From: Subject: Population Policy of Pakistan Date: Tue, 16 Mar 2010 10:36:22 -0400 MIME-Version: 1.0 Content-Type: multipart/related; type="text/html"; boundary="----=_NextPart_000_0000_01CAC4F4.85BA8BE0" X-MimeOLE: Produced By Microsoft MimeOLE V6.00.2900.5579 This is a multi-part message in MIME format. ------=_NextPart_000_0000_01CAC4F4.85BA8BE0 Content-Type: text/html; charset="Windows-1252" Content-Transfer-Encoding: quoted-printable Content-Location: http://www.mopw.gov.pk/event3.html Population Policy of Pakistan
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Population Policy of=20 Pakistan

Pakistan's population has increased from 34 = million in=20 1951 to 144 million in mid 2001. The addition of over 108 = million=20 Pakistanis in just five decades is due to the high = population growth=20 rates in the last thirty years. Continuing high population = growth=20 will amount to Pakistan=92s population reaching 220 million = by the=20 year 2020. Coupled with poor human development indicators = such as=20 low literacy, high infant mortality and low economic growth = rates,=20 such a large population will undermine efforts being = undertaken to=20 reduce poverty and to improve the standards of living of the = populace.=20

While Population Growth Rate (PGR) has declined from over = 3=20 percent in previous decades to its current level of 2.1 = percent per=20 annum, Pakistan still has an unacceptably high rate of = growth=20 compared to other developing countries. Therefore the = Government of=20 Pakistan is attaching the highest priority to the lowering = of the=20 population growth rate (PGR) from its current level to 1.9 = percent=20 per annum by the year 2004 and to reaching replacement level = of=20 fertility by the year 2020.

Pakistan is faced with its ever-largest adolescent = population,=20 because of its high levels of fertility over the last few = decades=20 and its very recent fertility decline. The adolescent = population, in=20 the age group of 15-24, as it enters into its reproductive = phase=20 embodies potential population growth for several decades. It = constitutes population momentum in the future that has = serious=20 implications for provision of schooling, health services and = other=20 basic amenities of life for the coming decades. The = Population=20 Welfare Programme has been able to create universal = awareness about=20 family planning with the current contraceptive prevalence = rate of 30=20 percent.  The challenge is to ensure continuous use by = current=20 users and increase existing CPR by meeting the percent unmet = need=20 for family planning services of currently married women = along with=20 sustaining the demand of new entrants in the reproductive = age=20 group.

Over one third of Pakistanis are living in poverty. The = impact of=20 population growth on poverty is obvious, since poorer = families,=20 especially women and marginalized groups bear the burden of = a large=20 number of children with much fewer resources further adding = to the=20 spiral of poverty and deterioration in the status of women. = This=20 large part of the population is constrained to live in poor = housing=20 and sanitation conditions and lack of access to safe = drinking water.=20 In particular, income poverty leads to pressures on food = consumption=20 and adversely affects caloric intakes and increasing = malnutrition in=20 poorer families and contributes to high levels of child and = maternal=20 morbidity and mortality. Furthermore, rapid population = growth=20 contributes to environmental degradation and depletion of = natural=20 resources.

The dynamics of Pakistan=92s demographic variables compel = that a=20 vigilant eye be kept on the phenomena of population growth. = The=20 Population Policy of Pakistan 2002 is in congruence with the = ICPD=20 paradigm shift to holistic care of the family, client = centered=20 quality care in family planning & RH. The government=92s = Poverty=20 Reduction Strategy and the Population Sector perspective = Plan 2012=20 framework sets out improvements in the quality of life of = all=20 persons, including children, adolescents, adults, aged, both = male=20 and female.  

Population and development inter-relationships have been=20 elaborated most comprehensively in the ICPD Program of = Action in=20 1994 to which Pakistan is a signatory. The main thrust of = ICPD is=20 that each country bring into balance its resources with = population=20 through a policy, which is in accordance with its own = social,=20 cultural, religious and political realities.

