It is good to see that Sindh province has taken the lead in launching a roadmap with a view to achieving family planning goals. The population policy launched on 22nd December, 2016 has pledged to increase contraceptive prevalence rate (CPR) from the current 29.5 percent to 45 percent by the year 2020 and to engage all segments of society for this gigantic effort to reduce population growth rate. It was recognised that past projections had estimated Sindh's population between 45 million and 50 million which had proved extremely conservative due to mass migration towards the province. Speaking at the launch of the policy document at a programme organised by the Population Welfare Department, Dr Tausif Ahmed, consultant for Sindh Population Policy (SPP) said that Sindh had fulfilled its constitutional obligation of preparing the policy document that demonstrates ownership of the population ministry and all its activities in line with the national and international commitments. Based on the recent population growth rates, population of Sindh was estimated to be around 42 million in 2011 and 46 million in 2015. It was likely to increase to 61.3 million by 2030. Earlier, Sindh's population had doubled in less than 29 years from 1981 to 2010. The declining trend of fertility in Sindh had been slow, with Total Fertility Rate (TFR) declining from 5.1 births in 1990-91 to 3.9 births in 2012-13 as against the target of 3.37 births for the year. The population of women, who wanted no more births, had, however, increased from 35.8 percent in 1990 to 51.2 percent by 2012.
The targets for the new policy are aimed at achieving the replacement level fertility, ie, 2.1 births per woman by 2035, universal access to safe and quality reproductive health/family planning services by 2020 and a significant increase in their availability in remote areas of the province, launch of efforts to reduce unmet needs for family planning from 21 to 15 percent by 2020, a decline in fertility rate from 3.9 (2013) to three births per woman by 2020. Ensuring contraceptive security at all service outlets by 2018 is also one of the goals. The policy document also said that Sindh's urban population is more than its rural population and the proportion of urban population was expected to increase further due to migration from other parts of the country.
The launch of the population policy document by Sindh government and its resolve to reduce the population growth rate through all the available means could only be appreciated. By taking this initiative, the province can genuinely claim credit for being in the forefront to attain a highly important objective of national importance. As it is, Pakistan continues to be the sixth most populated country in the world with an estimated population of over 195 million which is rising fast at a rate of nearly two percent, which is higher as compared to neighbouring countries like India, Iran and Bangladesh. Obviously, it could take decades to raise the standards of living of the population if the present trends in population and GDP growth rates continue to persist. The government is aware of the problem and has taken several initiatives such as the establishment of Family Welfare Centres, Reproductive Health Services Centres, Regional Training Institutes, and Mobile Service Units besides increasing female education and awareness to reduce the population growth rate but these measures have not yielded the desired results so far. May be the government is reluctant to confront the religious or conservative lobbies in the country who generally argue that burgeoning population could be a very valuable asset and tremendous dynamic resource for the country without realising that this asset could only become productive if it is healthy, educated, well informed and forward looking. If this asset does not have these qualities, it could become a great liability for the country. So far the declining trend of fertility in Sindh as well as in other parts of the country has been very slow due to low CPR because of high incidence of illiteracy, inadequate attention to promote birth spacing and a number of other barriers including social and cultural pressures. In our view, if Sindh can take the necessary initiative, other provinces should also follow suit because the continued high rate of population in other areas of the country could nullify Sindh's efforts due to the continued migration which cannot be stopped. For example, Karachi has been experiencing a growth rate of nearly four percent due to influx of a very large number of economic migrants, particularly from southern parts of Punjab.
Looking closely at the policy document, however, it becomes apparent that some of the targets are over-ambitious or nearly impossible to achieve. For instance, the policy envisions for people of remote and farthest areas of province increased access to family planning by 2018 and a decrease in the birth rate per woman from 3.9 to 3.0 by the same year. It is a job or task that is difficult to carry out. The Sindh government is therefore required to refrain from setting and pursuing over-ambitious targets. Hence the need for a realistic approach to the population growth challenge.