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ISLAMABAD: The unchecked and rapid rise in population poses the biggest threat to the state's plans to achieve self-sufficiency in various human development indicators, says Pakistan Bureau of Statistics (PBS).

The PBS in its latest report, "Contraceptive Performance Report 2019-20", released on Monday, stated that unchecked population growth in Pakistan is among one of the serious challenges, which the country faces today.

Major causes of this continuing surge are high fertility rate, public ignorance about modern contraceptive measures, religious taboos particularly in rural areas, son preferences, need of more earning hands, early marriages, avoiding family planning measures and people beliefs about family planning considering it contrary to Islamic teaching, it added.

The report noted that in Pakistan on average couples have one unwanted child. Low usage of contraceptives supply-side factors (including poor's access to family planning services, lack of counseling and technical knowledge of unmotivated providers, and insufficient of availability of affordable modern methods) are the major obstacles to the uptake of modern contraceptives, rather than the more frequently cited demand-side factors (including husband disapproval and religious opposition).

The comparison of Contraceptive Performance during 2019-20 in respect of these departments has also been made with the previous year 2018-19 at national and provincial levels.

It has been observed that this year Contraceptive Performance of Population Welfare Departments (PWDs) in terms of Contraceptive Performance in Terms of Couple Years of Protection (CYP) has decreased by 24.5 percent, while Contraceptive Performance of DoH (HF) and Departments of Health (DoH) has decreased by 6.8 percent and 26.7 percent respectively, when compared with previous year (2018-19).

Overall Contraceptive Performance of the PWDs for the year 2019-20 in terms of CYP has decreased by -24.5 percent in comparison with the last year 2018-19. Province and region-wise profile of CYP indicates an increase in Sindh (10.3 percent), whereas decrease has been noticed in Punjab (-19.2 percent), Khyber-Pakhtunkhwa (-74.1 percent), Balochistan (-19.0 percent), Islamabad (-28 percent), AJK (-39.4 percent), Gilgit-Baltistan (-13.3 percent), and merged area KP (FATA) (-59.9 percent).

Method-wise comparison of 2019-20 with 2018-19 of PWDs, in terms of CYP, decrease has been observed in all methods i.e. condoms (-25.4 percent), oral pills (-9.5 percent), injectables (-26.5 percent), IUCDs (-27.4 percent), sterilization/contraceptive surgery (-17 percent) and implants (-16.4 percent).

Outlet-wise contribution in terms of the CYP during the year 2019-20 compared with year 2018-19, has shown an increase of 19 percent in RHS-B Centers, 7.8 percent in Male Mobilizers (MM), 207.6 percent in (FPIH) Program.

The performance has decreased by -26.5 percent in Family Welfare Centers (FWCs), -19.7 percent in Reproductive Health Services-A (RHS-A) Centers -22.5 percent in Mobile Service Units (MSUs) 10.7 percent in PLDs, -26.1 percent in Registered Medical Practitioners (RMPs), -57.7 percent in Hakeems and Homeopaths (H&H) -37 percent in RTIs, -79.2 percent in counters and -34.7 percent in others (franchise clinics etc).

Overall Contraceptive Performance of Departments of Health (Health Facilities) for the year 2019-20 in terms of CYP has decreased by -6.8 percent in comparison with the last year 2018-19.

Provincial/regional profile of Departments of Health (HFs) in terms of CYP has shown an increase in Sindh (20.2 percent), Balochistan (3.1 percent) and AJK (830.8 percent), whereas, decrease has been witnessed in Punjab (-11.0 percent), Khyber-Pakhtunkhwa (-40.9 percent), Islamabad (-19.0 percent), Merged Area-KP (FATA) (-34.6 percent), and Gilgit Baltistan (-48.4 percent).

Method-wise comparison of DoH (HFs) for 2019-20 with 2018-19, in terms of CYP, has depicted increase in injectables (13.0 percent) and implants (86.4 percent) whereas decrease has been witnessed in condoms (-4.3 percent), oral pills (-26.9 percent), IUCDs (-7.0 percent), and sterilization/contraceptive surgery (-26 percent).

The report noted that PBS has no mechanism for on-spot checking of data quality except asking justification for +/- 10 percent change in current year performance as compared to previous year performance and getting the data vetted by the source agencies.

It is proposed that the PBS, as a third party, may carry out random on-spot checking for ensuring data quality, at least once in a quarter.

The report also noted that there is a lack of coordination between Provincial Population Welfare Departments and Departments of Health (Health Facilities and Lady Health Workers) and NGO(s) working in provinces.

Though, Sindh and Khyber-Pakhtunkhwa have taken some positive steps and started coordination meetings but these are not being organised regularly.

Copyright Business Recorder, 2021

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