This Population Policy is designed to achieve social and = economic=20 revival by curbing rapid population growth and thereby = reducing its=20 adverse consequences for development. It is intended to = achieve a=20 reduction in dependency ratios, to alleviate pressures on = dwindling=20 resources and to help in the reduction of poverty. The = Population=20 Policy has several wide-ranging consequences for the = economy,=20 polity, human rights and the long-term prosperity of = Pakistan.

The Population Policy is the outcome of a participatory = process=20 and enjoys the consensus of all stakeholders and partners, = within=20 government, NGOS and, civil society.

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  VISION

The overall vision of the Population Policy is to achieve = population stabilization by 2020 through the expeditious = completion=20 of the demographic transition that entails declines both in=20 fertility and mortality rates.

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  GOALS

The Population Policy seeks to:-

  • Attain a balance between resources and population = within the=20 broad parameters of the ICPD paradigm.=20
  • Address various dimensions of the population issue = within=20 national laws, development priorities while remaining = within our=20 national social and cultural norms=20
  • Increase awareness of the adverse consequences of = rapid=20 population growth both at the national, provincial, = district and=20 community levels.=20
  • Promote family planning as an entitlement based on = informed=20 and voluntary choice=20
  • Attain a reduction in fertility through improvement in = access=20 and quality of reproductive health services.=20
  • Reduce population momentum through a delay in the = first birth,=20 changing spacing patterns and reduction in family size = desires.=20
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  OBJECTIVES

Short Term:

  • Reduce population growth to 1.9 percent per annum by = 2004.=20
  • Reduce fertility through enhanced voluntary = contraception to 4=20 births per woman by the year 2004.

Long Term:

  • Reduce population growth rate from 1.9 per cent per = annum in=20 2004 to 1.3 percent per annum by the year 2020.=20
  • Reduce fertility through enhanced voluntary = contraceptive=20 adoption to replacement level 2.1 births per woman by = 2020.=20
  • Universal access to safe family planning methods by = 2010.=20
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  STRATEGIES
  • Develop and launch advocacy campaigns to address = special=20 groups, such as, policy makers, opinion leaders, youth and = adolescents.=20
  • Increase ownership of population issues by the = stakeholders=20 and strengthen their participation in the processes of = service=20 delivery and program design.=20
  • Reduce unmet need for family planning services by = making=20 available quality family planning  & RH services = to all=20 married couples who want to limit or space their children. =
  • Adopt a shift from target oriented to people-centered = needs=20 and services.=20
  • Ensure the provision of quality services especially to = the=20 poor, under-served and un-served populations in rural = areas and=20 urban slums.=20
  • Coordinate and monitor a comprehensive network of = family=20 planning & RH services in Pakistan.=20
  • Build strong partnerships with concerned Line = Ministries,=20 Provincial line Departments particularly Health, = Non-Governmental=20 Organizations and the private Sector including the = industrial=20 sector to maintain standards in family planning by = providing=20 assistance/guidance through advocacy, training, monitoring = and=20 other means of participation and quality assurance.=20
  • Strengthen contribution to population activities by = civil=20 society players, particularly NGOs and media.=20
  • Expand the role of the private sector by making = contraceptives=20 accessible and affordable of contraceptives through social = marketing of contraceptives and through local manufacture = of=20 contraceptives.=20
  • Decentralize program management and service delivery = to=20 provincial and district levels.=20
  • Ensure availability of the four prioritized areas of = the=20 Reproductive Health Package, i.e. family planning, safe=20 motherhood, infant health and RTI / STDs through = nationwide=20 service delivery outlets in the public & private = sector.=20
  • Harness support, cooperation and involvement of men in = strengthening the family as the basic unit of society and = in small=20 family size decision making.=20
  • Ensure Population and Family Life Education for school = and=20 college students.
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  AREAS OF=20 POLICY FOCUS
   POPULATION MAINSTREAMING = IN=20 NATIONAL PLANNING AND DEVELOPMENT PROGRAM=20

Population mainstreaming entails incorporation of the = population=20 factor in development plans to promote social justice and = address=20 poverty through socio-economic development in the context of = migration, urbanization, environment and sustainable growth. = This=20 Policy is developed and co-ordinated through a = multi-sectoral=20 strategy towards population issues in which there is a = synergy=20 between population dynamics, economic revival and poverty=20 alleviation programmes. The connectivity of population with = poverty,=20 status of women and sustainable development will be = established=20 because they are intrinsically interrelated and progress in = any=20 component can catalyze improvement in others.

