KARACHI, Jan 19: Speakers at a seminar on birth spacing said on Thursday that a major reason why family planning programme had failed in the country was the fact that the term family planning (khandani mansubabandi) was generally associated with limiting childbearing that was perceived as an un-Islamic act and a direct interference in personal family matters.

The public opposition, they argued, could be overcome if the government instead promoted the concept of birth spacing that also had the approval of religious scholars.

The seminar, Institutionalization of the Birth Spacing Paradigm in Sindh, was organised by the Population Council under its Falah (Family Advancement for Life and Health) Project related to reproductive health and family planning. The project is funded by the United States Agency for International Development (USAID).

The five-year project was started in 2007 in different districts of Sindh; Sanghar, Sukkur, Dadu, Ghotki, Larkana and Thatta, said Dr Ali M. Mir, who is overseeing as chief of party the implementation of Falah. The project was also initiated in three towns of Karachi, but couldn’t be sustained due to fund constraints.

“The goal was to bring about tangible improvement in the well-being of families by improving awareness about the benefits of birth spacing, removing barriers to its adoption, increasing awareness of the benefits associated with early, late, closely spaced and high parity pregnancies, enhancing knowledge of the various contraceptives and improving their accessibility,” he said.

While the project had been completed in Sindh, it still continued in 15 other districts across the country, he added.

Under the project, he said, about 30,000 people working in the related departments and private organisations were trained, communities were directly approached and religious representatives were taken on board.

“Scientific evidence shows that multiple pregnancies increase risks both for the mother and the baby and we believe that these risks can be effectively reduced by a simple health intervention, that is, birth spacing.” He said the community response was very positive and a baseline study was under way to see the difference in the use of contraceptives before and after the conclusion of the project.

Population Council Country Director Dr Zeba A. Sathar said the fact that a million abortions were carried out in Pakistan showed that a great demand for contraceptive methods already existed to avoid unplanned pregnancies. However, he said, there were problems of accessibility, affordability and lack of competent service providers.

She highlighted the need for integrating family planning programme with health services.

‘Religion not a hindrance’ Qari Mohammad Bilal Sajid, a prayer leader who received training under the project in Thatta, said that the concept of having only two children was against the teaching of Islam and he, too, initially declined to attend awareness-raising sessions.

“But all my reservations were removed once I attended one such session. A great change has come through the project and we want that every imam at the union council level is educated about the significance of birth spacing and that they know that religion is not a hindrance but promotes the same as it advises mothers to breast-feed their child for two years,” he said.

Giving her presentation, Dr Nighat Shah, representing Society of Obstetricians and Gynaecologists of Pakistan, said that country’s maternal death ratio of 276 per 100,000 might not seemed worrying, but actually it was very high if compared with other countries.

Sharing her experience of attending to flood victims in Sindh, she said women were found to be perpetually pregnant and the most precarious case was of young mothers.

She also showed a slide in which three women of the same family; a mother, her daughter and grand daughter, were all pregnant at the same time. “We learnt that the community was not reluctant to use family planning methods and that we need to educate young girls now so that they do not have to pass through the same trauma as their mothers or sisters had to go through.”

Former information minister Javed Jabbar, also the chairman of JJ Media, gave a detailed introduction about Falah’s communication and social mobilisation strategies. He said: “Now the challenge is to sustain and strengthen what has been achieved under the project and take it to rest of the 100 districts of the country.

“It’s shameful that a foreign agency is helping us do one of the most basic things that we should have done a long time ago. We must not wait for USAID funding to continue the work.”

Dr Ghaffar Billoo, patron of NGO Hands, and Dr Nasreen Khan, a USAID representative, also spoke.