Showing posts from category Pakistan.
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How Did We Arrive at 7 Billion – and Where Do We Go From Here? [Part Two]
›October 26, 2011 // By Elizabeth Leahy MadsenThe world’s women will determine whether the global population in 2050 is as low as 8 billion or as high as 11 billion through their choices (or lack thereof) about the number and timing of their children. Women in developing regions of the world will have the greatest effect on these potential population trajectories. Even if fertility rates remain constant at current levels (which is unlikely), developing regions would grow from 5.7 billion in 2010 to 9.7 billion in 2050, but the total population of developed countries would remain essentially unchanged.
The UN estimates that the seven billionth person alive today will be born on October 31. Demographer Elizabeth Leahy Madsen explains how we got to that number, its significance, and where our demographic path might take us from here. Read part one here.
The world’s women will determine whether the global population in 2050 is as low as 8 billion or as high as 11 billion through their choices (or lack thereof) about the number and timing of their children. Women in developing regions of the world will have the greatest effect on these potential population trajectories. Even if fertility rates remain constant at current levels (which is unlikely), developing regions would grow from 5.7 billion in 2010 to 9.7 billion in 2050, but the total population of developed countries would remain essentially unchanged.
The way that people decide the timing and number of their children is not easily distilled into a simple formula with a single solution. Still, some basic and important facts are known. In the developing world, where more than 80 percent of the world’s population lives, women in rural areas, those who have little or no education, and those who are poor, have larger families. As demographers have shown in modeling the determinants of fertility, women tend to seek contraception once they are confident that their children will survive to adulthood and when socioeconomic development increases the “costs” of having children, for example by motivating parents to send them to school rather than to work.
One of the most direct reasons for past declines in fertility rates was the rapid expansion of family planning and reproductive health programs, supported by country governments and international donors, that enabled women and men to more effectively choose the size of their families. But today, about 215 million women across the developing world would like to delay or avoid pregnancy but are using ineffective contraception or none at all. Funding programs to meet the family planning needs of these women, which would cost about $3.6 billion annually, would both empower them and help fertility rates continue to decline.
Beyond Access: Gender Inequality Inhibits Contraceptive Use
While increasing support for family planning programs tops the list of demographers’ recommended policies, ensuring that contraceptives are available and accessible will not alone achieve the fertility declines projected in most of the UN’s range of possibilities. Many women who are having or planning to have large families know about family planning and where to find it, but are choosing not to use contraception for cultural reasons that are often deeply engrained.
In sub-Saharan Africa, the region with the highest global fertility rate, only 16 percent of married/partnered women of reproductive age are using effective contraception. In comparison, between 62 and 75 percent of their peers in Ireland, the United States, and Uruguay – countries whose fertility rates are almost exactly at replacement level – are using it.
Logically, sub-Saharan Africa needs similar levels of contraceptive use to bring its average fertility rate towards replacement level as the UN projects, so the region’s average prevalence rate for modern contraception would need to rise by at least 10 percentage points in each of the next four decades. However, contraceptive use in the region has grown by only 0.5 percentage points or less over the past 30 years.
What is inhibiting the use of contraception? Demographic and health surveys find in Nigeria, for example, that 10 percent of married women are using an effective contraceptive method, while twice as many have an unmet need for family planning. This low use of family planning demonstrates high potential for change in the country’s demographic future, which, as the most populous in Africa, will greatly influence global and regional trends. Yet among women who do not intend to use contraception, 39 percent report that they or their family members are opposed to family planning, and another 16 percent fear side effects or have other health-related concerns. If Nigeria’s fertility rate remains unchanged, the country will be home to 500 million people by 2050.
In Pakistan, where 24 percent of births are unintended, surveys show similar barriers. Ninety-six percent of married women know about effective contraceptive methods, but only 22 percent are using one. More than one-quarter of women who do not plan to use contraceptives report that their fertility is “up to God” and 23 percent report that they or their family members are opposed to family planning. Pakistan’s population would more than double from 174 million to 379 million by 2050 if current fertility trends hold constant.
