt found that every dollar invested in family planning saved the government $31.22 This projection included government
expenditures on education, food, health, housing, and water and sewage services.
Bangladesh's population growth rate: 3.0%/ year in 1973; 1.6%/ year in 1999. Today, the average woman in Bangladesh has 3 children compared to 6-7 children 30 years ago. The total fertility rate has dropped by half since 1975
It estimated that family planning services would cost $15150 for each DALY saved; prenatal and delivery care $30250 per DALY saved; STI/HIV prevention $1250 per DALY saved; and prevention of breast and cervical cancer, $50100 for each DALY saved. By comparison, the cost per DALY saved on other health interventions
ranged from $5-20 for preventing deficiencies in iron, vitamin A or iodine, to $5250 for prevention of malaria, to $1,6003,500 for environmental control of dengue.
Treatment generally costs much more than preventionfor example, prevention of cervical cancer costs $100 per DALY saved, but treatment costs $2,500 per DALY saved. Preventing cardiovascular conditions costs $150 per DALY saved, treatment $2,00030,000
Estimates of the cost (in 2009dollars) for a womans first visit to obtain oral contraceptives average about $8.00: $1.00 for drugs and supplies, $0.50 for labor, $6.50 for overhead (including capital). Delivery costs for an uncomplicated vaginal birth average about $28.00: $5.00 for drugs and supplies, $6.00 for labor, $11.00 for overhead (including capital) and $6.00 for the hospital stay.
The estimated global total cost for prevention and treatment rises from $3.2 billion
in 2001 to $10.5 billion in 2005 to $15 billion in 2007. The largest share (around 50% of the total) is for AIDS care and treatment, followed by HIV/AIDS prevention (about 44% of the total). A much smaller share (about 9% in 2008 and 12%, or $1222 million, in
2007) would provide care for children orphaned by AIDS
Each year, 3.02 million persons add to the population of Pakistan. With current growth rate of 2.2 percent, Pakistan's population will double in next 32 years. High Total Fertility Rate (4.0) and lower literacy rate (35%) among females are major obstacles to sustainable development. Fifty percent of Pakistan's population is forced to live in one-room houses. Over one third of women, with three children in Pakistan, do not look forward to another pregnancy. Nevertheless, they get pregnant because they do not have access to reproductive health facilities.Low per capita income (US$ 753). Forests in Pakistan occupy only 4% of the total area.Pakistan is an agricultural country but per capita arable land is shrinking due to higher pressure on land. In 1951-52, per capita agricultural holding was 1.1 acres due to higher pressure on land which reduced to 0.5 acres in 1977. Slowdown in population growth rate, wider coverage of reproductive health services, education of women, and effective steps to eradicate poverty are prerequisites for sustainable development in Pakistan.
However, because of the absence of a coherent approach to overcome the social and cultural obstacles to the use of family planning in conjunction with poor service delivery and outreach activities; ineffective information, education and communication campaign; frequent changes in the organisational set up of the programme; inefficient management and lack of political commitment to family planning, the programme failed to achieve tangible success.
The only way out of the present stagnation is to merge the ministries of population and health,. "This has been suggested for years. An FP package should be offered as part of a total MNCH package of services.
"There is no need for a Ministry of Population. If a woman comes for child immunisation, take that opportunity to counsel her on spacing her pregnancies; invest all the money that comes under FP in female education. FP is not a passive activity. A woman has to be fully aware and take responsibility, but she cannot do this unless she is educated,
"I do not think that any of the crises we are facing today whether it is the food crisis, the water crisis, the financial crisis or the crisis of climate change can be managed unless greater attention is paid to population issues,"
Part will be soon published about conclusion and other factors.
Usman karim based in Lahore lmno25@hotmail.com
"A combination of factors like non-availability of services, baseless traditional beliefs and misconception play a big role. Everything depends on population: the economy, security, progress, values, culture.
Most of classic Economist as well as subsequent theorist based their theories on Malthusians theory .According to theory pressure of population brought down the wages to subsistence level and there was a constant fear of positive checks(faimine,war,and epidemics) .If preventive checks(celibacy,abstinence,and later marriage) were not applied.
Pakistan population grew from nearly 33 million in 1947 to about 180.8 million to date--an increase of over five times since the year of independence. Continued rapid growth in population has ranked Pakistan seventh in world and the third biggest contributor to world population growthIt was estimated as 146 million in mid-2002, (Source: Population Census Organization, 1998 Census Report of Pakistan and Economic Survey 2001-02).
