After nearly four decades we once again hear Sindh government talk about birth control. Recently the Sindh government formed a working group to implement and supervise an ambitious family planning programme project at an estimated cost of Rs 79 billion, to be completed by year 2020.
It will largely be a waste of money, as it had been over four decades since the 1960s when Ayub Khan initiated Family Planning in Pakistan. No doubt an awareness of smaller families was created, thanks to regular features and talks in newspapers and PTV respectively, in those days. But to date the ideal three children per couple has not been achieved nor is it likely to be achieved in the next four years. Sindh's population is projected to increase to 50 million by 2020.
Awareness that there should be smaller families is not a guarantee people will produce fewer children. No Family Planning project, however good it is on paper, succeeded in reducing the size of a family. The number of children depends on the number of male off-springs. Nature, however, prefers more females to males, hence it is the natural state of affairs that an average family will have more girls. If those girls are born first then the couple will continue to try for a male child. Thus on average even in the most aware urban middle-class in Sindh there are usually four, even five or six children per couple. No Family Planning project can alter the social constraints of our patriarchal set up. But this time round the project is concentrating on contraceptives. The main agenda of the working group, called Costed Implementation Plan (CIP), is to 'improve' the existing pathetic contraceptive prevalence rate (CPR) of 30 percent to 45 percent by 2020.
It is revolting to subject women to contraceptives. No method,is absolutely safe if used for more than five years. Modern contraceptives are said to be much safer than they were fourty years ago. However in rural areas especially there is no counselling about the sideeffects and choice of contraceptive method. The CIP intends to gear up the population welfare ministry, the health ministry and Peoples Primary Healthcare Initiative (PPHI) to make contraceptives and various methods available especially in rural areas to be discretely accessible at locations and through the Lady Health Workers.
I once had an opportunity to talk to Lady Health Workers from Umerkot. They said they were strictly forbidden to talk about family planning and birth control methods. They did not carry any contraceptives in their bags, not literature, nor volunteered to take a woman to a clinic. It was the rural social set up which dictated this. So is that going to change just because the (CIP) has this wonderful idea of introducing contraceptives to fertile women in the whole of Sindh? I doubt it.As someone once said: You cannot change behaviour until you change the social order which dictates how people think.
An astonishing piece of data is that Sindh has a high rate of induced abortions at 62 percent (Balochistan has the highest rate at 63 percent). This is touted as proof that women in the province do not want more than three children. This is pure fiction. Which woman, anywhere in the country, in any class of society can decide how many children she will produce? Asma Jahangir once said in a PTV interview that women do not have a right to their own wombs. That is to say husbands and the family of both couples determine how many children a woman will produce, whether she wants to or not. Also, it is hardly true that abortions are done on demand. In Pakistan abortions are legally allowed only to save the life of a woman.
After the second world war the children which were born were called 'baby boomers'. There was worldwide increase in the number of children born since the mid 20thcentury. For the West the most alarming scenario was that while fewer children were born in the developed nations, the third world, including Asia and Africa produced like rabbits. The West feared its territory would be overrun by job-seeking Asians and Africans. Thus birth control and family planning became the slogan of the 1960s to 1980. It was talked in the same frenzied manner in which the West today deals with terrorism from our world to theirs. The whole world adopted birth control programmes, largely financed by the West and the United Nations. In Pakistan we were more interested in this new source of money inflow than in actually ensuring fewer babies would be born. This time too, finance is expected from global donors to the tune of 101m US dollars.