The writer is Country Director, Population Council
SUGGESTIONS for policy reforms and inputs for party manifestos are surfacing as we move towards the evolving reality of the February 2024 election, which is expected to usher in a new government.
There is a real possibility of all political parties agreeing on some mandatory reforms that are compelling, and adopting them across party lines. Primary discussions at the moment are focusing around economic revival.
Before the next election campaign becomes skewed in the direction of financial strategies, it is important to broaden the discussion to include other catalysts for economic growth. It is time to focus on human development not as a separate agenda, but as an essential prerequisite for Pakistan to turn its economy around.
For the last two decades, Pakistan has practically put its human development objectives on hold. There has been insufficient investment in quality education, primary healthcare and skills development, leaving the country in the midst of an acute human capital crisis. This approach is premised on the belief that the human development agenda can wait till the economy is revived.
However, the World Bank’s 2023 Human Capital report and the accompanying Reforms for a Brighter Future challenge this notion. The policy note expresses grave concern over Pakistan’s failure to deliver on human development. It prioritises actions to address the alarmingly high figures of child stunting and out-of-school youth.
The data highlights the policy failures of the last two decades, marked by a lack of priority regarding the development agenda. This neglect has led to high maternal mortality, amounting to nearly 11,000 deaths each year. Infant mortality rates follow a similar trend, with around 360,000 babies dying each year.
Furthermore, high abortion rates have been recorded as an outcome of millions of unwanted pregnancies. A large number of closely spaced children due to high fertility rates contribute to these indicators including malnutrition among children and consequent stunting. Poor population planning and resulting high population growth rates have played a central part in creating the looming human capital crisis.
Even economists who traditionally shun human development must come to terms with the fact that economic reforms will have to incorporate human development to ensure growth and productivity for economic recovery. When countries such as Vietnam, India and Thailand faced similarly unprecedented economic crises, they were able to overcome economic challenges. However, they embarked on their recovery pathways with stronger human capital profiles and in the later stages of their fertility transitions.
A consensus has to be reached among several influential quarters, especially economists, that reducing fertility rates ought to be a policy objective in order to spur economic development. The success story of Bangladesh is a testament to a well-supported population planning programme there, which significantly brought down fertility rates, thereby enabling a country previously considered a basket case, to evolve into a successful development model.
Under the National Security Policy 2022, human development has entered the agenda of security think tanks. Population planning is now under discussion at high-level security dialogues as a policy imperative for dealing with Pakistan’s non-traditional threats.
It is now widely accepted that if state resources are freed from catering to the pressure of keeping up with the ever-expanding six million children being added to our population each year, we can focus on other investments. In particular, 2m to 3m youth looking for employment each year are now presenting one of the biggest threats to our economy and our state’s future viability and security.
The Population Council and UNFPA have worked for the last few years to achieve a carefully crafted consensus on the part of the clergy on the need to endorse family planning and birth spacing to reduce maternal and child mortality. Let us build on that and not lose ground. The new population narrative termed ‘tawazzun’ (balance) endorsed both by religious and political parties, calls for a balance between resources and population numbers.
Due to limited economic growth and lack of population planning, the country is unable to meet the basic needs of people, such as food, education, health and employment. People are thus being deprived of their fundamental human rights.
Agreement by political parties to prioritise population planning is only possible if it is seen as improving the lives of millions of families, particularly women and children. The argument is that women once inclined towards the idea of birth intervals will see improvements in their own health as a result of fewer pregnancies.
They will subsequently be motivated to make wiser decisions related to children’s health, nutrition and schooling. Parents, if their offspring are offered free and decent quality education, as guaranteed under Article 25-A of the Constitution, would certainly make an informed choice to send their children to school.
First and foremost, there is a need for a persuasive communication campaign based on ‘balance’ and promoting voluntary family planning as a means of improving women and children’s health to cement the point of agreement across the political and religious leadership. This should be followed by decent quality services for the millions of women and couples who want to postpone their next child for health and economic reasons but are unable to access family planning services. The idea of having smaller families to ensure better-educated children will take root if free basic education becomes a reality.
A clear narrative is critically important to bring political parties on board regarding the issue of available resources and the needs of an ever-growing population. Many politicians are ready to include most aspects of ‘tawazzun’ in their election manifestos.
Of course, more needs to be done to ensure a strong political will after the polls to lower the pressure on resources by investing in population planning. Reducing the burden on resources will allow for greater investment in health, education and youth’s capacity building.
The country must focus on the human development of 240m Pakistanis — who range from a stunted child, to a girl who never goes to school or a young woman looking for a job after persuading her family to support her ambition of pursuing higher education.
The writer is Country Director, Population Council.
Published in Dawn, December 11th, 2023