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IF there is a basic truth we still have to learn with regard to improving the lives of people it is that development can take place only when a holistic and integrated approach is adopted. It is not possible to concentrate on only one aspect of people’s socio-economic lives and expect poverty to be eliminated and growth to take place uniformly.
It would be pertinent to study the approach of the Oxford Poverty and Human Development Initiative, a think tank working on strategies to address poverty issues.
The OPHDI emphasises that poverty is more than a lack of income. It is a multi-dimensional phenomenon. Even if a person is earning a reasonable amount, he may not be able to improve his life if health and education facilities are skewed in favour of the very wealthy. Violence is another factor which affects people unequally and its impact on the poor is greater. The OPHDI cites a UNDP study to point out that “successful countries have addressed different deprivations together”.
This basic truth is also recognised clearly by Zeba Sathar, country director of the Population Council Pakistan, and her co-authors in the book Capturing the Demographic Dividend in Pakistan with reference to the population sector.
While describing population as the centrepiece, Sathar refers to health, education, employment, gender and youth policies as “the spokes of the wheel of development”. Needless to say, this has not been understood sufficiently in this country. Our failure to recognise the interdependence of the different social sectors has resulted in flawed strategies that have led to our inability to achieve all-round and balanced growth.
Sathar succinctly points out that in the population and development discourse it must be made clear that the “potential effects of the demographic dividend, even when fertility begins to fall more rapidly, are not automatic”.
I feel that it is the failure of the leadership in Pakistan that it has not developed a balanced approach to development. Policies have been framed in such a way that they cater to the specific needs of some people in power, even if they militate against the wider interests of the majority. History is replete with anti-poor measures being adopted for the benefit of a small privileged class.
Development is possible only if in the words of Dr Akmal Hussain, a professor of economics, an “inclusive growth paradigm” is adopted. This means growth has to be equitable. In his chapter on equitable development, he recognises the importance of this approach.
If one were to develop only the education sector and that too with the goal of expanding coverage — as the education for all policy touted today aims to do — not much impact will be felt in the demographic sector. Education of a poor quality for the majority and high class schools and colleges for children of the elites is not going to reduce our population growth rate.
Moreover, this pattern of education will not help the youth as it will not develop a well-trained and qualified labour force. That will only result in unemployment that is already becoming the bane of our economy.
Take the healthcare sector. Very little attention is being paid to this as a result of which the health indicators of the country, as the Pakistan Medical Association has been repeatedly pointing out, are deteriorating.
This has a far-reaching impact on all other sectors. An unhealthy labour force leads to poor productivity as Pakistan has a very high disease burden. Children who lack vitality are undernourished and are falling ill frequently do not do well in their studies as their rate of absenteeism from school is high and their ability to concentrate on mental work is low.
This becomes a kind of vicious cycle. Failure in education and healthcare has the most deleterious effect on all the other areas of life. For instance, the training and employment of youth and the empowerment of women suffer most when education and healthcare have been grossly neglected. All this collectively affects the population growth rate.
What also needs to be understood is that population explosion negatively affects all socio-economic sectors. Had our population size been more manageable and growth not so rapid, it would have been easier to provide good education and healthcare to the fewer children that we would have had to care for.
So one can ask, what next? Since the relationship of one sector with the others is so profound, the impact of one on the other is far-reaching. This vicious cycle has to be broken somehow. A beginning could be made by prioritising the need to boost contraceptive prevalence by facilitating birth control services.
Given the high rate of unmet need (40pc) — women who want to use contraceptives but have no access to them — the easy availability of birth control facilities would have an immediate impact. That is also the conclusion that Capturing the Demographic Dividend reaches.
Another priority should be the empowerment of women. This will have an all-round impact on the social sectors and, by implication, on population policy outcomes. But the most immediate effect of a raised status for women would be to reduce the preference for the male child which is a major factor in determining the family size in Pakistan.