In 1950 Pakistan had a population of 37 million and was the world's 13th largest country. By 2007 it was the sixth largest country with 164 million people. Pakistan population was 144 million people in 2000.In 2008 PAKISTAN population is 180.8 million ,In 2020 -336 million, 2040-446 million, 2060-550 million populations will be expecting by Pakistan. Is population boom is crisis or a blessing as a result of economy growth?
Pakistan is the worlds seventh-most populous country, with a population density of over 226 people/ km². Most of the population is concentrated in the plains surrounding the Indus River and its tributaries. The country has a moderate youth bulge; the average age is 21 and over 37% of Pakistanis are under 15 years of age.
Sexuality and reproduction are fundamental to personal identity and fulfillment, and to Family and social relationships. Sexual and reproductive health services help individuals
And societies achieve a range of social and economic goals.
32% of girls are married before 18 years of age from 1998-2007 (UNICEF), 33% Unmet need for family planning (PRB), Current total fertility rate: 4.0 (PRB) Pakistans total fertility rate (average number of children born by a woman in her lifetime) has declined in the past few decades. UNICEF estimated the total fertility rate at 6.3 in 1990 and 3.5 in 2007. The Population Reference Bureau estimates the current TFR at 4.0 (2009).
The TFR in rural areas (4.5 births) is considerably higher than the rate in urban areas (3.3 births). despite the decline in fertility rate, women in Pakistan have more children than those in the neighbouring countries like India where TFR is 2.7, Bangladesh 3.0 and Nepal 3.1.
Each year almost 400,000 infants and 16,500 mothers die from pregnancy- related causes. The infant mortality rate (75 deaths per 1,000 live births) is way above the world average of 52 deaths, and in more developed countries this rate is around 6 deaths (PRB, Pakistan Still Falls Short of Millennium Development Goals ).
Pakistan launched one of the first population control programmes in the 1950s, yet has lagged far behind other countries in effectively implementing or developing its understanding of population programmes. When Pakistan launched its national population programme in 1965 it was one of the first countries to take this ambitious step. Yet 46 years later, the programme is remarkable for its lack of impact on contraceptive Prevalence and fertility reduction, not for its achievements.
Government economists and academics from Harvard University, who assisted the Planning Commission in designing both the First (1955-60) and Second (1960-65) Five Year Plans, urged the government to recognize that even a 1.4% rate of population growth was a threat to economic progress. Ayub Khan took serious note of these early warnings but found him frustrated in his search for a quick solution.
The population sector has suffered because of this problem, more so since 1976 when the Programme was fully federalized. In 1979 UNFPA suggested provincialization as the first step in the transition towards the full integration of population with health, which was already the responsibility of the provinces
The Muslim world has one of the world's highest rates of population growth if not the highest. This is causing increasing human pressures upon a region of the globe that has suffered from millennia of abuse and degradation. Perhaps for this region, the Muslim world has been involved in more armed conflicts (mainly along the interface between the Muslim and non-Muslim worlds) than any other region of the world. (Africa has a similar rate of population growth and a similar number of armed conflicts.). Of the 10 countries that achieved the fastest reduction in the total fertility rate between 1980 and 1999, eight were Islamic countries
There is a well-known story about how a society stabilizes its population. As a country transitions from poverty to affluence, birthrates plungefrom six or eight children per woman to just about two. Population growth levels off. Prosperity and education, the story goes, are just about the best form of birth control there is. But this tale gets it backward. Low birthrates arent a consequence of national wealth; rather, theyre needed to create it. Soaring unemployment, endemic poverty, and flailing schools are quite simply impossible to combat when every year adds more and more people.
Economic Development in Low-Income Countries. It argued that population control would allow families to accumulate more money for investment and thereby solve the problem of insufficient capital in poor countries
Family Planning Scheme for Pakistan during Third Five-Year Plan, 1965-1970 Prevent 5-6 million births in next 5 years. Reduce annual birth rate from 50 to 40 per 1000 by 1970.Cover all 20 million fertile couples with services by 1970.main objective was, Maintain present and planned level of increase in per capita income. Obtain self-sufficiency in food, avoid imbalance in age structure of population. . Full-time staff included 1392 Family Planning Officers, 1200 Lady Family Planning Visitors, and 1209 Family Planning Assistants. Among the part-time staff were 25 000 traditional birth attendants, village 'dais' (Traditional Birth Attendants) were employed (one 'dai' for two villages), who earned referral fees for clients they brought in (Ministry of Health 1965). Usa aid it had spent over $30 million on Pakistan's population programme; during 1965-75 US AID provided 40% of total programme inputs.