Peak Planet? Population Growth and Consumption Strain Environmental Resources
Because Nigeria, Pakistan, and other countries’ demographic trajectories may not follow the path laid out in population projections, we can’t take a world of nine billion for granted. While human ingenuity and technological advancements have improved standards of living in many countries, scientists caution that the combination of rising human numbers and growing consumption has serious environmental implications. Already, the quantity and quality of fresh water supplies are under strain, and forests in many developing countries are being rapidly depleted.
Population projections are much more than wonkish speculation – they foreshadow the serious problems that lie ahead if health, environment, and development policies aren’t strengthened. If the UN projections of our demographic future are to bear any semblance of reality, we must move beyond the status quo. While improving physical access to family planning should remain a top priority, meeting unmet need will also require addressing the deep-seated challenges of women’s education and empowerment.
Elizabeth Leahy Madsen is a consultant on political demography for the Wilson Center’s Environmental Change and Security Program and former senior research associate at Population Action International.
Sources: Bongaarts and Sinding (2009), Bongaarts (2006), Futures Institute, Guttmacher Institute and UN Population Fund, Measure DHS, O’Neill, Dalton, Fuchs, Jiang, Shonali Pachauri, and Katarina Zigova (2010), UN Population Division, Washington Post.
Photo Credit: “Afghan Internally Displaced Persons,” courtesy of flickr user United Nations Photo. -
Jennifer Dabbs Sciubba, The Philadelphia Inquirer
Family Planning Can Help in Afghanistan
›September 6, 2011 // By Wilson Center StaffThe original version of this op-ed, by Jennifer Dabbs Sciubba, appeared in The Philadelphia Inquirer.
Most experts agree that the mark of long-term success in Afghanistan will be stable governance that allows the economy, democracy, and the people to flourish. Many factors will determine that, but a major one that seems to be left out of most high-level conversations is population.
Afghanistan is a country of 31 million people, but that number will double by 2035, according to the most recent UN projections, and could reach 126 million by midcentury. That’s 95 million more Afghans to govern, clothe, feed, and employ.
Without attention to population, countries like Afghanistan and Pakistan stand a good chance of staying mired in poverty, conflict, and corrupt, repressive government. That is why sustained investment in family planning by the United States and other countries would do more to stabilize the political climate there than any other foreign policy initiative. Though efforts by the Afghan government to provide contraceptives have met some resistance by conservative Muslim groups, the success of family planning in other Muslim states demonstrates that it can be effective.
Continue reading on The Philadelphia Inquirer.
Sources: UN Population Division.
Photo Credit: “100430-F-2616H-050,” courtesy of flickr user Kenny Holston 21 (Kenny Holston). -
Michael Kugelman, Huffington Post
Pakistan’s Biggest Threats May Not Be What You Think They Are
›August 30, 2011 // By Wilson Center StaffThe original version of this article, by Michael Kugelman, appeared on the Huffington Post.
The most troubling news to emerge from Pakistan in recent days has little to do with militancy or other headline-grabbing scourges that afflict the country. Rather, it relates to a new Oxfam report’s finding that more than a third of the country’s population – about 60 million people – is undernourished.
Pakistan may well be convulsed by extremist violence; according to Pakistani estimates, it has killed or injured 30,000 in recent years. Yet contrary to what U.S. media coverage may suggest, this is not the greatest threat to the Pakistani people.
Numerous candidates contend for this dubious honor. One, underscored by Oxfam, is hunger. Even before last year’s devastating floods, which destroyed more than 2 million hectares of arable land, the World Food Program estimated that 77 million Pakistanis were going hungry. Another is water insecurity, one of Pakistan’s biggest killers. With a third of Pakistanis lacking access to clean water, no wonder waterborne illness claims the lives of 1.2 million Pakistanis per year – and 630 children every day. Lack of education also tops the list. More than 40 million of Pakistan’s 70 million school-age children (those between the ages of 5 to 19) are not in school. And then there is Pakistan’s energy crisis. Due to power shortfalls, some Pakistanis suffer outages for as long as 20 hours per day – crippling industry and bringing misery to millions of households. All of this is compounded by state corruption, which constrains access to these precious resources and services.
Continue reading on Huffington Post.
Sources: Business Recorder, Oxfam International, PBS, World Food Program.
Michael Kugelman is a program associate with the Wilson Center’s Asia Program.
