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POPULATION WELFARE PROGRAM, NWFP
AN OVERVIEW

By Zar Wali Zahid,
Directorate of Information NWFP

In biblical language, Adam was turned out of Eden with the curse, “Go forth and multiply”. So men and women have multiplied faster than the yield from land and other means of production and income. This is what Malthus, the English economist also discovered and propounded. By having just a look on one of the localities of the Global village that is called Pakistan, we will find there the mother of all problems i.e. overpopulation. Overpopulation is giving birth to innumerable multidimensional problems in this part of the globe. Although the population explosion issue has now become global issue yet the galloping rate of population growth is a matter of concern for the people of Pakistan in particular. It is also of great concern for those of us who inhabit the third world, scare as we are in resources and saddled as we are with overwhelming problems. Overpopulation is, in fact, the root cause of social problems including poverty, unemployment, disease, illiteracy, hunger, low investment, social unrest shortage of housing, health and education facilities; law and order situation etc.
With population of more than 160 million, Pakistan ranks at 7th position in terms of world’s population size. With population growth rate of 2.1 percent per annum and addition of 3.1 million persons every year, Pakistan is facing a formidable challenge of tackling the issue of economic, development and poverty reduction.

Such sizeable addition to the population not only dilutes the results of the development efforts but also creates unsustainable level of demand on already scarce resources to cater for the needs of the population. This also imposes restrains on efforts for improving the living conditions of the population. In the past, high population growth has significantly pushed the population below poverty lines. It the current trends persists, Pakistan’s population will exceed the digit of 210 million by the year 2020. Based on the present growth pattern and trends, the economy would not be able to sustain the growing pressure of population and the resultant deterioration in quality of life will foil government’s recent efforts for social uplift.

Pakistan has been facing the ever-largest adolescent population, because of its high level of fertility over the last few decades. The adolescent population, in the age-group of 15-24, as it enters into its reproductive phase embodies potential population momentum with serious implications for provision of schooling, healthcares and other basic amenities of life for the coming decades. Almost one third of our population is living below poverty line. The impact of population growth on poverty is obvious, since families specially women and marginalized groups bear the burden of a large number of children with relatively few resources, further adding to the spiral of poverty and deterioration in the status of women thus, large part of the population is destined to live in poor housing and sanitation conditions with lack of access to safe drinking water and hygienic food. Malnutrition in poorer families contributes to high levels of child and maternal morbidity and mortality. Furthermore, the rapid population growth also contributes to environmental degradation and depletion of natural resources. The country has to amass additional resources to food, cloth and provide various services to the population. The population of the country has marked with considerably high proportion of young age, high dependency ratio and big size. The increasing number of population has resulted in low level of human development, low savings and investment ratios, low labour force participation rate and low per capita income. Hence Pakistan is classified among the low income countries. It is in the grip of population explosion and if we want to secure a good future for our people, the problem of population explosion should be controlled through effective ways of family planning. Addressing this problem should undoubtedly be magna cartae of the overall planning perspectives. The need to pursue an effective population programme at all levels can neither be ignored nor exaggerated.

Family planning programmes have been perused in the country since 1950s. Family planning was initially introduced after family planning association of Pakistan (FPAP) was established in 1953. In 1965, family planning program (FPP) was launched through Ministry of Health. During the 3rd five years plan period the program received priority and family planning council headed by federal minister for health was created. Similarly, provincial boards under health department formed. In 1976, the program was federalized but later on in 1980 the services of the program employees were provincialized which followed the transfer of field activities to the provincial governments through an ordinance in 1983.
A major development took place in 1993 when Supreme Court declared the employees as civil servants of the federal government. Later on in 2000 the program was devolved to provinces.
The vision of the population policy of Pakistan has been the achievement of population stabilization by 2020 through the expeditious completion of demographic transition that entails decline both in facility and mortality rates.
The population welfare program, NWFP is continuation of the ongoing special development endeavor within the frame work of nationally accepted population and development policy. A broad based reproductive health approach in the light of international conference for development and population (ICDP) 1994s is pursued with emphasis on family planning and mother and child health.
Two PC-1s of regular population welfare program, NWFP (2003-09) and Reproductive Health Service (RHS-A), Expansion project PC-1 (2005-09) are under implementation to achieve the following objective by 2014.
• To reduce the population growth rate from 2.19 % to 1.84%
• To reduce the crude birth rate from 30.07/1000 to 25.63/1000.
• To reduce total fertility rate from 4.35 to 3.50 per women
• To increase contraceptives prevalence rate from31.67 % to 41.75 %
• To reduce crude death rate (CDR) from 7.40/1000 to 6.55/1000.
• Reduce fertility rate through enhanced voluntary contraceptive adoption to replacement level 2.1 birth per women by 2020.
• Universal access to safe family planning methods by 2010.
Before going into further detail about the program, let’s have a bird-eye view over the demographic profile of the province. According to the latest available sources of Ministry of Population Welfare and UNFPA the total population of the province is 21.328 million. In proportion to the total population of Pakistan the share of this province is 13.18 percent. NWFP consists of 24 districts and its population density is 238.1 per square kilometer. It is contraceptive prevalence rate is 32% while the total fertility rate is 4.6 and growth rate is 2.19. Maternal Mortality Rate (MMR) in the province is 350-500/100000 while Infant Mortality Rate (IMR) is 77/1000 live birth. The socio economic indicators of the province show that the size of its house hold is more than 08 family members and 27.7 percent of its population is living in one room house, 57.3 percent of its population is living without latrine, only 27.2 percent of its population is having piped water. While 41 percent of its population is living below the line of poverty in other words 41% of the population can not earn one US Dollar per day.