In 1965 The annual crude birth rate was around 45 per thousand and death rate was around about 18 per thousand and net growth rate was 2.7% per annum. Annual crude birth rate was around 45 per thousand and death rate was around about 18 per thousand and net growth rate was 2.7% per annum.
Family Planning Scheme for Pakistan during (1970-1977) Reduce birth rate from 45/1000 to 40/1000 (in original Fourth Plan, 1970-1975) 34% of married women will practice effective contraception by 1975. 9.6 million births prevented.Main Objective was Maintain a growth rate in GNP higher than population growth.Rapidly reduce fertility. 1972 Census were made public; they revealed that Pakistan's poulation had grown from 43 million in 1961 to 65 million, and fertility levels remained Unchanged. In late December 1971, the population was estimated at 65.2 million.
Following Zia ul-Haq's coup d'état in 1977, government population planning efforts were almost halted. In 1980 the Population Division, formerly under the direction of a minister of state, was renamed the Population Welfare Division and transferred to the Ministry of Planning and Economic Development. This agency was charged with the delivery of both family planning services and maternal and child health care. The population by 1980 had exceeded 84 million
Family Planning Scheme for Pakistan during (1983-1987) Zia froze the population programme when he first assumed power in 1977. One stated reason for his decision stemmed from the widespread belief that Bhutto had used PPP workers as field motivators. Reduce birth rate from 40.3 to 37.3/1000 by 1987.Increase contraceptive
prevalence rate from 9.5% to 18.6% by 1988.Reduce rate of growth from 2.87 to 2.69 by 1987.If above achieved, then 0.5 million births will be prevented per year by 1987-88 (Sixth Plan)
In preparing the Sixth Five-Year Plan (1983-88), the government projected a national population of 147 million in the year 2000 if the growth rate were to be a constant at 2.8 percent per year, and of 134 million if the rate were to decline to the desired 2.1 percent per year by then
By the Seventh Five-Year Plan (1988-93) period, the multipronged approach initiated in the 1980s had increased international donor assistance and had begun to enlist local NGOs.
Modifications of the multi-sectoral approach during Seventh and Eighth Five-Year Plans1988-1998). Seventh Plan 1987-1993 Lower crude birth rate from 42.3 to 38/1000 ncrease contraceptive prevalence rate (CPR) from 12.9% to 23.5% .Prevent 3.17 million births Accelerated Programme 1991: Eighth Plan 1993-1998 Raise CPR from 14% to 9%.Reduce total fertility from 5.9 to 5.4. Reduce crude birth rate from 39 to 35/1000 revent 4.66 million births Reduce population growth rate from 2.9% to 2.6%.
Objectives Increase in child survival will help reduce fertility Overcome inadequacies in service availability and involvement of other Government sectors. two child polices was introduced in that plan.
8th plan 1998-2003 aims at reducing Growth Rate from 2.4% to 1.9%, Total Fertility Rate from 5.2% to 4.2% and to increase Contraceptive Prevalence Rate from 24.4% to 40.3%. Total population 146 m 2002 Economic Survey, 2001-2002,
Budgetary allocation and expenditure on Family Planning Programme by Five-Year Plan Period, 1955-2011.
(1)1955-60, Allocation 0.5 million, Expenditure (in Millions rupees), % foreign ssistance to expenditure o, Utilization % -
(2)1960-65, 30.5, Expenditure (in Millions rupees) 19 , % foreign assistance to expenditure 60, Utilization % 62.29
(3) 1965-1970 , Allocation 284 million, Expenditure (in Millions rupees) 356 % foreign Assistance to expenditure 18, Utilization % -125
(4) 1970-1978, Allocation 1028.8 million, Expenditure (in Millions rupees) 833.9, % foreign Assistance to expenditure 51.3, Utilization % -81.1.
(5) 1978-83, Allocation 1800 million, Expenditure (in Millions rupees) 617, % foreign ssistance to expenditure 18.8, Utilization % 75.
(6) 1983-88 Allocation ,2300 million, Expenditure (in Millions rupees) 1686.3, % foreign
Assistance to expenditure 52.6, Utilization % 82.
