Myth of population control
It is the dawn of 2023. Ahead of us are several national problems that continue to be overlooked. The solutions are obvious, but the intent to act is missing. Critical areas face stagnation, with population and education on top of the list. Both sectors are interrelated but their current state is at the heart of everything that plagues Pakistan’s progress. The last 10 years show little change in our educational trends. Universal primary enrolment, especially for girls, is lagging. And fertility rates have not changed for a decade.
But while state responsibility for education is at least widely discussed, the public discourse on our annual population growth rate of two per cent frequently disappoints. Our demographics are well known to those who matter. So, don’t they see the linkages between human and other development? Instead, we hear the frequent lame excuses — ‘Population is a provincial subject’, ’population control is against our religion, ‘it is a politically inexpedient topic’, etc.
This impasse is dominated by an outdated but continuing concept of population control. ‘Population control’ is a term full of fallacies; it is decidedly not the way the state should tackle demographic challenges. A rights-based approach must be on top of the agenda. Whether it is a question of granting political rights or citizens’ rights to services, the philosophy and orientation of the state must change.
Fifty years ago, Mahmood Mamdani wrote a revolutionary book, The Myth of Population Control, on the impact of Indira Gandhi’s Emergency on a village in Indian Punjab. India’s population control policy during the Emergency failed miserably. It caused Mrs Gandhi’s downfall and led to an extreme distrust of state policies. Only a few miles away, we would not expect anything different to happen in Pakistan if the state adopted this policy of population control. ‘Population control’, as it stands, has already been regarded as something negative, and rejected by most people as a way of taking away our values.
The new population narrative asks that the state should not be the controller but the enabler.
The China and India examples of draconian population control policies cannot be followed. Instead, we must emulate states that have successfully reduced their population growth rate. Plenty of examples abound in the region. Iran made contraceptives available to its public health services, Bangladesh invested in community outreach services and the empowerment of women, and Saudi Arabia permitted women to access contraception in the private sector without foisting any state policy.
Pakistan too, must move to provide similar solutions which would enable families to actualise their own wishes and fundamental rights. The new population narrative asks that the state not be the controller but the enabler — it must not decide how many children people should have; instead, it should provide the information and means for families to decide. The state must play its role in enabling change by increasing choices and access to services for women who need them.
There are enough glaring statistics that show the current disconnect between state institutions and the people, especially the poor. Clichés are used widely to condemn the reproductive choices of the poor, when millions of pregnancies are unwanted. Many in power flippantly say that the masses want lots of children. This is a callous abdication of responsibility when 6.5m women express an unmet need for family planning services, 2.2m abortions take place annually because of unwanted pregnancies and 1.4m unwanted children are born each year.
Women can and must decide on how many children they want and when. Many women with an unmet need for family planning services are powerless and cannot make decisions about their own healthcare or move outside their homes. They need state support to guard their decisions. They must be provided access to voluntary services, through subsidised transport and services. Family planning must be seen as beneficial through aggressive public service advertising. The government must do this in partnership with the private sector. Citizens and entities should be invited to give their input for services such as low-cost housing, telehealth and distance learning.
After the 18th Amendment, responsibility for providing services lies with the provinces. However, the federal government can also show more intent. At the moment, federal institutions support a pronatalist stance: the NFC award with 82pc weightage for population size contributes to greater resources for higher population growth. This is an incentive for provincial governments to increase population sizes. Paradoxically, while numbers boost political representation and resources for the powerful, they do not translate into access to services, nor human development for the people of a province.
A new financial arrangement must be made, and additional amounts allocated to incentivise provincial governments to improve the presently lagging education, health and family planning outcomes. Providing services for the 6.5m women, with an unmet need, located across Pakistan would cost Rs13 billion. The arrangement must be devised by the federal government to share these costs, minimising any drain on state resources. The potential gains are huge: halving the number of pregnancies, lowering fertility rates, increasing the per capita income and making progress in enrolling millions of out-of-school children.
Finally, a federally conducted population and housing census is going to be rolled out in March 2023. The Council of Common Interests’ decision was based on a political party’s demands for fresh constituency boundaries. The funding was found for a digital census costing Rs33bn. It must be remembered this time that a census’s main purpose is to count everyone living on Pakistani soil to distribute resources and to ensure that housing, school and work opportunities reach everyone.
The state must use its resources to convince the public that the census is a count for ensuring each man, woman and child’s entitlement. The census must be more transparent this time, sharing results openly with the provinces, and be seen as a tool for guaranteeing the constitutional rights of individuals.
The time to change the state’s stance on population is now and it must seize the opportunity while the situation is still salvageable.
The writer is Country Director, Population Council.
Published in Dawn, January 16th, 2023