Pakistan’s population is roaring to great heights with the current population being 228,984,435 compared to the 207.9 million in 2017 and is expected to soar to 227 million in the next five years.
At the time when the entire world is talking about family planning and how important it is to control more births so that the already available population can reap the fruit of the economy, At the same time Pakistan’s birth rate has increased by 10 folds over the past three decades even in this inflation. The median age of the country is presently at 19.
When we see the per capita income of an average Pakistani, it is much higher than the average low-income countries, yet one earning per 6 people household on an average disrupts the entire earning, making it almost impossible to live, leading to raised number of family suicides in the country.
Because of the condition of living communicable diseases such as diarrheal diseases, respiratory infections, tuberculosis, and childhood disease still account for the major portion of sickness and death in Pakistan.
Maternal health problems are also widespread, complicated in part by frequent births. In fact, Pakistan lags far behind most developing countries in women’s health and gender equity: of every 38 women who give birth, 1 dies. The infant mortality rate (101 per 1,000 ) and the mortality rate for children under age five (140 per 1,000 births) exceed the averages for low-income countries by 60 and 36 percent, respectively.
Although use of contraceptives has increased, but taking about birth control methods have a religious tag attached to it resulting in 5.3 births per woman, and population growth rates are much higher than elsewhere in South Asia. The underlying problems that affect health-poverty, illiteracy, women’s low status, inadequate water supplies and sanitation persist.
Birth Control methods
In addition to social and demographic characteristics of respondents, a representative household survey collected information on psychological correlates of family planning behavior from 1,788 non-pregnant wives and 1,805 husbands with not-pregnant wives. Males and females were from separate households. Principal components analysis was conducted to identify the underlying constructs that were important for each gender. Multinomial logistic regression analysis was conducted to determine the correlates of male and female intentions to use contraceptive methods.
Amongst women, the perception that her in-laws support family planning use was the strongest determinant of her intentions to use contraceptive methods. A woman’s belief in the importance of spacing children and her perception that a choice of methods and facilities with competent staff were available were also powerful drivers of her intentions to use contraceptive methods. The strongest obstacle to a woman’s forming an intention to use contraceptive methods was her belief that family planning decisions were made by the husband and fertility was determined by God’s will. Fears that family planning would harm a woman’s womb lowered a woman’s intentions to use methods requiring procedures, such as the IUD and female sterilization.
The perception that a responsible, caring, husband uses family planning to improve the standard of living of his family and to protect his wife’s health was the most important determinant of a man’s intention to use condoms. A husband’s lack of self-efficacy in being able to discuss family planning with his wife was the strongest driver of the intention to use withdrawal. A man’s fear that contraceptives would make a woman sterile and harm her womb lowered his intention to use modern contraceptive methods.
Stigma relating to Still Births and Miscarriages
The women who experienced multiple stillbirths or miscarriages are stigmatized as “child-killer” or cursed or being punished by God. They are avoided in social gatherings within the families and community, because of these social pressures these women seek spiritual and religious treatment, and struggle to conceive again to deliver a live baby. It was observed that the psycho-social and medical needs of these bereaved women remain unaddressed not only by the healthcare system but also by the society at large.
What needs to change?
Health care providers including physicians, lady health workers, and traditional birth attendants should be trained on provision of psychosocial support along with the routine care that they provide in communities and health facilities. Moreover, the health care providers should also counsel family members on contraceptive methods and how to manage the symptoms relating to it. Apart from that the stigmatization in the society should be minimized and topics such as family planning and birth controls must be openly discussed to bring about a change in how people perceive it.