 

   Service = Delivery=20 Expansion and Improvement of Quality=20

The strategy of this Policy is essentially aimed at = tackling the=20 more immediate objectives of reducing the high unmet need = for family=20 planning services through bringing FP services into the fold = of=20 health outlets, developing greater partnerships between = various arms=20 of the public sector and public private sector partnerships. = The=20 reduction of the gap between what married women want in the = way of=20 fewer children and longer spacing and utilization of family = planning=20 services will be the first thrust of this policy.

Ensuring quality in a wide range of family planning = services will=20 be the major short-term goal of this policy. In the longer = run=20 whilst the public sector will not relinquish its = responsibility as=20 service provider, recognizing the magnitude of the task it = will=20 fully engage the non-governmental and private sectors. To = achieve=20 this requires the building of capacity of non-governmental = and=20 private sector partners to cope with future needs of service = delivery.

Service provision in family planning & RH will = concentrate on=20 improving access & expanding coverage with special = emphasis on=20 rural & under served areas and slums. This will be = achieved=20 through Population Welfare Program=92s infrastructure & = through=20 the health service delivery infrastructure, partnerships = with=20 private sector and networking with civil society. The = provision of=20 family planning service will include RH, counselling = services for=20 attitudinal change for enhanced family planning practice and = ensuring adequate supplies. Contraceptive choice is to be = widened by=20 providing training to service provider in latest techniques. = Quality=20 service provision will be ensured through regular = monitoring.

Service delivery will specifically include:

  1. Strengthening Community-Based Services: Population in = rural=20 and remote areas where there is established unmet need do = not have=20 adequate access to affordable family planning & RH = services.=20 These communities need special attention, which is being = addressed=20 through community-based workers and out reach services. = Female=20 community workers will provide family planning services = and serve=20 as a referral for clinical methods. Male community workers = will at=20 the grassroots provide information and counselling, health = education & awareness through IPC.=20
  2. Linkages with Institutional Service Delivery System: = The high=20 unmet need for family planning requires a  concerted = effort,=20 by all stakeholders. The large Health Department = infrastructure,=20 relevant Provincial Line Departments, Public & Private = Sector=20 Institutions and others will provide comprehensive family = planning=20 services and attend to referrals.=20
  3. Strengthening and upgrading the existing Family = Welfare=20 Centers: The gap in universal awareness of family planning = &=20 the contraceptive use rate will be addressed through = quality=20 client centered family planning services which are = accessible and=20 affordable. Family Welfare Centres will be strengthened = and=20 upgraded to function within the ICPD framework of = integrated=20 service centres, which address the holistic needs of a = family. In=20 addition to family planning & RH services, basic = social=20 services will be offered in an integrated manner and will = be run=20 by a local management committee in which elected women = councilors=20 will be actively involved. Serving the community in a = coordinated=20 manner.=20
  4. Public-Private Partnerships: Social marketing will be=20 encouraged and facilitated to intensify efforts in urban / = semi=20 urban areas and move out to rural areas by associating = registered=20 medical practitioners, hakims, homeopaths, paramedics,=20 chemists/druggists and networking with CBOs. These = activities=20 would be built around advertisement, outdoor publicity, = point of=20 sale promotion, Inter Personal Communications, training = and=20 dispensation of products including interventions such as = Norplant=20 Implant and facilities for voluntary surgical = contraception.=20 Initiatives for local production of contraceptives would = be=20 supported and facilitated to reduce dependency on imported = products.=20
  5. Male Involvement: Men have a dominant role in decision = making=20 in the family setting, their active involvement is, = therefore,=20 essential in planning family size, supporting = contraceptive use,=20 assuring adequate nutritional status of pregnant women, = arranging=20 skilled care during delivery and avoiding delay in seeking = emergency obstetric care. Men need to be sensitized to = their role=20 as responsible fathers and in recognizing the critical = role of=20 women in the health of the family. For enhancing male = involvement,=20 male workers have been recruited in the rural areas to = engage into=20 a regular dialogue with male community and sensitize the = elders=20 and parents. Provision for male contraceptive surgical = procedures=20 will be strengthened, and the method promoted.=20
  6. Improve and Ensure Quality of Services: Provision of = quality=20 services need to be ensured to address the large unmet = need for=20 family planning and for improving contraceptive use rate.=20 Accessibility of services, attitude of service providers, = their=20 technical skills, counseling and follow up are the main = pillar for=20 quality service provision. Basic standards for quality = service=20 provision are required to be formulated through a = consultative=20 process of all stakeholders. For ensuring high quality = services of=20 uniform standards at all service outlets a system of = technical=20 supervision and monitoring needs to be institutionalized. = MoPW=20 will be responsible for laying down standards for family = planning=20 service provision and will be involved along with other=20 stakeholders in preparation of protocols for monitoring = family=20 planning standards and will also be responsible to make = required=20 improvements. Training, orientation & refresher = courses will=20 be conducted periodically at training institutions of = MoPW.=20

