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PECC Seminars
Factors
Associated With Failure Of Family Planning Methods In Pakistan: A Case Study
Speakers:
Date:
Monday 06 October 2003
Time: 4:00 pm
Venue: SDPI, #3 UN Boulevard, Diplomatic Encalve, Islamabad
In Pakistan, the highest unmet need for knowledge and use of contraceptives is among the rural women. This phenomenon is prevalent throughout Pakistan, yet is not only associated with level of education of women, but also with the socio-cultural restraints, that deprive a women over the control of her body. Furthermore, poverty, lack of opportunities and poor management of the available facilities, further burden the society, which then seeks refuge by having a large family. The aim of this study is to validate the hypothesis, that cultural and psychological factors, particularly the husband's behavior and attitude influence the women's decision on issues regarding fertility regulation. To identify these factors, we drew both on previous empirical research and on exploratory qualitative interviews that were conducted during a six-month field visit of Burhan, district Attock, tehsil Hassan Abdal, with a population of about 8,000. The socio-economic survey was conducted from 80 households only and the total population of the selected households was 616 persons comprising 56 per cent males and 64 per cent females. The survey used a stratified sample of the entire village, and yielded a sample of 43 married females of reproductive age for detailed interviews.The principal objective of the study was to estimate the causes of unmet need for family planning and to identify obstacles that effect their decision to practice contraception. To obtain such information, structured and unstructured interviews were taken and two focus group discussions were also held with Lady Health Vistors (LHVs) to cross check the data. Specific questions were asked concerning the respondent's knowledge and views about modern contraceptives as well as traditional methods of family planning, husband's approval, health concerns, perception of access to services inter alia. Additional information was collected on demographic and socio-economic characteristics of the respondents, including measures of economic status, family composition, years of schooling, number of living children and women's degree of autonomy and the extent of her decision-making power in various domains of everyday and family life. It was assumed that all these variables accurately reflect the stage of the respondent's ability to express and formulate reproductive intentions and their authority to make reproductive decisions.On the basis of this exploratory qualitative research, the findings show that 77 per cent of the 43 women interviewed, were below 20 years of age when they got married and 17 per cent were below 15 years at the time of their marriage. The spousal gap was also indicative of the traditional practices in Pakistan, which may contribute to over population, as 42 per cent women were 7-9 years younger than their husbands, while 21 per cent were 10-12 years younger. The literacy level among the women further emphasized the need for education as a key component to combat overpopulation and encourage the use of contraceptives. Twenty-eight per cent of these women had no schooling, while 33 per cent had five years of schooling and 26 per cent had 8 years of schooling. This study, did however, also reveal that even an educated women had no say in the decision making process with regards to the family size and fertility rate, because of the social constraints and culturally, traditionally defined norms. Decision making was solely the responsibility of the husband in 88 per cent cases, while only 5 per cent of the families involved both the wife and husband and in a further 5 per cent, the husband and mother-in-law were involved in the decision making process. There was only one case, where the wife alone was involved in the decision-making process for fertility regulation. With regards to the spousal communication, this study revealed that in 28 per cent spacing between children was discussed between the husband and wife, whereas only 19 per cent actually discussed the number of children that they would have and 16 per cent discussed maternal health. The most intriguing aspect of this study was revealed when women were asked about the degree of freedom granted to them by their husbands. Of these 43 women, 14 per cent said that their husbands gave them permission to leave their homes alone, 9 per cent could go the hospital alone, 58 per cent were allowed to talk to other women about matter related to family affairs and 49 per cent were allowed to talk to family health workers (LHVs, LHWs etc). The interesting part of this finding was the fact that not a single woman said that she would argue with her husband. This was difficult to believe, but in the given circumstances of our cultural set-up and the fact that most of these women are taught that a good wife is an obedient wife, the answer was quite understandable.The culture of a given community determines the reproductive behavior of a person including family planning, family size, desire for a male child etc. It is not the person rather the culture that determines how much autonomy one individual has in making family planning decisions. This study re-enforces this hypothesis, with the added fact that the role of males is essential to curtail the menace of increasing population. At the same time, female education and empowerment of women go hand in hand with social justice and development. There is no doubt that in our society, be it rural or urban, education and empowerment of women is not considered a high priority. Women marry at a young age to men who are often 7- 12 years older then them. As a result, they are dominated by their spouses and the prevailing conservative traditions; hence have little to say with regards to their own reproductive health. Therefore, in order to effectively promote the use of contraceptives and make family planning a success, new indicators need to be identified and captured. The role of men must be addressed adamantly and couple's joint decision-making should be promoted as a strategy for increasing family planning use. Furthermore, interventions are needed to improve women's autonomy, education to strengthen their negotiating capacity for family planning use
SPECIAL SEMINAR ON THE WORLD POPULATION DAY
ON JULY 11, 2002
Why is Pakistan’s
Development a failure:
A critical analysis of impeding factors
(Islamabad): Population and Environment Communication Center of SDPI arranged a special seminar on the World Population Day on July 11, 2002 at the SDPI premises.
The basic theme of the seminar whirled around "competitiveness", a term that has emerged strongly in the new era of globalization. In the last decade, it has become a keyword to describe the economic strength of countries, or a position taken by certain companies with respect to its competitors in the market place. At the macro level, competitiveness of nations reflects the standard of living of citizens. National competitiveness is a consolidation of micro-level performances among companies and individuals - true agents of economic growth.
Recent evidence suggests that a key distinguishing factor between high growth and low, or negative, growth countries is competitiveness, which could be mainly achieved through good governance, high productivity and the application of quality management principles (not only in manufacturing and services but also through effective policy formulation and quality of service delivery in Public Sector).
Poor quality of services and low productivity of public sector organizations in Pakistan has led to serious resource constraints. This limits the state's capability of investing in education, health, human capital, and infrastructure, thereby weakening the country's competitiveness to fight the emerging challenges in the post-WTO scenario.
This presentation explored measures through which Pakistan can compete at the global level. Indexes were used as measures of competitiveness to illustrate their usage with graphical examples of competitiveness. Most of the projects initiated in the public sector failed to achieve the desired results due to poor planning, excessive centralization, low empowerment, lack of proper training, resulting in the waste and mismanagement of financial, human, and natural resources. The consequent fallout impact is excessive waste, rejects and scrap causing low productivity, which ultimately lowers economic progress, reduces GDP and low level of income for household utilization.
These factors only increase our dependency on foreign aid, but also stipulate the acceptance of conditionalities imposed by the International Financial Institutions (IFIs). A review of the role of IFIs was carried out with a view to ascertain their contribution through structural adjustment programs in 1980 - 90s.
An overall analysis of the existing state of the public sector, followed by alternative suggestions to overcome the barriers for enhancing competitiveness, through effective state intervention, were presented and discussed by the speaker Dr Ali Sajid and the invited audience. Dr Sajid is a former consultant to the World Bank.