Nearly three years after the devolution of the Ministry of Health under the 18th Amendment, confusion between the federal and provincial governments persists over responsibility for addressing population issues in the country.
The federal government believes that post-devolution it is the responsibility of the provinces to formulate policies to deal with the population issues, while provincial governments are of the view that they cannot shoulder the responsibility. Due to lack of clear policies, planning, a governance mechanism and limited coordination among relevant stakeholders, Pakistan may not be able to achieve goals related to family planning.
According to a study, “The State of Family Planning in Pakistan: Targeting the Missing Links to Achieve Developments,” conducted by Pathfinder International in collaboration with UNFPA states that Pakistan has 180 million people with an annual growth rate of 2.03 per cent. “If this trend continues the population will double in the next 35 to 36 years which will have adverse implications for socio-economic development,” warns the report.
The report found that coverage and access to family planning services across the country remained poor as health departments did not own the programme and that lady health workers’ focus was diluted due to emphasis on polio immunisation. A complex funding mechanism with delayed and insufficient releases caught the programme in a vicious cycle of low performance and supply shortage.
Macro growth documents by the Planning Commission including Vision 2030 and the New Growth Framework 2011, do not focus on population issues and concentrate on the demographic dividend in relation to growth strategies without taking into account the need for effective family planning programming on which it hinges, highlights the report.
An official working with population welfare department Punjab, who wished not to be named, said the ministry’s devolution was done in haste, capacity-building of provincial governments was neglected and as a result they were unable to run health programmes. Planning Division Population chief Shahzad Malik said the ministry’s devolution had not affected the population welfare programme as in 2002 family planning service delivery was shifted to the provinces.
UNFPA representative Rabbi Royan was of the view that a policy on family planning was needed for the country to clarify vision and strategies.
Tauseef Ahmed, Pathfinder International’s country representative said, “Devolution was done in a hurry without capacity-building of provincial counterparts for their new responsibilities.” Family planning is the right of every woman and by depriving them, you’re putting their lives at stake, he added.
Published in The Express Tribune, December 6th, 2013.
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