 

   Advocacy=20

The Policy addresses those who being illiterate lack = knowledge or=20 have inhibitions to practice family planning. There is need = also to=20 address prevalent fears and misconceptions. A change in = beliefs and=20 the value system is required to reduce fertility to = replacement=20 levels. This will be done through a carefully designed = program of=20 advocacy and promotional campaign, which addresses all = segmented=20 target groups. 

The Policy also addresses the issue of population = momentum, which=20 due to its current ever-largest cohort of adolescents = entering=20 reproductive lives will be the main engine of population = growth in=20 coming decades. The two-pronged strategy addresses = adolescents=20 through population and family life education in the formal = &=20 non-formal education sector and reaches out to young couples = with=20 appropriate media, interpersonal messages and services.

An Advocacy Campaign will be devised to build and sustain = adoption of the small family norm.  It will raise = awareness=20 about population and development issues by engaging change = agents to=20 communicate on the impact of runaway population growth on = the lives=20 of the individual, family and communities.

  • Advocacy programmes will utilize all channels of = communication=20 particularly the media, interpersonal communication and = mass=20 education to convey the macro and micro effects of runaway = population growth. It will address the public and various=20 influential groups as follows:=20
  • Public Representatives: will be given orientations on = the=20 population problem and its critical link to social and = economic=20 progress. They will be invited in turn to be advocates of = the=20 programme.=20
  • Policy/Decision Makers: will be targeted to enhance = their=20 understanding of the inter-linkages between population and = sustainable development, to integrate population variable = into=20 their sectoral planning, commit increased level of = resources and=20 extend overall support to the population sector.=20
  • Opinion Leaders: will be sensitized about the = continued=20 benefit of birth spacing, safe motherhood and responsible=20 parenthood for enriching and improving the quality of = life.=20
  • Men: Males will be sensitized that family planning is = a need=20 for their own health and family well being.=20
  • Youth & Adolescents: Youth are the future = generation and=20 need to be sensitized about the wide-ranging consequences = of rapid=20 population growth for the individual, family and nation = and,=20 therefore the need to build a mindset for responsible = parenthood.=20
  • Medical Profession: medics and paramedics will be = motivated to=20 accept family planning as integral to the work of their=20 profession, particularly in the context of primary health = care.=20
  • Organized Sector: Organized sector is to be associated = as a=20 partner to educate, inform and provide services to their = employees=20 through their infrastructure in family planning & RH.=20
  • Intelligentsia/Influential Groups: will be provided=20 information about inter-relationships between population = and=20 sustainable development to sustain awareness, = understanding and=20 enhance social acceptability of the programme in society. =

 

   Training and = Capacity=20 Building=20

The following training programme and human resource = development=20 would be key features of the strategy:

  • Family Planning Training: Population Welfare Programme = has a=20 nationwide institutional set-up of Training Institutes. = They are=20 equipped not only to provide pre-service and in-service = training=20 to all population welfare training personnel but also on = an=20 organized basis respond to the training needs of nation = building=20 departments, public sector organization and NGOs.=20
  • Human Resource Development (HRD): A Human Resource = Development=20 Plan will be prepared for programme personnel. This has = assumed=20 added importance because of the need for re-training in = new skills=20 and management approaches. In addition, there has been = neglect in=20 maintaining the level of programme staff which is = currently=20 denuded due to superannuation and limited recruitment. It = is=20 proposed to address these needs in the HRD Plan. As a = starting=20 point under the devolution plan, District Government = personnel=20 will be re-trained in new methodologies of planning, = coordination=20 functions, problem-solving skills and improving their = capacity to=20 manage activities relating to the population sector. =