Photo Credit: “People returning home as soon as the water recedes enough,” courtesy of flickr user DFID – UK Department for International Development. -
The Role of Faith-Based Organizations in Maternal and Newborn Health Care
›Government and nongovernmental organizations have consistently played a key role in addressing maternal mortality. While these initiatives are well documented, the role of faith-based organizations (FBOs) in maternal and newborn health is less well understood.
In November, the Wilson Center’s Advancing Policy Dialogue to Improve Maternal Health series will bring diverse institutions together such as the Pakistan Initiative for Mothers and Newborns (PAIMAN) and Pathfinder International to discuss country experiences and evaluate opportunities for overcoming challenges.
According to the World Health Organization, FBOs own up to 70 percent of the health infrastructure in sub-Saharan African countries and often work in remote regions where government and NGO services are limited. FBO’s are critical to improving maternal health as they fill gaps in the health system – particularly in low-resource settings – and approaching culturally sensitive barriers that often prevent mothers from seeking health care.
The level of trust communities place on their religious leaders explains one of the main reasons why FBOs are attaining success. A study conducted by Pew Charitable Trust found that a vast majority of people in sub-Saharan Africa identify themselves as adherents of Christianity or Islam, and approximately 75 percent trust their religious leaders.
As partnerships with FBO’s increase, it is imperative that organizations share their lessons learned and identify capacity and knowledge gaps in order to improve effectiveness.
Pakistan Initiative for Mothers and Newborns
The Pakistan Initiative for Mothers and Newborns (PAIMAN), which started out as a six-year project funded by USAID and led by JSI Research and Training Institute, is a strong example of a program incorporating faith to improve maternal mortality rates. The project aims to ensure that women have access to skilled birth attendants during and immediately after giving birth. Additionally, the project focused on increasing the quality of care both in the public and health sectors. PAIMAN was able to achieve substantial success by utilizing various communication interventions such as mass media, community media, and advocacy efforts. One of the most successful initiatives PAIMAN organized was reaching out to 1,000 religious scholars, known as ulamas, to deliver frequent messages on maternal and newborn health care. Since its initiation, this project has “saved more than 30,000 newborn lives resulting in a 23 percent decrease in neonatal mortality,” according to their numbers.
Pathfinder International
Pathfinder International is another great example of an organization that has understood the value of FBOs and worked in collaboration with them to achieve results for maternal health. Pathfinder has worked in numerous countries including Nigeria, Ghana, Ethiopia, Egypt, Uganda, Kenya, and Bangladesh to educate religious leaders and communities on communication strategies for improving maternal health behaviors.
In Ethiopia, Pathfinder organized over 250 religious leaders representing the Orthodox Christian, Catholic, Protestant, Seventh Day Adventist, Mekaneyesus Christian, and Muslim faiths to educate them about maternal mortality. At the conclusion of the seminar, the religious leaders agreed to condemn a host of harmful traditional practices, including female genital cutting, marriage by abduction, early marriage, rape, and unsafe abortion and agreed that they are not required by the Bible or Korean. Religious leaders in Egypt also came to similar conclusions after participating in these types of seminars.
“By helping religious leaders see the links between reproductive health and families’ well-being, Pathfinder enables them to become committed advocates for positive reform,” wrote Mary K. Burke, technical communications associate at Pathfinder International in the 2006 report, Advancing Reproductive Health and Family Planning through Religious Leaders.
Challenges: Equipping and Encouraging
Despite the prevalence of success stories among FBOs to improve maternal mortality, challenges do exist. For instance, although religious leaders are highly respected by their communities, their teachings become useless, as pointed out by a USAID-sponsored Extending Service Delivery Project report, unless they are also properly trained and equipped with the latest service delivery systems and scientific information.
The report also describes the importance of cooperation and support from the government and decision-making representatives. If the private, public, and government sectors are fragmented and no formal recognition exists to acknowledge the work of religious leaders for improving maternal mortality, then success may be significantly hampered.
To learn more about the role of faith-based organizations in women’s health, be sure to check out the Global Health Initiative event on FBOs coming in November, with representatives from PAIMAN, Pathfinder International, and others.
Sources: Extending Service Delivery Project, JSI Research and Training Institute, Pathfinder International, Pew Charitable Trust, USAID, World Health Organization.
