Sophie Seidner and Liz Plunkett Topic: Increasing Family Planning Programs in Pakistan To: National Institute of Health

and National Commission for Human Development, Pakistani Government [Sohpies Summary] In order to prevent overpopulation, high fertility rate among Pakistani women and low access to and use of contraceptives must be addressed. Based on current data, Pakistani women want to have fewer children, or space the births of their children, but are prevented from doing so by a variety of factors. source: http://gillespiefoundation.org/Pakistan.html

One of the main factors contributing to higher fertility rate is lack of access to contraceptives and family planning programs. Family planning programs in Pakistan are run by two different ministries, leading to high inefficiencies in implementing programs, poor logistics, lack of contraceptives at service points, as well as ill trained and ill equipped staff (http://populationaction.org/wpcontent/uploads/2012/01/pakistan.pdf). This, combined with a low female literacy rate, result in a lack of education on family planning. The link between education level and lower fertility rate in developing countries has already been established; in Pakistan, each year of education among girls lowers fertility rate by .3 to .5 children on average (http://populationaction.org/wp-content/uploads/2012/01/pakistan.pdf). Cultural and religious preferences also impact rates of contraceptive use. The most common barriers to use of family planning among married women are a belief that fertility should be determined by God (28 percent); opposition to use by the woman, her husband, others or a perceived religious prohibition (23 percent); infertility (15 percent); and concerns about health, side effects or the cost of family planning (12 percent). http://populationaction.org/wpcontent/uploads/2012/01/pakistan.pdf In addition, there is still a entrenched cultural preference for male and multiple children, based on traditional cultural values. Decreasing fertility rate and increasing use of contraceptives is necessary because of the dangers of overpopulation and long term costs to government that

will be incurred if the current population rate is maintained. Based on Pakistans current growth rate of 2.05 percent, the opulation would double in 33 years. This will put an extreme strain on natural resources, the enviroment and impede improving quality of life. Currently, Pakistan is the 6th most populous country in the world, has South Asias highest growth rate and 40% of the population is below the age of twenty five. By addressing fertility rate and family planning now, young people will have the opportunity to attend school longer, and have more control over the number of children they have. As well, less children with higher education lead to a decrease in the likelihood of young people getting involved in extremism and terrorist activity. It is also imperative that the Pakistani government provides further resources to development. Although most countries are currently plagues by economic and budgetary issues, to prevent worsening of these issues in the future, resources must be allocated to curb population growth now. In order to solve the problem of increased population growth, high fertility rate, and low access to family planning, Pakistan needs to model its family planning programs off of the more sucessful family planning programs of other Middle Eastern countries such as Jordan, Morocco, and Egypt. The main way this can be achieved is by utilizing the current health sytem as a method for education women on family planning and disseminating contraceptives. By educating general practitioners and hospital workers on contraceptives and family planning, the information can be more easily accessed and spread through larger segments of the population. For example, during routine appointments for the woman, or immunizations for her children, she can be given information on contraceptives and family planning initiatives. In addition, to address the problem of resource allocation and budgeting as a result of the current economic climate, Pakistan should utilize UN Relief and Work Agency or other funding and programs, and allow the UN to be active in family planning implementation and efforts. While this policy prescription will have higher costs in order to implement programs and educate doctors and health workers, by addressing these issues immediately, Pakistan should be able to decrease population growth, and therefore higher costs that would be incurred in the future by a much larger population and the stresses this would put on infrastructure and resources. As well, by implementing these programs now, the number of children and people living below the poverty line should decrease as a lower number of children per family leads to increased resources being available per child, and for the family in whole. There may also be some cultural clash with the previous generation over traditional values, and potential religious opposition. However, the majority of religions practiced in Pakistan are not against family planning and birth control, and with time and education it becomes overwhelmingly clear that increased family planning leads to higher quality of life for the overall population and leads to more opportunities for young people and women.