THE last 75 years have seen massive socioeconomic changes in the subcontinent; one of them is the huge demographic change witnessed in our region. Pakistan’s population has increased sixfold from 30 million in 1951 to 220m in 2022, leading us to a staggering fifth highest position in the world from the 13th in 1951 (when the population included East Pakistan) and eighth in 1981.

We have very little else to offer in terms of human power and education, health and economic achievements. The potential seen in Pakistan in the 1960s and the 1970s has been squandered. South Asia took centre-stage in world population growth and population policies in the 1970s with the realisation that the future course of any country’s development was strongly intertwined with its population trajectory.

Pakistan initiated its population programme much earlier than other regional countries, in the 1960s, but the modernist, development-oriented military regime of Ayub Khan did not translate it appropriately as being related to individual wellbeing and welfare rather than to macro goals of development and growth. With 1971 came the split from the East Wing and the emergence of Bangladesh; that is when the two halves broke into separate pathways of population, politics and development.

One visible effort to ratchet up education, health and population planning was during the Zulfikar Ali Bhutto period (1973-77) when Begum Nusrat Bhutto led us to the famous Bucharest population conference. But this period was cut short by another military coup. This time Gen Ziaul Haq, with his more conservative undertones, took us into down a spiral in terms of population planning. While other countries shot ahead in terms of their population policies, notably Indonesia and Bangladesh, a moratorium was imposed during 1977-88, and the population narrative took on a different meaning.

After witnessing one of history’s largest migrations, Pakistan’s population grew from 30m in 1951 to 220m in 2022. A lack of consensus on population control policies impedes national development.

A turning point?

Could this have been a turning point? Above all, the regressive actions bred confusion in the minds of the people that religion is at odds with family planning. This conviction spread wide, especially to the middle classes.

The ambiguity and ambivalence regarding the permissibility of family planning in the religion stems from the pronatalist 1943 Maududi treatise that was reprinted in 1962. The main argument was that family planning could not be sponsored as a state policy and enforced upon the people by the government. While presenting several arguments against population ‘control’, he did, however, concede that if it was a question of preserving human life, especially of the mother and the child, parents could adopt any measure in consultation with and on the advice of a medical practitioner.

The latter aspect of the treatise never received much attention. However, the pronatalist views were exploited and used in the movements against Ayub and Bhutto, both of whom supported population planning. Conversely, the clergy in Indonesia, Bangladesh, Jordan, Morocco, Egypt (where the Grand Mufti of Jamia Al-Azhar issued a fatwa in favour of family planning) and in Iran (where a similar fatwa was issued by Imam Khomeini) were unequivocal in their support. In Pakistan, it was not until 2015 that attempts were made to obtain a broad-based consensus on the permissibility of family planning (Figure 1).

Bangladesh’s success

The standout story of Bangladesh’s success in lowering its population size is worth telling. It was achieved through sustained political will at the highest level, a far-sighted and consistent population and development policy, community outreach and women’s empowerment. The outcome was obvious (Figure 2).

Starting at the same level in 1971, Bangladesh already has 61 million less people than us whose needs it had to serve. By the year 2100, Bangladesh is expected to level off to 150 million, while Pakistan is likely to be home to over 400 million. Pakistan has by and large been the most indecisive in reconciling the belief that sheer numbers of people give strength, provide opportunity to exert our might at the borders, increase remittances, and expand political power with the capacity to provide basic rights of primary education, health, clean drinking water and the ability to breathe good, clean air.

The clearly pronatalist National Finance Commission (NFC) Award formula rewards a larger population by province and is the base of political representation and resource distribution on the basis of 82pc weightage for the divisible pool of resources. It stands in contradiction to population policies encouraging fertility decline.

Rapid urbanisation

A striking feature of Pakistan’s demographic situation is its much more rapid rate of urbanisation than in India and Bangladesh. In one of the world’s largest migrations, the influx of 6.5 million Muslims into Pakistan following the partition of India and their disproportionate move to urban areas was the basis for the major source of growth of cities like Karachi and Lahore.

The steadily increasing share of urban population is a result of migration from rural to urban areas, but also continued high fertility in urban areas. More than 50pc of Pakistanis will be living in urban areas by 2050 — already at 2.5 times compared to 1951. The rapid rate of urbanisation has had a profound impact on the social milieu in Pakistan, as more and more Pakistanis move from rural bases to urban areas, even though many might end up in squatter settlements and slums in the big cities.

While social change has always preceded in urban areas, the difference has not been as drastic as found in most other societies. This is because even when rural Pakistanis move to cities and towns, they may do so without their extended, and sometimes even their nuclear, families. Ties with natal relatives and feudal linkages continue to extend their influence despite changes in residence. Certainly, social patronage and control continues to influence values and family size norms though to a much lesser extent. But even more so, improved road links and better transport options lead to frequent home-to-work travel.

Interestingly, provincial fertility differentials have been small, despite considerable differences in levels of development across the regions. Sindh has the lowest fertility rate, but this is primarily due to the large population of Karachi; here, ethnic divisions transform into urban-rural differentials. In other provinces, too, certain ethnic groups, like the Pakhtun and Seraiki populations, have larger numbers of children compared to Urdu-speaking and Punjabi communities.

The fertility decline in Pakistan began in the late 1980s and the early 1990s, coinciding with the post-Zia period (1988-2000), when population growth benefited from being part of the focus on the social sectors under the social action programme. One of the most remarkable and effective achievements was the induction of hundreds of thousands of lady health workers across Pakistan by the government head by Benazir Bhutto. It was a period of hope, but was soon followed in the late 1990s by an economic downturn after a longish period of high economic growth rates in the 1980s.

The resultant expectation was that the rapid decline would continue, but this did not transpire. The military coup in 1999 coincided with economic growth, but fertility declined at a much slower pace and contraceptive use began to lapse. Despite the return to democracy and three successive elected governments, from 2007 to 2020, population trends at best have remained stagnant.

The last call

The setback of more than a decade not only put us behind our neighbouring countries, it also entrenched a mindset that is hard to change. It is difficult to disentangle in a hurry the considerable number of factors that comprise the fabric of Pakistani society — a heterogeneous, vibrant but troubled country — and to link them to fertility changes. But the factors are there for sure.

What we are facing is really the last call to wake up to this sharpening drop in our ranking in per-capita income, literacy, women’s education, and health, especially in comparison with India whose population growth rate has come down to 1pc this year and below replacement fertility to -2.0 children per woman compared to 3.6 in Pakistan.

Bangladesh has a distinct growing economic trajectory owing to the advantage of rising exports, increasing foreign exchange reserves and a competitive edge in the world market. In our case, an earlier focus on economic growth came at the cost of neglect of human capital development, now exacerbated by illiteracy, unskilled labour, rapid population growth, and poor health indicators. Our prospects to achieve the same results as Bangladesh or other Asian tigers have been much eroded.

In the last 75 years, we have witnessed an erosion of a public consensus on population. The role of the state has outweighed the greater interests of the populace over the last few decades. The state could have played a responsible role in shaping mindsets, providing a solid primary education base, improving curriculum content rather than guiding it away from reflecting on Pakistan’s realities, ensuring that laws are implemented, and introducing new social-sector programmes.

Equally important are clearly articulated policies with consistent funding, particularly population policies that are currently weak and not implemented. The resolution of the impasse in progress on lowering population growth and investing in human development has not been any government’s priority and we are unfortunately paying the huge, avoidable price.

The writer is Country Director, Population Council, Islamabad.