(7)1988-93, Allocation 3555 million, Expenditure (in Millions rupees) 3172.485, % foreignAssistance to expenditure 38.6, Utilization % 104.
(8)1993-1998, Allocation 9000 million, Expenditure (in Millions rupees) 8400, % foreign ssistance to expenditure 26, Utilization % 92.
(9) An amount of Rs.8140 million has been so far allocated for Population Welfare Program during 1998-2002 as against plan provision of Rs.15625 million. The allocation against plan provision comes to 52% only. An amount of Rs.4182 million has been proposed for the year 2002-2003 to establish the service delivery infrastructure which could not be established during the years of the 9th Plan.
(10) PSDP 2002-2003, 3200.0 allocation, propsed-4200 millions rupees.
(11) PSDP 2003-2004 ,Allocation,3700 million,Propsed-4809 millions rupees.
(12) 2004-2011-allocation,29680.1,Propsed-61207.1 million rupees.
(13)PSDP2001-2011 Funds allocation 71941-5,Propsed-71941.4 millions rupees, Resource Gap-32760.9 million rupees.
The largest amount earmarked for family planning since the 1994 International Conference on Population and Development in Cairo was in 1995, with US$723 million committed, remaining above $600 million for all but one year to 1999. The latest estimate, for 2007, is about $338 million
Poverty Trends in Pakistan and Urban-Rural Areas:1990-91 to 1998-2008.
1992-93 total , 24.9,Urban 19.8 ,Rural,27.0. 1993-94,total, 27.7,urban,15.2,rural,33.0
1996-97,total,24.5,Urban14.8,rural,28.7.1998-99-total,30.6,urban,20.9.rural,34.7,1999-2000,Total,35.2,urban,31.7,rural,39.2.
Percentage of population living below the poverty line has fallen from 34.46 percent in 2001 to 23.9 percent in 2004-05, a decline of 10.6 percentage points. In absolute numbers the count of poor persons has fallen from 49.23 million in 2001 to 36.45 million in 2004-05. The percentage of population living below the poverty line in rural areas has declined from 39.26 percent to 28.10 percent while those in urban areas, has declined from 22.69 percent 14.9 percent. In other words, rural poverty has declined by 11.16 percentage points and urban poverty is reduced by 7.79 percentage points
The WB validated the decline in poverty from 22.3 per cent in 2005-06 to 17.2 per cent on the basis of the data collected in 2007-8 under the Household Income Expenditure Survey (HIES). The latest survey found that poverty in the urban areas stood at 10.10 per cent and in the rural areas, it stood at 20.60 per cent. PCs own panel of economists, led by renowned economist Dr Hafeez A Pasha, had estimated poverty in the range of 37.5 per cent just a few months back.
Almost 74% of the population lives below $2 per day (UNDP,Human Development Report) with 31% below the poverty line of $1 per day (PRB). Due to increased food prices and poor access to affordable health care, progress in reducing poverty has been set back seven years (WHO, Impact of Food Crisis on Health).
Rural poor, Agricultural Laborers 5%, Farmers ,Baluchistan 2%, Farmers WFP 6%, Farmers Sindh 11%, Farmers Punjab 24%, Non-farm elf-Employed 17%, Non-farm Other 35%. Access to land is highly skewed: only 37 percent of rural households own land; 61 percent of these own less than 5 (15 percent of total land).
Pakistan has the highest number of out-of-school children in South Asia, with over 8 million of the almost 20 million school-age children out of school (UNESCO, Children out of School). Literacy rates in Pakistan have increased gradually over the past decades from 18.4 percent in 1961 to about 44 percent according to the 1998 population census results. This percentage increased from 27 to 55 for males, and for females from as low as 8 to 32 during the same period
Government of Pakistan spent about Rs.1332 billion to reduce the poverty. And as a result poverty reduced from 39.26 to 28.10 percent (rural) and from 22.69 to 14.9 percent (urban). By having a close look at the facts it is revealed that although a heavy amount has been spent on poverty reduction but the attained results are not up to the mark as poverty percentage stands quite high.
If humanity acted with resolution it is still possible to stabilise global population around 8.5 billion by the middle of the century. China and Iran are the two most conspicuous cases of successful population policies, and instead of criticising China for its somewhat brutal one-child policy, we should praise it for its courage to have done so. Imagine China with a population of 2 billion towards of this century.