Photo Credit: “Woolly hats needed,” courtesy of flickr user Church Mission Society (CMS). -
Farahnaz Zahidi Moazzam on the Population Reference Bureau’s “Women’s Edition” Trip to Ethiopia
›The original version of this article, by Farahnaz Zahidi Moazzam, appeared on the Population Reference Bureau’s Behind the Numbers blog.My name is Farahnaz Zahidi Moazzam, and I’m a freelance journalist, writer, and editor from Pakistan. My passion is writing about human rights with a special focus on gender issues and reproductive health. Blogging is a personal joy to me, as I put my heart into my writing and blogging allows for a more personalized style. Digital journalism is a sign of evolution – one I happily accept. My pet peeve is marginalization on any grounds. I am a mother of a teenage daughter and live in Karachi.
As part of the Population Reference Bureau’s (PRB) group of journalists in Women’s Edition 2010-2012, I recently had the chance to travel to Ethiopia on a visit that was unforgettable. The visit inspired a series of seven brief travel-blogs, based on my seven days there. Women’s Edition is a wonderful opportunity to connect with other like-minded female journalists from developing countries around the world, and learn solutions to the problems from this interaction. The program has reaffirmed my belief that our commonalities are more than the differences.
Read Farahnaz Zahidi Moazzam’s posts from her trip to Ethiopia on her blog, Impassioned Ramblings, and view photos from the trip on PRB’s Facebook page.
Photo Credit: PRB. -
Michael Kugelman, Foreign Policy
Pakistan’s Demographic Dilemma
›July 15, 2011 // By Wilson Center StaffThe original version of this article, by Michael Kugelman, appeared on Foreign Policy’s AfPak Channel.
Pakistan’s 2011 census kicked off in April, but less than three months later, it is embroiled in controversy. Several members of the Sindh Census Monitoring Committee have rejected as “seriously flawed” the recently completed household count. They allege that census workers, directed by an unspecified “ethnic group,” have counted Karachi’s “inns, washrooms, and even electric poles” as households in an effort to dilute the city’s native “Sindhi” presence.
These Census Monitoring Committee members are not the only Pakistani politicians to be concerned about the census. Pakistan is experiencing rapid urbanization; while a third of the country’s people have long been rurally based, at least 50 percent of the population is expected to live in cities by the 2020s. Pakistan’s political leadership draws much of its power from rural landholdings, power that could be greatly reduced if a census confirms this migration toward cities.
This politicization underscores the perils of census-taking in Pakistan. In many other nations, it is a routine process completed regularly. Yet in Pakistan, myriad factors – from catastrophic flooding and insufficient funding to the turbulent security situation and intense political opposition – have conspired to delay it for three consecutive years, making the country census-less since 1998.
Accurate census data enables governments to make decisions about how to best allocate resources and services. In Pakistan, such decisions are critical. Consider that its current population, estimated at about 175 million, is the world’s sixth-largest. It has the highest population growth, birth, and fertility rates in South Asia – one of the last regions, along with sub-Saharan Africa, still experiencing young and rapidly rising populations. Additionally, with a median age of 21, Pakistan’s population is profoundly youthful. Two-thirds are less than 30 years old, and as a percentage of total population, only Yemen has more people under 24.
Continue reading on Foreign Policy.
Michael Kugelman is a program associate for the Asia Program at the Woodrow Wilson Center and co-editor of Reaping the Divided: Overcoming Pakistan’s Demographic Challenges.
Sources: UN Population Division.
Photo Credit: “Pakistan Diaster Relief,” courtesy of flickr user DVIDSHUB. -
Pakistan’s Population Bomb Defused?
›What is going on over at the UN Population Division? In response to The New Security Beat’s post on the UN’s sub-Saharan projections, Ed Carr of USAID recently highlighted what appears to be gross overestimations in the 2010 population revision for Ghana. Yet in the case of Pakistan, the opposite is seemingly at play – the projections appear to wildly (and unrealistically) underestimate population numbers for the coming decades.
The 2008 revision’s mid-variant estimate for Pakistan in 2050 was 335 million people. The new revision projects only about 275 million by that year. Even the new high-variant estimate (314 million) falls below the earlier mid-variant projection. Furthermore, the constant-fertility variant estimate for 2050 has fallen from 450 million to under 380 million.
