



Tahira, a 28-year-old woman, living in a shanty town in Lahore, has given birth to five children in her eight years of marriage.





Her oldest child is a seven-year-old son and her youngest are three-year-old twins — a girl and a boy. Her second child died as an infant. After her third child, she compulsively went to a government health unit to get contraceptives — she did not want more.“They placed an implant. But it reacted adversely with my system. I gained weight and started having severe body pain, so I decided to give up contraceptives altogether,” Tahira laughs and adds that the twins came after that incident.Now the couple is facing financial conundrums — her husband earns a meager salary of Rs9,000 a month. Tahira has decided to get an operation; a treatment medically known as sterilisation. But she fears since her previous treatments did not go well.Dr Muhammad Saeed, a gynecologist, explains about misconceptions about contraceptives in Pakistan.“Women tend to believe that all illnesses occurring after using contraceptive methods are related to them, without any biological correlation,” says Dr Saeed.He points out that since reproductive health units come under the social welfare department, staffers do not consult medical experts from the health department and this creates a serious problem in addressing health issues related to contraceptives.According to the Economic Survey 2010-11, Pakistan has the highest fertility rate of 3.5 in South Asia, with the lowest contraceptive prevalence rate of 30 per cent. Dr Saeed adds that religious beliefs are one of biggest hurdles in increasing contraceptive prevalence amongst women in Pakistan.Muneera, a mother of six, was recently visited by a team of the Population Welfare Department, to inform her of birth control methods but she is reluctant.“They asked me to come to the clinic, but my mother-in-law will not approve of it. It is because of her that I have so many children, since she wanted grandsons,” adds Muneera.Punjab Secretary Population Javed Akhtar says after the recent devolution of the Ministry of Population that funding “is now becoming a major issue in giving quality reproductive health services”. But he expects that the federal government will honour its commitment of providing Rs3 billion for the on-going year to develop this sector.“Political and social support is what we still lack and that is why population is not on the priority list of our government either,” said Akhtar.When asked about religious problems encountered with government initiatives, he said that the government should alter the slogan, adding that instead of highlighting “two children are enough” it should focus on “space between children” since they had difficulty breaking the mind barriers associated with birth control.According to a development economist, Qais Aslam, currently only 55 million people in Pakistan – which is less than one-third of the population – are feeding themselves and the rest.The United Nations projects that world population will surpass seven billion by October. According to a statement released for World Population Day by Dr Babatunde Osotimehin, the United Nations Population Fund (UNFPA) executive director, the world needs to work together to meet the needs of some 215 million women in developing countries who want to plan and space their births but do not have access to modern contraception.Published in The Express Tribune, July 12, 2011.