Expert suggests Pakistan adopt ‘One child’ policy to defuse the population bomb

Published: October 17, 2012

"A woman who received no schooling was more likely to die during pregnancy or delivery than the one who did," Dr Farid Midhet, a former director at the Asia Foundation.

"A woman who received no schooling was more likely to die during pregnancy or delivery than the one who did," Dr Farid Midhet, a former director at the Asia Foundation. "Sindh’s health indicators were poorer than those of war-torn K-P, and only slightly better than those of the Balochistan," Dr Nabeela Ali of USAID’s technical assistance unit.

KARACHI: With the country’s population having doubled, twice over, since 1951, the time may be ripe for Pakistan to follow China’s lead and implement the “One child” policy. With high infant and maternal mortality rates as well as aversion to the use of contraceptives, the policy might be just what the country needs to defuse the population bomb.

Dr Farid Midhet, a former director at the Asia Foundation, expressed these views on Tuesday while attending a dialogue organised by the JSI Research Institute and the Aga Khan University Hospital (AKUH). The United States Agency for International Development (USAID) facilitated the event. Officials from the provincial health and population welfare departments as well as health experts came together to discuss public health issues and the bottlenecks that have emerged after healthcare and population planning were devolved to the provinces after the 18th constitutional ammendment.

Dr Midhet said that Pakistan’s population was set to cross the 200-million mark by 2020. But he also thought that it was asking too much of the government to implement the “One child” policy. “The high percentage of youngsters will not be of any advantage to the country unless they are well educated.” Mega urban centres like Karachi are being squeezed for space as population densities are rising, added the expert.

Socioeconomic factors

Dr Midhet observed that a woman who received no schooling was more likely to die during pregnancy or delivery than the one who did. The husband’s level of education, meanwhile, appeared to have no effect on the maternal mortality rate.

Only 30 per cent of Pakistan’s citizens use contraception, the lowest rate in the region. Not surprisingly, the country also boasts the highest fertility rate in the region, at 4.1 births per woman. Dr Midhet suggested that family planning programmes and healthcare policies should focus on increasing the availability and usage of contraceptives through campaigns run by lady health workers and by bringing men and religious leaders on board.

While sharing data from a study conducted in 1995 on women who had died and were brought to Jinnah hospital, Prof Sadiqua N Jafarey said that most of those who died belonged to the lower socio-economic strata. Prof Jafarey said that 36 of the women died because of lack access to healthcare facilities, 25 per cent due to lack of transport, 13 per cent for the absence of the husband, and 11 per cent due to financial difficulties.

Sindh faring worse than K-P

Despite the increase in the prevalence of health services like prenatal care and tetanus immunisation from 1991 to 2007 in Sindh, the maternal mortality rate in the province, at 311 deaths per 100,000 live births, is higher than the national average of 274 deaths. Dr Nabeela Ali of USAID’s technical assistance unit for health added that Sindh’s health indicators were poorer than those of war-torn Khyber-Pakhtunkhwa, and only slightly better than those of the worst affected province, Balochistan.

Dr Zulfiqar A Bhutta, founding chair of the women and child health division at AKUH, presented ways in which key reproductive health factors, including family planning and malnutrition, could be tackled in an integrated manner in Sindh. He advised the government to focus on providing post-natal care, as 45 per cent of total deaths can be prevented if two conditions, pneumonia and diarrhea, could be tackled in an effective manner.

DG Health Dr Feroz Memon, additional health secretary Dr Suresh Kumar, Heath Reform Support Unit chief Kiran Noman and Newborn and Child Health Sindh manager Dr Saheb Jan, talked about bureaucratic issues like low funding and post devolution problems.

Published in The Express Tribune, October 17th, 2012.

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Reader Comments (18)

  • Oct 17, 2012 - 8:59AM

    Communism, here we come.

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  • Waleed
    Oct 17, 2012 - 11:07AM

    Good..i wanted that to be implemented too-

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  • Mir
    Oct 17, 2012 - 11:07AM

    Communism .. better late than never..

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  • KB
    Oct 17, 2012 - 12:04PM

    What about China’s threat of having no young population to even compete in the world after 20 years and Pakistan becoming a country with highest young populations means this could turn in Pakistan’s favour

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  • Bala
    Oct 17, 2012 - 12:44PM

    This is ridiculous, Pakistan is not even able to administer Polio drops, I wonder how in heaven it can enforce one-child policy, even if we assume one child policy is good for pakistan.

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  • charlie
    Oct 17, 2012 - 2:47PM

    rebuild schools….educate children especially girls…..carry out family planning awareness programs….encourgae them to not have more kids…..dats it…. many muslim countries including bangladesh have been successful,so can pakistan…one child policy will miserably fail in pakistan..leading to widespread attacks and further deterioration of law and order …….Recommend

  • charlie
    Oct 17, 2012 - 2:49PM

    “Only 30 per cent of Pakistan’s citizens use contraception, the lowest rate in the region. Not surprisingly, the country also boasts the highest fertility rate in the region, at 4.1 births per woman”…………… afghanistan has more fertility rate than pakistan…but the thing is their population density is low …so won’t matter much….Recommend

  • YP Toronto
    Oct 17, 2012 - 4:29PM

    Sooner the better

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  • A. Khan
    Oct 17, 2012 - 6:00PM

    You don’t need an expert to tell you that Pakistan has a population problem. Give it another 20 years and you will see the results of nocturnal activities in food riots and ever growing poverty.

