The 1951 population census showed a crude birth rate of 49 per thousand. But the crude death rate was also very high. Accordingly, the rate of population growth was not very alarming. However, the first Five-Year Plans took a serious notice of the population growth. Therefore, at that time it was stressed to promote the concept of family planning through a private organization, the Family Planning Association of Pakistan, during the 2nd half of fifties.
Family planning activities were initiated by the government in the public sector during 1960-65, and a comprehensive “Population Planning Program” was formulated as an integral part of the overall development program during 1965-70. At that time, it was realized that the cost of averting a birth by a family planning program is much less than the cost of raising a child to an age at which it could become a productive factor. Again, for a better income distribution and improving the lot of the poor, the need for family planning is greater for a low income than for the higher income groups. The increase in size of the family of the poor persons will have the effect of decreasing the income share of each member, hence of consumption which is already at a low level. Therefore, there is a big need to give priority to family planning programs at government level. Moreover, the family planning programs should be directed more to the poor families habitual of producing more children than to the rich families having other recreational facilities and alternatives.
Accordingly, during the period of 3rd five-year plan Rs 284 million were allocated for family planning activities. The target stipulated was to bring down the crude birth rate from an estimated level of 50 per thousand to 40 per thousand. The administrative set-up of the program was based on a three tier semi-autonomous organization, with the Population Planning Council at the Federal Level and the Population Planning Boards and District Boards at the Provincial and District Levels. The program provided for the recruitment and training of paramedical personnel, field staff and the establishment of family planning clinics. The clients (the couples etc, whom family planning services were to be provided) were to be approached by Dias (indigenous mid – wives) for motivation and distribution of contraceptives at their doorsteps. The program did not prove to be very much successful in its demographic impact. As in 1965-66, Sterilization cases were 1644, which rose to 10296 in 1969-70. The cases of IUD insertion were 186996 in 1965-66 which increased to 342960 in 1969-70.
In the period of 1965-70, the gross root role was played by “Dais” to distribute family planning devices. “While” the clinical family planning services were distributed family planning devices. “While” the clinical family planning services were provided by the Leady-Health Visitors- the employees of Health Department.
In the next phase, I.e during 1970-75, the earlier administrative structure was retained and the concept of “Continuous Motivation System” (CMS) was introduced. This program had following salient features:
- To create a general awareness regarding family planning. In this respect, general motivation will be created to adopt family planning devices. Accordingly, the married couples will be registered or couple approach will be followed.
- The Dias will be replaced by the whole time matriculate male and female teams of ‘ Field Motivators’. They will distribute the conventional contraceptives or they will perform the function of delivery of materials.
- The clinical facilities or delivery of services will also be provided by the family planning staff at the clinics etc.
In connections with this approach, following is the performance of family planning department. In 1970-71, the Sterilization cases were in number of 4767, which rose to 7740 in 1974-75. The cases of IUD insertion were 236552 in 1970-71, which fell to 137496 in 1974-75. The distribution of Oral Pills packets was 59544 packets in 1971-72 which rose to 2540688 in 1974-75. In 1971-72, 25.2 million conventional contraceptives were used, which went to 82.8 million in 1974-75.
“Because” of such family planning activities the birth rate which was 50 per thousand in 1965 decreased to 42 per thousand in 1975. However, the death rate which was 20 per thousand in 1965 also fell to 13 per thousand in 1975. As a result, the birth rate which was 3% per Annam in 1965 fell to 2.9% er Annam in 1975. Thus, it was found out that the achievements of the program in terms of the reduction of fertility rate remained insignificant. The Pakistan Fertility Survey 1975 revealed that 90% of the persons interviewed never used any contraceptive. While 10% reported to have used a method, of which 6% were using contraceptives.
The survey also showed that 90% who never used any contraceptive, 52% intended to use them in the future, while the remaining 38% had no intention of doing so. It showed a wide gap between the desire for and practice of family planning.
It was an objective of 4th plan (1970-75) to prevent 9.6 million births through family planning techniques. In 1976-77, the Sterilization cases were 14625, number of IUD cases were 168765, number of packets of Oral Pills were 4090195 and use of Contraceptives units was 94.5 million. In 1977, when Zia-ul-Haq took over as a ‘Martial-Law Administrator, most of the activities of the family planning were suspended. The couple to couple approach or the method of registering the married couples was abolished.
Despite such all measures, we feel that there are remote chances of success of family planning devices in Pakistan. It is confined to the educated class, top businessman and industrialists, government and private employees and limited urban population. The middle class population, whether living in cities or in villages; and whether they are men or women have also shown hatred for the programs of family planning. The religious class rather making ‘Ijtehad’ always accorded this program tantamount to anti- Islamic codes and philosophy. Both the literates and illiterates have been found having same views regarding population control. They are so determined and inflexible that every single legislative push to control populace through electronic media are bringing about vain. Something more is as yet required, I.e lack of education should be expelled; individuals should be persuaded with respect to the event of little family.Thus, the multilateral approach based upon the cooperation on the part of teachers whether of government whether of government institutions or of private institutions, government and NGOs
may be helpful in removing illiteracy and changing the defective existing social set-up which is big hindrance in the way of checking the high birth rates