Family planning in Pakistan
[1] Challenges to Pakistani's well-being, opportunities for education and employment, and access to health care are escalated due to the country's continuously-growing population.
[2] Though Pakistan's fertility rates still exceed those of neighboring South Asian countries with a total fertility rate at 4.1 (3.3 children in urban settings and 4.5 children in rural areas) and contraception use is lower than 35 percent, approximately one-fourth of Pakistani women wish to either delay the birth of their next child or end childbearing altogether.
[1] According to Dr. Ansar Ali Khan, an advisor of reproductive health to the United Nations Population Fund in Pakistan, "A combination of factors like non-availability of services, baseless traditional beliefs and misconception play a big role.
"[2] In addition, Ali Khan stated that "a fairly large number of the population believes the use of artificial contraceptives for family planning is against nature and also against Islam.
[6] Waheed, a member of the All Pakistan Women's Association, began advocating for birth control when her maid died from an attempt to abort her own pregnancy.
[7] The FPAP was unsuccessful in changing family planning policies until President and military leader Ayub Khan took interest in the problem of overpopulation in the late 1950s.
[7] In 1971, while the country was split apart and international assistance halted due to army atrocities in Bangladesh, the Pakistan Peoples Party took power of the Pakistani government.
[7] Its leader, Zulfiqar Ali Bhutto, needed to gain legitimacy and popularity by taking an anti-American, anti-capitalist, and anti-Ayub Khan-stance.
[citation needed] In 1977 Bhutto's Chief of Army Staff, General Zia ul-Haq, deposed the leader and declared martial law.
"[7] Near the end of Zia's era of power, family planning and population control became tied to the Ministry of Health (Pakistan).
Unfortunately, the program has remained fairly unchanged over the past 35 years due to implementation problems involving over-centralization, lack of coordination, and structural flaws.
[7] One of Pakistan's largest problems is its rapidly expanding population and their limited access to necessary essentials such as readily available healthcare, doctor's, and basic sexual education.
[12] In Pakistan, extremely conservative Islamic beliefs predominate in many parts of the country, in which purdah restricts women to their homes unless chaperoned by a male relative.
[5] When Ayub Khan resigned in 1969, religious demonstrators attempted to discredit the leader morally using the slogan "Family planning, for those who want free sex!
[5] Though Pakistani couples commonly cite religious reasons for avoiding birth control, there is not one definitive agreement about family planning and contraception in Islam.
[5] In Pakistan, many local religious figures are supportive of family planning and have begun discussions in their communities in order to promote the health of women and children.
Islamabad based think tank Research and Development Solutions reports that there is no quantitative evidence that any of these interventions have resulted in an increase in CPR in these communities.
Historically, political strife and cultural restrictions on women constraining their empowerment have hampered implementation of family planning strategies throughout the country.
Due to a lack of access (especially in the rural areas), no clarity (dearth of awareness, understanding and education), fear of legal persecution (especially in the public sector), an inability of health care professionals to interpret the law, as well as a form of FP, women are often forced to seek abortion by untrained providers.
According to the World Health Organization and Population Action International, as of 2007, "only 16 percent of women receive at least four antenatal care visits during pregnancy, fewer than one-third of births are attended by skilled health personnel, and the maternal mortality ratio, at 320 maternal deaths per 100,000 live births, remains high.
"[1] Dating from 2002, Pakistan's current family planning policy reflects the government's concern with rising population trends and poverty.
The policy's goals include reducing population growth (from 2.1 percent in 2002 to 1.3 by 2020), reducing fertility through voluntary family planning (from 4 births per woman in 2004 to 2.1 births per woman by 2020), and as a signatory to the Programme of Action developed at the International Conference on Population and Development in Cairo in 1994, Pakistan pledged to provide universal access to family planning by 2010.
This is exactly equal to the increase in number of women served by NGOs (supported by donors such as USAID, DFID, KfW, GIZ, David and Lucile Packard Foundation etc.
This program recruited married women, with at least 10 years of schooling, that lived in rural areas, and trained them to provide family planning services to their communities.
