‘The population is growing faster than the country can provide for’

Sindh Primary Healthcare Programmes Coordinator, Shahnaz Wazir Ali

Shahnaz Wazir Ali is well-reputed educationist, developmentmentalist, former Member of the National Assembly, Special Assistant to the Prime Minister on Social Welfare and a seasoned politician of the Pakistan Peoples Party. She is also a recipient of the Sitara-e-Imtiaz for her work in the education sector. At present, she is the coordinator for all primary healthcare initiatives in Sindh, including the family planning and, maternal and child health programmes. This week she speaks to Bol News about the state of population growth in the country. Following are excerpts from the interview;

The country’s population is projected to double in the next 30 years. What are some of the major reasons for this?

Shahnaz Wazir Ali: The concept of population growth only first became part of political discussion in the 70s. Before there was no political will and attention was not paid to it during the first three decades of the country’s history. At this time there were no statistics on families and households, or population growth. Then during much of the 80s and 90s democratic governments who took up the issues of population management, women’s role in family-planning and girls education, were removed, for one reason or the other. Furthermore, not every government has given the issue the same level of importance. At present, while the services provided and initiatives taken are better than ever before, they are still not adequate enough to meet the demand for family-planning in the country.

What are the likely long-term impacts of population growth on Pakistan?

SWA: We see them already. Overcrowded cities, housing crises, lack of clean drinking water, joblessness, hunger, health issues, poverty and depleting infrastructure. These factors are only going to worsen with population growth as State will not be able to meet the needs of the people.

Which demographic(s) is most affected by the rapid growth rate?

SWA: Mothers and children suffer most. Rural mothers without access to healthcare facilities nearby end up in multiple precarious births and many die during child-birth. They do not have access to proper transportation, sanitation at their homes or midwifes to help during childbirth. Meanwhile, children are under-nourished, stunted, live in impoverished conditions, and many die during infancy.

Why are existing measures to curb population growth not meeting desired goals?

SWA: It is not easy to openly discuss delaying firstborn birth, specifically in smaller rural settlements that do not offer the anonymity of larger cities. Lady Health Workers (LHW) must persuade rural households who are intwined in cultural norms and segments of the population influenced by religion against contraception, to plan their families. It is not an easy task to create awareness regarding contraception and it requires a one-on-one approach. Also, LHWs are largely targeted at rural areas, but the increasing rural-urban migration has meant that the demographics by region have shifted, creating a need for urban LHWs.

How does population growth factor into the rising economic insecurity in the country?

SWA: Pakistan today is already insufficiently providing for its citizens because the population is growing at alarming rate. The population is growing faster than the country can provide for.

How can the government devise a more pragmatic action plan?

SWA: We must implement a national narrative encouraging family planning and warning against population growth, but the decision making, as well as, implementation must occour at the provincial level. Some specific measures include, behaviour change initiatives, widespread access to education, provision of contraceptives and outsourcing Basic Health Unit to the private sector, unless the government can demonstrate efficiency. Additionally, all healthcare units, as well as, all private practitioners must provide family planning and the LHW programme must be expanded.