What gives? Thanks to some helpful staff at the Population Division and Population Action International’s Elizabeth Leahy Madsen (who helped translate the UN’s demographic-ese for this non-specialist), I can only conclude that the UN has decided to hedge its bets that Pakistan’s fertility rates will fall, simply because its South Asian neighbors (and other nations) have followed this trajectory.
If so, I believe this assumption is spurious. As reported in the Wilson Center’s recent book on Pakistan’s population challenges, though Pakistan’s fertility rate is in decline, it is falling at a considerably slower pace than that of its neighbors, and the rate of decrease has slowed considerably over the last decade. The country’s total fertility rate (TFR) today is just under four, considerably above the replacement level rate (2.1).
By many indications, Pakistan’s TFR does not figure to fall quickly anytime soon. Pakistan’s maternal and reproductive health sector is deeply troubled, with family planning services either of poor quality or nonexistent – particularly in rural areas. Many rural women are obliged to travel on average 50 to 100 kilometers to obtain such services. Meanwhile, the status of Pakistani women is dreadful; female literacy is estimated to stand at only 44 percent (some places it as low as 35 percent), while women’s labor participation rates barely approach 20 percent. Not surprisingly, Pakistan’s contraceptive prevalence rate is quite low (30 percent), while its rate of unmet need for family planning is high (25 percent).
With all of Pakistan’s problems, improving access to family planning is simply not a front-burner issue for Islamabad (in fact, as our book notes, demography on the whole is largely neglected in Pakistan), which makes the 2010 revision’s projections all the more questionable.
The UN is expected to release details on the methodology behind its basic assumptions in the coming weeks; here’s hoping for some clarity. (Editor’s note: As Liz Madsen points out, there’s also a white paper on the new probabilistic model to sift through, if you’re prepared for some heavy reading.)
Michael Kugelman is a program associate for the Asia Program at the Woodrow Wilson Center.
Chart Credit: Modification of projections of total fertility based on Bayesian hierarchical model, courtesy of the UN Population Division. -
Michael Kugelman, Dawn
Aquaculture’s Promise for Food-Insecure Pakistan
›June 7, 2011 // By Wilson Center StaffThe original version of this article, by Michael Kugelman, appeared on Dawn.
“Give a man a fish and you feed him for a day,” the ancient Chinese philosopher Lao Tzu famously said. “Teach a man to fish and you feed him for a lifetime.”
For years, this adage has helped frame debates across a variety of disciplines. However, while globally influential, it is by no means universally applicable – as the sad realities of Sindh make painfully clear. In this parched, food-insecure region flush with fishermen and farmers, people have long known how to fish. The problem is that with water bodies shriveling up, there are increasingly fewer fish to catch. Many impoverished residents would be grateful for a single fish, given their struggles to secure a day’s worth of food.
Pakistan’s natural resource constraints know no provincial borders, yet they are notably severe in Sindh. Water tables are plummeting, with great volumes of Indus River flows diverted upstream to satiate agricultural and urban demand in Punjab.
Sindh’s water security is further threatened by population growth and global warming, and by the water-intensive, large-scale farming envisioned by foreign investors jockeying for agricultural land.
With surface water supplies threatened, users are increasingly tapping groundwater resources – yet according to the Pakistan Council of Research in Water Resources, a staggering 95 percent of the province’s shallow groundwater supplies are bacteriologically contaminated. This is unsurprising, given the technical deficiencies and inefficiency that characterize Sindh’s water treatment facilities.
In a province where so many livelihoods are tied to water availability and food production, water stress aggravates food insecurity and threatens economic well-being. A recent World Bank report concludes that Pakistan’s poorest spend at least 70 percent of their meager incomes on food – and undoubtedly many of them hail from Sindh. According to data from the Pakistan Agricultural Research Council, some of the province’s small farmers spend a whopping 87 percent of their incomes on food.
Continue reading on Dawn.
Michael Kugelman is a program associate for the Asia Program at the Woodrow Wilson Center.
Photo Credit: A child stands amongst buildings destroyed by the floods in Sindh province, courtesy of flickr user DFID – UK Department for International Development.