 

   Decentralization=20

The Program which to date has been federal will be = defederalized=20 with administrative, financial & programme transfers to = the=20 provinces: The defederalization will further decentralize = the=20 program to the District level in line with Governments = devolution=20 plan. This will be done through subsidiarity of the = Population=20 Welfare Program at the district level. In addition, Health=20 Departments are mandated to provide family planning services = in the=20 primary health care infrastructure.

 

   Coordination=20

The Policy recognizes that population is a crosscutting = issue,=20 which cannot be addressed in isolation and warrants an=20 institutionalized coordinating mechanism. Coordination is = required=20 at all levels within the government and outside and with all = stakeholders. This function rests with the Population = Welfare=20 Division.

 

   MONITORING=20 MECHANISMS=20

The following interventions would be critical for an = effective=20 monitoring and evaluation mechanism:

Management Information System

The Ministry of Population Welfare will ensure a review = of its=20 MIS system so that it is based on a District monitoring of=20 socio-economic demographic indicators and incorporates = quantitative=20 and qualitative data on programme result based = performance.

 

Logistic Management Information System

It is imperative to institutionalize an uninterrupted = supply of a=20 range of contraceptives. Since the policy envisages active=20 involvement of all public and private sector agencies in the = dispensation of Family Planning/ Reproductive Health = services,=20 therefore an omni watch on the stock position of = contraceptives in=20 the services outlets of all sectors would be crucial. This = requires=20 a strong and established Logistic Management Information = System=20 (LMIS). Efforts would, therefore, be made to introduce a=20 computerized inventory control system at central warehouse = for=20 proper records of receipts, issue and for smooth = distribution of=20 contraceptive supplies to all outlets.

 

GIS /Mapping

A proper mapping in each District of health, population = welfare,=20 NGO & private sector family planning facilities is = visualized,=20 this would reduce duplication of resources, increase = coverage=20 especially of un-served and under=96served regions by = relocating=20 facilities, establish a blue print for effective referral = system at=20 the district level, streamline services and finally serve as = a tool=20 for planning and monitoring purposes.

 

   Research in = Population=20 and Development=20

NIPS will continue to provide national data analysis and = research=20 findings to ensure that planners, decision makers & = programmers=20 receive operationally relevant information and analysis on = the key=20 interrelationship between population and development = variables.=20 Under NIPS mandate it is entrusted with research covering = all=20 aspects of population and development such as education, = health,=20 women, environment, labor force, aging, adolescents and=20 urbanization. This is in addition to NIPS traditionally = strong=20 research areas, which include family planning, fertility, = mortality,=20 evaluation for the population programme components etc. The = mandate=20 also makes the Institute responsible for imparting training = in the=20 field of population and development. NIPS would also broaden = its=20 focus to cover a wide range of population and development = issues and=20 to collaborate with the community of researchers within and = outside=20 the population field in implementing the agreed = agenda.

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  Funding

The Planning Commission had allocated an amount of Rs.9.5 = billion=20 for the Three-Year Development Plan (2002-2005) an average = of over 3=20 billion per annum. Keeping this as a bench- mark, = implementation of=20 the Population Policy would require a financial input of = Rs.24=20 billion for the remaining 8 years of Perspective Plan 2012 = and=20 subsequently another Rs.16 billion at a declining rate of = Rs.2=20 billion per annum till the year 2020. Hence a total of = Rs.49.5=20 billion requirements are estimated for the next 19 years for = achieving the fertility replacement perceived under the = Population=20 Policy by the year 2020. Major part of the financial inputs = will=20 cover the provision of subsidized contraceptives to the = clients,=20 service delivery, training, advocacy, and research and to = cover=20 human resource and infrastructure gaps essential for = achieving the=20 population policy objectives.

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