In the last decade, however, In the last decade, however, contraceptive use has more than doubled, from 11.9% in 199091 (National Institute of Statistics and IRD/Macro International 1992) to 27.6% in200001 (Hakim et al. 2001), contraceptive use in 2001-2008 is 32% in Pakistan.and there are signs that fertility rates are also falling . Why is the contraceptive prevalence rate in Pakistan only 23.9, why arent the people of Pakistan using these methods when their immediate neighbours, India and Bangladesh are slowly and steadily increasing their contraceptive rates.
The Ministry of Healths programme the National Programme of Family Planning and Primary Health Care, commonly referred to as the Lady Health Worker Programme (LHWP) was launched under the Eighth Five-Year Plan (199398). In health sector People in Pakistan's health indicators are among the worst in the world.
As a result, Pakistan's population growth rate fell from 3.7%/ year in 1990 to 1.8% in 2006 .
Internal migration depicts significant relocation of the population mainly from rural to urban areas: about 32 percent of the rural population has moved to urban areas. This also affects interprovincial spatial relocation whereby 60 percent of internal migrants originated in the Punjab and 67 percent in the NWFP, and Sindh received the majority of these migrants. Pakistan is the most urban country in South Asia : 24% of the urban growth can be attributed to migration, while the overall natural increase in urban areas remains 2.6%. This trend poses daunting challenges for housing, environment and employment. International migration with influx of Bangladeshis, 2 to 3 million ther illegal entrants, and 7 million Afghan refugees, amounts to additional strains on overstretched resources.
There is an urgent need to educate women about emergency contraceptives with emphasis on available methods and correct timing of use. The Total Fertility Rates (TFRs) of some Arab countries, notably Tunisia, the United Arab Emirates, Bahrain, Kuwait and Lebanon are either below or very close to the stability level of 2.1 children per woman. Algeria and Morocco are at 2.4 and dropping fast. Some other Islamic countries are also in this zone of population stability or decline, including Turkey (2.1) and Indonesia (2.29)
Indonesia, with the largest Muslim population of any country in the world (190 million), has had one of the most successful population stabilisation programmes.In October 1983, almost 22 years ago, a national conference of the Ulama (local-level religious leaders), passed a resolution stating, "Islamic teachings justify family planning for the betterment of health conditions of mother and child, to make the child healthy, intelligent and devout".the annual population growth rate is a manageable 1.4% a year (India's is close to 2%)
In the Islamic Republic of Iran, after the overthrow of the Shah in 1979, the new fundamentalist leaders dismantled the country's earlier family planning programme and introduced pro-natalist policies. They soon realised their mistake, as the population rate soared, increasing by almost 40% in a decade. The sudden increase in the population led to a rethinking of policy: between 1976 and 1986 the population went up from 34 million to 49 million. In December 1989, the family planning programme was revived with the support of religious leaders. Population growth dropped from 3.2 per cent to 1.2 per cent by 2001 In the late 1980s, they made an abrupt about-turn, promoting modern methods of contraception, including the pill, IUDs and condoms.
Muslim country, sterilisation techniques are accepted forms of birth control. Reversal of vasectomy is also available and has a success rate of 80 per cent. The leaders of Iran have shown that it can take difficult decisions, reversing old traditions in matters that are beneficial to the people.
Tunisia, another almost wholly Islamic country, has a successful family planning programme which goes back to the mid-1970s. It is the only Islamic nation where polygamy - having more than one wife - is banned by law.
Morocco's Total Fertility Rates: 5.6 in 1979, 2.5 in 2003 In the last 10 years, Morocco's annual population growth rate has come down from 1.9% to 1.6% and the fertility rate of women (the average number of children women have) from almost four to under three"
Mexico has made. In 1970, a few years before Mexico initiated its national family planning program -- with significant assistance from the United States and the United Nations Population Fund (UNFPA) -- less than a quarter of women used contraceptives, average fertility rates were about seven children per woman, infant mortality rates were 69.0 per 1,000 live births, and average life expectancy was 62 years of age.
By contrast, today two-thirds of Mexican women use contraceptives, average fertility rates are 2.2 children per woman, infant mortality rates are 20.5 per 1,000 live births, and average life expectancy is 75 years of age.
Bangladesh, Turkey and Egypt are two others - where family planning is widely practised, using modern methods of contraception, including sterilisation. Abortion, admittedly, remains a controversial area, but some of these countries permit it if the health of the woman is in danger.
