Health Advocates In ‘Shock’ As PM Accepts Dam Donation From Tobacco Company: Unmet Need For Contraception Remains At 17percent

Health Advocates In ‘Shock’ As PM Accepts Dam Donation From Tobacco Company: Unmet Need For Contraception Remains At 17percent
The newly-released results of Pakistan Demographic and Health Survey (PDHS) 2017-18 showed major improvements in child survival and maternal health care, while progress has been slower in nutrition and family planning. This is the 4th DHS survey conducted in Pakistan since 1990-91. The survey findings describe that more children in Pakistan are surviving early childhood than ever before as under-5 mortality has sharply declined.

Currently, the under-5 mortality rate is 74 deaths per 1,000 live births, a decline from 89 deaths per 1,000 live births in 2012-13. This means that approximately 1 in every 14 children in Pakistan does not survive to their fifth birthday. Basic vaccination coverage has improved in Pakistan.

Meanwhile reproductive healthcare coverage among Pakistanis is also improving. Nearly 9 in 10 women aged 15-49 receive antenatal care from a skilled provider such as a doctor, nurse, midwife, or lady health visitor. Additionally, more than half of women have their first antenatal care visit in the first trimester, as recommended. Half of the women make four or more antenatal care visits, a notable increase from 37 percent in 2012-13. More births are delivered in a health facility, from 48 percent in 2012-13 to 66 percent in 2017-18. Yet, 1 in 3 births takes place at home.

The bad news is that unmet need for contraception remains high at 17%. There is dire need of political support for the family planning agenda, and the need for integration of family planning within health services immediately, to change the current non-curve in our demographic transition.

According to the United Nations Population Fund (UNFPA) 2.2 million abortions are carried out in Pakistan every year, thus the need to cater to a persisting unmet demand for contraceptives in the country becomes all the more important.

There can be no denying the difficulties a Pakistani woman faces as she’s forced to abort an unwanted pregnancy simply because of the failure of the authorities to provide her the contraceptives. It is important to know that Abortion is not a family planning method.

Almost half of all pregnancies in Pakistan, around 4.2 million each year, are unplanned and around 54 percent of those end in termination, according to a report by US research firms Population Council and Guttmacher Institute. Decades ago, a family planning campaign with the slogan “bache do hi ache,” or “two children is good,” was rejected by religious leaders as well as nationalists who wanted a bigger population to rival the 1.2 billion people in neighboring India.

Authorities have not yet been able to make this issue an emergency for Pakistan. However, Prime Minister Imran Khan in December acknowledged the lack of political will on the issue and promised pro-contraception campaigns using the media, cell phones, schools, and mosques.

The absence of women in decision making is one of the key reasons behind poor family planning. Many people do not even bother to plan their families due to the desire to have a male child. This was yet another cause cited of overpopulation. Besides, low-quality services and unavailability of stock of contraceptives also led to poor family planning.

Today with a population of around 207 million, Pakistan’s baby boom is stretching its resources beyond capacity and experts warn of trouble ahead. In order to meet its family planning commitments made at the London’s FP2020 Summit in 2017, Pakistan is required to raise the CPR to 50 percent by 2020, by committing additional resources, raising the per capita expenditure on family planning, and bringing in a programmatic refocus to address the information and services needed. There exists an unmet need for both the spacing and limiting of births, and the extent of each of these varies with women’s age, parity and education. The low levels of contraceptive use and the large numbers of unwanted pregnancies point to the need to provide quality accessible family planning services in the country. Access to family planning services is a fundamental right which is crucial to slowing and reversing unsustainable population growth.

The author is a freelance writer and associated with the development sector. He can be reached at He tweets @MansorQaisar