Of the nearly 23 million married women of reproductive age, around seven million actually use family planning.
ISLAMABAD: This is with reference to Mahnoor Sherazee’s report of August 29 titled “Contraceptive supply: 50-paisa population fix no one is using”. The reporter needs to be congratulated for writing a much-needed article on an important topic.
The question of why a simple and cheap solution is not tried out by our policymakers is a very relevant one. However, there is considerable data to suggest why this may be the case. For instance, the Pakistan Demographic Health Survey of 2006-7 tells an interesting story. Of the nearly 23 million married women of reproductive age, around seven million actually use family planning. Many of these — around 2 million — use a traditional method which is very uncertain in its efficacy. Another 2.7 million have had a medical procedure done, and this happens mostly in women who are older than 30 years of age and have had four or more children already. That leaves under three million women — or around 12 per cent of all eligible women — that actually receive family planning services.
The government, either via the federal health ministry or the ministry of population welfare, serves around a third of these. Over half get their contraceptives directly from retail stores, while NGOs and private practitioners serve around 12 per cent.
The report’s focus that as much attention needs to be placed on providing actual supplies of contraceptives as in convincing people to use them is important because it is trying to point out a major flaw in the government’s approach to the whole issue of contraception use.
Thus, the work of USAID, the NGO ‘Deliver’ and the UNFPA is welcome. However, a major limitation is that Deliver works only with the government while the UNFPA procures supplies for NGOs and the government. Between the two, they are likely to put together some critical resources such as warehouses and supply management systems. However, a crucial question is, should the government remain a major recipient of resources for family planning when it reaches fewer than five per cent of the eligible women who need such services? Especially when the cost is much higher than for the private sector to provide them?
If not, can we consider some private sector models for family planning since people do seem to be managing without the government? And here the question is, should donors and experts not help such efforts?
Adnan Khan
Published in The Express Tribune, September 5th, 2011.