Investments in health care services, including those related to sexual and reproductive ealth, can make valuable contributions to wider development goals. The cost to avert an unwanted birth in a typical low-fertility Latin American country was estimated at $133, and savings at $1,600meaning that each dollar spent on family planning saved the government $12 in health and education costs alone.
A study in Vietnam found that over time every dollar invested infamily planning would save about $8 in health, education and other social services.
every dollar invested in Thailands family planning program saved the government more than $16-$21.Even more dramatic, an analysis in Egypt found that every dollar invested in family planning saved the government $31.22 This projection included government
expenditures on education, food, health, housing, and water and sewage services.
Bangladesh's population growth rate: 3.0%/ year in 1973; 1.6%/ year in 1999. Today, the average woman in Bangladesh has 3 children compared to 6-7 children 30 years ago. The total fertility rate has dropped by half since 1975
It estimated that family planning services would cost $15150 for each DALY saved; prenatal and delivery care $30250 per DALY saved; STI/HIV prevention $1250 per DALY saved; and prevention of breast and cervical cancer, $50100 for each DALY saved. By comparison, the cost per DALY saved on other health interventions
ranged from $5-20 for preventing deficiencies in iron, vitamin A or iodine, to $5250 for prevention of malaria, to $1,6003,500 for environmental control of dengue.
Treatment generally costs much more than preventionfor example, prevention of cervical cancer costs $100 per DALY saved, but treatment costs $2,500 per DALY saved. Preventing cardiovascular conditions costs $150 per DALY saved, treatment $2,00030,000
Estimates of the cost (in 2009dollars) for a womans first visit to obtain oral contraceptives average about $8.00: $1.00 for drugs and supplies, $0.50 for labor, $6.50 for overhead (including capital). Delivery costs for an uncomplicated vaginal birth average about $28.00: $5.00 for drugs and supplies, $6.00 for labor, $11.00 for overhead (including capital) and $6.00 for the hospital stay.
The estimated global total cost for prevention and treatment rises from $3.2 billion
in 2001 to $10.5 billion in 2005 to $15 billion in 2007. The largest share (around 50% of the total) is for AIDS care and treatment, followed by HIV/AIDS prevention (about 44% of the total). A much smaller share (about 9% in 2008 and 12%, or $1222 million, in
2007) would provide care for children orphaned by AIDS
Each year, 3.02 million persons add to the population of Pakistan. With current growth rate of 2.2 percent, Pakistan's population will double in next 32 years. High Total Fertility Rate (4.0) and lower literacy rate (35%) among females are major obstacles to sustainable development. Fifty percent of Pakistan's population is forced to live in one-room houses. Over one third of women, with three children in Pakistan, do not look forward to another pregnancy. Nevertheless, they get pregnant because they do not have access to reproductive health facilities.Low per capita income (US$ 753). Forests in Pakistan occupy only 4% of the total area.Pakistan is an agricultural country but per capita arable land is shrinking due to higher pressure on land. In 1951-52, per capita agricultural holding was 1.1 acres due to higher pressure on land which reduced to 0.5 acres in 1977. Slowdown in population growth rate, wider coverage of reproductive health services, education of women, and effective steps to eradicate poverty are prerequisites for sustainable development in Pakistan.
However, because of the absence of a coherent approach to overcome the social and cultural obstacles to the use of family planning in conjunction with poor service delivery and outreach activities; ineffective information, education and communication campaign; frequent changes in the organisational set up of the programme; inefficient management and lack of political commitment to family planning, the programme failed to achieve tangible success.
The only way out of the present stagnation is to merge the ministries of population and health,. "This has been suggested for years. An FP package should be offered as part of a total MNCH package of services.
"There is no need for a Ministry of Population. If a woman comes for child immunisation, take that opportunity to counsel her on spacing her pregnancies; invest all the money that comes under FP in female education. FP is not a passive activity. A woman has to be fully aware and take responsibility, but she cannot do this unless she is educated,
"I do not think that any of the crises we are facing today whether it is the food crisis, the water crisis, the financial crisis or the crisis of climate change can be managed unless greater attention is paid to population issues,"
Part will be soon published about conclusion and other factors.
Usman karim based in Lahore lmno25@hotmail.com
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If we want to develop our GDP to that of a developed nation we need to hold the reins here. I believe a population of around 100 million would be optimal for our region. Another thing we can do is to encourage Pakistanis to immigrate to other parts of the world and at the same time spread our culture 