Population welfare program, NWFP has its own separate and full fledge department headed by an administrative secretary. The Directorate of Population Welfare is headed by a Director General who is the operational head of the department supported by three Directors and six Deputy Directors. The Directorate has its district set ups at all the districts of the province. The district set up is headed by a district population welfare officer supported by Dy. District Population Officers and Dy. Demographer. The district set up has further been extended to tehsil set up headed by tehsil population welfare officer. The service delivery components of the department include reproductive health service centre category (A) (RHSC-A) (headed y women medical officer) and Mobile Service Unit (MSU, headed by Women Medical Officer) at every district. The department has established a family welfare centers (FWC) at every Union Council. Moreover, a mobilizer is also deployed at Union Council level. In addition to above cited service delivery components the department has some other supporting components including communication/advocacy, monitoring and evaluation, training, contraceptive logistics and management information system. The main functions of the Population Welfare Department NWFP include:

 Planning for the population program in the province and its implementation.
 Monitoring population activities and evaluation of the program.
 Collection, maintenance and analysis of demographic and population statistics.
 Organizign and operating information and education for the furtherance of population welfare activities.
 Training, seminars, workshops on population development issues.
 Provision of family planning services.
 Research in different aspects of the program.
 Promotion of population planning activities through public sector agencies and infrastructure.
 Coordination with line departments
 The systematic introduction of population education.

The population welfare department has so far established 422 family welfare centers, 30 mobile service units, 23 reproductive health service centers and has registered 544 male mobilizers against the target of 615 in the regular PC-1 2003-09 thus achieving more than 99% of target of the PC-1.

The present government under its 5 years expansion plan (2009-14) intends to; increase the number of FWCs from the existing 422 to 1972 (2 per union councils at least), increase the number of social mobilizers from 544 to 2450 (one per 10000 population), register 2450 female social mobilizers (one per 10000 population), increase RMPs from 491 to 991 and increase hakeems from 286 to 586 which will not only give boost to the population program to effectively operate but also create opportunities of employment in the province.

The population welfare program NWFP is a program of choice not of control which operate under the strategy of developing and launching advocacy campaigns, promoting small family norms, reducing unmet needs for family planning services, ensure the provision of quality services, building strong partnership with concerned lines, ministries, departments and private sectors, bringing attitudinal changes, involvement of opinion leaders and religious scholars, extending family planning services to underserved and ensuring population education for school and college students. Some worth mentioning initiatives of the program includes; introduction of male mobilizers for creating awareness in male segments of the community for responsible parenthood and behavior change towards small family norms, introduction of improved level of pre-service training for all cadres of technical and non-technical employees, introduction of women medical officers in mobile service units, training of master trainer, ulema/pesh imams to provide further training at district level (about 1950 ulema trained so far), development of reference material, development of year book on population welfare program and the like. In public sector collaboration, provincial population council has been set up which is headed by the Chief Minister while the population welfare department has close collaboration with the health and education departments.
Based on the recommendations of international council for population and development (ICDP), population policy and millennium development goals (MDGs) the goals and strategies of next 5 years program of the present government would be; population should mainstream as planning and development program, strategic focus should be on service expansion, advocacy/social mobilization be culturally and religiously sensitive, capacity building/accountability, the strategic plan should support devolution/proper positioning of population welfare program, joint and integrated collaborative efforts and intervention between the public sectors, public – private partnership, monitoring, mid-term reviews of projects, research operation be encouraged to make evidence based interventions and innovative approach will be piloted so as to choose the best practices. The population welfare program makes commitment to service the underserved with particular focus on rural areas, women empowerment, give free choice of family planning methods within religious/social partners, provide quality service and improve reproductive health and happy life. Lets every one of us put our efforts together to realize the dream of stabilized population of our province.