DECENNIAL population census is a must in most countries of the world nowadays. Population census is conducted to gather basic information on the total number of people living at a particular point in time in a given country.

This information is absolutely essential to plan services, fix budgetary allocations and improve the quality of life for citizens. Census data is used by government ministries, different agencies, researchers and academics to plan and analyse demographic trends, and plan and project future scenarios. For any such planning to be effective accurate information on population numbers is a must.

In Pakistan, where focus on service delivery is hardly a top-level priority, the population census is correspondingly low on governmental priorities.

Pakistan enjoys not too good a reputation when it comes to organising a census at the regular interval of 10 years. Up until the fourth census in 1981, Pakistan was pretty good at meeting the target of an on-time decennial census. However, the census of 1991 was delayed by seven years to 1998. Since then, the next census, which was due in 2008, is already late by eight years. One newspaper aptly highlighted normalised delays with the heading ‘18 years and still counting’. Perhaps the headline should have been ‘18 years and still calculating the political cost of organising census’.

A headcount is key to determining the burden of disease.

Indications are that it is the politics of numbers which has been at the heart of the delay. With shrinking resources and expanding populations, the latter occurring unevenly across the country and different ethnic groups, the census has become a highly charged political issue. The exercise is hedged with a range of apprehensions, both voiced and unvoiced.

The country has changed enormously in terms of political consciousness, the rural-urban divide, demographics and ethnicity. These factors weigh heavily on the headcount exercise. The massive urban migration, likely to be confirmed by a new census, is set to reduce rural representation, with implications for the landed political elites’ hold on power.

Similarly, the ever-changing ethnic balance in the strategic provinces of Sindh and Balochistan is also triggering anxieties. For example, Balochistan was over 50pc Baloch in the last census. This may change in the new census in view of the massive influx of Afghan refugees into the province over the last two decades. As a result, the Baloch’s fears of being outnumbered by Pakhtuns in the province and hence the Baloch’s pleas for Afghan refugees to be excluded from the census enumeration process are growing vociferous.

Much the same can be said about Sindh where the urban population, composed of Urdu speakers and migrants, is increasing at a pace faster than the local Sindhi population. Again this has serious implications for issues of resource allocation, identity and the status of Sindhi in the province. Within Karachi, the MQM is apprehensive about the rising influx of displaced persons from ongoing conflicts in the country. This concern has been voiced in coded words like ‘Talibanisation of Karachi’. Above all, Punjab may also have to live with its share of the NFC award reduced a bit in line with its population size; it is perceived to be growing at a pace slower than other provinces with the exception of Balochistan.

These are big political obstacles that have stood in the way of organising the census. Yet the option of not holding a census is equally fraught with more serious dangers. In the absence of reliable population data, our planning is based on guesstimates extrapolated from the last census which goes back to 1998. Since then, estimates of population are routinely made on the back of envelopes. Most of our policymaking is organised on these estimates.

Yet population is hugely important from the viewpoint of public health. Public health is about the health of the population. Accurate population figures are key to determining the burden of disease and distribution of disease among a given population. WHO uses population data to determine the global burden of diseases and undertake projections vital to health planning and financing.

In addition, epidemiology, an important part of public health, deals exclusively with the study of distribution of determinants and frequency of disease distribution in a given population. This discipline of public health is unlikely to make accurate predictions about the incidence and prevalence of disease if population census data is not accurate. In fact, epidemiology and demography are historically tightly bound with each other.

Moreover, population census data contains crucial information on housing conditions, which provides vital information about the social determinants of health. Additional information about disabled people is of great help in designing services appropriate to this segment of the population.

The fear project historically built around the census exercise may serve some political ends in the short term, but it may deal a death blow to the concept of sound planning in health and other social sectors.

The writer is a development consultant and policy analyst.

Published in Dawn, April 5th, 2016