    However, the problem is linked to lack of social security net for people in their retirement. Hence people keep reproducing as retirement insurance i.e. somebody to look after them in their dotage. Education will solve part of the problem through knowledge and use of contraception. But without addressing other issues like culture (boys preferred so keep on reproducing until a son is born), maulvi culture (contraception being the great Zionist conspiracy against Islam), the problem will remain as it is.

    One thing we as a nation need to understand is for population, quality beats quantity. A smaller, well educated, healthy and prosperous population is better than teaming millions who are uneducated, diseased and mired in poverty. Where do you think Pakistan is right now ?

    Re. the maulvi culture I mentioned earlier, I feel these mullahs are doing a great disservice to Islam by encouraging unchecked population growth resulting in poor, uneducated masses. Perhaps that’s where they draw their power.

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  • MAD
    Oct 17, 2012 - 6:04PM

    And how do you plan to implement that.

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  • G. Din
    Oct 18, 2012 - 1:06AM

    Before Pakistan takes this “expert”advice, it should consult its “deeper-wider-higher” friend about its (Chinese) experience with “one-child” policy. It has been an unmitigated disaster. What is more is that its effects linger on and would do so for decades to come. There was widespread cheating of this law in spite of doctrinal enforcement by communist commissars and agents. There is a widespread simmering rebellion against this policy in the Chinese population and may prove to be one of the main factors which would dethrone communists in the near future. Socially, in the years to come China will find it exceedingly difficult to support a growing aging population (there have been great advances made in the health and well-being sectors) because of the dwindling young population which is supposed to support their parents.
    Having said that, it should not be taken to mean that there should be no control of the burgeoning population. In this case, “Hum Do, Hamaare Do” (Two child policy) is far better than “Hum Do, Hamaare Pachees”. Learn a few lessons from India. Indian population is also increasing but, in contrast to China’s policy, India adopted sensible population control policies which are paying dividends now! And, it did that without intruding into what must be the decisions at the family level.

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  • Raj - USA
    Oct 18, 2012 - 2:24AM

    Only solution. End load shedding.

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  • Dr.A.K.Tewari
    Oct 18, 2012 - 9:15PM

    Either Islam or family planing . Population bomb will explode in Islamic republic to make it secular republic in few years .

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  • sheikh
    Oct 18, 2012 - 10:48PM

    @Raj – USA:
    hahahahahaha……………good one dude!!!!!!!!!!!!!

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  • Nizamani
    Oct 19, 2012 - 4:16PM

    Someone tell me how on earth is no school education in any way related to death during pregnancy or delivery??

    Most of the elderly ladies in my village had no education but almost all of them have more than 5 children, both the mother & the child have done well and in every case the children have been educated.
    Such an absurd claim are these stupid doctors trying to make. It is the lack of proper health care facilities that kills, not school education!!!
    And frankly Pakistan’s problem is not its population, little economic growth & education is the main issue. Give proper education & high economic growth, the current Pakistani population will not be sufficient & Pakistan will have to import workers from abroad to fill the gap!!

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  • Khurram
    Oct 20, 2012 - 4:13PM

    We should have mass campaigns for Vasectomy, which can be easily performed in basic health units, It should be offered free of charge to all men in the country.

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  • Nov 5, 2012 - 1:19PM

    population growth rate is the average annual percent change in the population, resulting from a surplus (or deficit) of births over deaths and the balance of migrants entering and leaving a country. . The growth rate is a factor to determine the burden would be imposed on a country by the changing needs of its people for infrastructure (e.g., schools, hospitals, housing, roads), resources (e.g., food, water, electricity), and jobs.
    Rapid population growth can be seen as threatening by neighboring countries.
    Pakistan’s existing population growth rate is 2.03 which is highest in the south Asian countries and second to Egypt ( 2.6) in Muslim countries.Bangladesh has fertility rate of 2.2

    as per Pakistan census 2011 the population stands at 197.4 million( increase of 34.2% from last decade) this is in excess of 20 millions as as estimated/ forecast in UN documents.it has already surpassed Brazil and become 5th most populous country and at this rate by 2030 can surpass Indonesia too in population to rank 4th most populous country
    The average household size is as high as 6.8 ( compared to 2.6 in USA or western countries. ) Less than 30% women use contraceptive . With high illiteracy among women coupled with religious belief are obstacle in population control.
    Population bomb is tickling and its explosion is not heard by many. Addition in population will exert burden on scarce resources, , Now it is up to the government to take remedial steps or to face the music.

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  • GS@Y
    Nov 19, 2012 - 12:04AM

    This is a bad idea. The one child policy is undemocratic and fundamentally opposed to basic human rights. It’s high time these “experts” woke up and admitted that social change cannot be legislated into reality. It requires education, information, resources, and hard work at the grassroots. Do your part instead of coming up with hair-brained schemes.

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