LAHORE, May 3: Pakistan has an alarming ranking on the Human Development Index, according to the United Nations Development Programme (UNDP). It has reached number 145 on the list of 187 countries. This is important to consider because not only does this signify the population explosion, it also means that at least 60 per cent of Pakistan’s population is living on less than two dollars a day.

The situation is grim: child and infant mortality rate is high, maternal mortality rate is even higher and because the Millennium Development Goals (MDGs) for maternal health are unlikely to be met, quality health, education, living, social security and justice remain a challenge for most Pakistanis.

Population welfare, which means how the quality of people’s lives can be improved by providing them with essentials, especially health and education, is something which must be considered today by all political parties, especially with their focus on marginalised sections of society such as women, children and minorities.

Therefore, it is important to see how some of the main political parties have addressed this issue in their manifestos.

The Pakistan Tehreek-e-Insaf (PTI) has mentioned population welfare in its manifesto with a separate heading. It promises to launch public awareness campaigns and reinforce programmes to bring the population growth rate down from 2.2 per cent to 1.6 per cent. PTI Manifesto Committee Chairman Firdous Naqvi says though it is a huge jump, it must be taken into consideration.

“We have included in our policies the need to introduce welfare programmes to improve the impact of existing projects and perhaps most important of all, to support modern family planning methods and give women greater role in making decision on children.”

He says the biggest issue around which people’s welfare revolves is the increase in population. The more the people, the more problematic it will be to meet their needs. Therefore, even more important is to let women decide how many children they want to have.

According to the Pakistan Demographic and Health Survey (PDHS) 2006-2007, around 25 per cent of married Pakistani women (approximately seven million), want healthy timing and spacing of their pregnancies, but have limited access to family planning information and services. A large chunk of them is not even allowed to voice their opinion on the matter.

Unintended and untimely pregnancies may result in deaths, and leave many children motherless. They increase financial burden on families for medical treatment, cause long-term health problems in women and affect women’s productivity at home as well as workplace. The population explosion and its implications on the health and wellbeing of families, country’s health system, facilities, infrastructure and the national economy is well-recognised and is being witnessed everyday by its citizens.

Senator Taj Haider of the Pakistan People’s Party (PPP) points out that this election year his party has done a poverty survey, studying the problems faced by those living below the poverty line.

“We have seen most of the population bulge in these sections, because of a lack of education. At the same time we think that by giving expecting mothers prenatal care, cashier vouchers to buy things related to their pregnancies or children, and free family planning advice, we expect a huge change,” he says. “After the child is born, the state will be responsible for immunisation, nutrition, and in later years free education.”

Currently, he says, lady health workers have done a tremendous job, but by focusing more on health, these issues can be addressed more effectively. The manifesto however does not separately take into account the population growth rate and directly related facets.

On its website, under social issues, there is a section on health, where the Pakistan Muslim League-Nawaz (PML-N) talks about modernisation of federal and provincial hospitals and general health care. However, there are no specifics given on maternal health though there is a mention of prevention of AIDS. It mentions population programme in its preamble to health but not as such in its future plans.

Pakistan Muslim League-Quaid’s (PML-Q) manifesto treats the issue with a similar disinterest. And while the Awami National Party (ANP) talks about crimes against women, and other issues, it gives too much of a generalised attention to health and population.

Comparatively, and like the PPP, the MQM in its manifesto gives much more details, especially about health, focusing on raising health expenditures and establishing hospitals and health care centres in districts and villages. “We feel that if health issues are addressed, specifically women’s health issues, population welfare issues will automatically be affected positively,” says party leader Farooq Sattar. “We also feel that like they did in Bangladesh, the issue can be best resolved once people take ownership themselves. Religious leaders need to play their roles, and the importance of local governments should be very obvious in this context. Only then can we eventually have durable peace and a drastic improvement in human development.”

The MQM manifesto focuses on increase in staff and equipment at primary and secondary health centres, training of providers at all levels, Basic Health Units, Rural Health Centres and Mother and Child care centres, and gives a separate section to Family Welfare that talks of bringing down the population growth rate. However, it does not specifically mention how this is expected to be done or whether Family Planning programmes will be promoted. The MQM also talks about banning social evils such as honour killing, interference of traditional religious beliefs in politics and society, and speaks about giving at least five per cent of the reserved seats to minorities in legislative bodies.

A part of why the population welfare is set under health is because the population welfare ministry has been officially combined with the health ministry. After the devolution, this has been further ignored even though population experts say that it should be treated as a separate subject.

Although Senator Haider says a separate ministry does not matter because most work has to be done on the field, experts maintain that the subject of population welfare should be treated separately because it encompasses and integrates many aspects of a citizen’s life. By combining the department under the ministry of health, many other issues are therefore more or less ignored.