Family Planning in Asia and the Pacific - International Council on ...

<strong>in</strong>volvement <strong>and</strong> poverty, entered<strong>the</strong> agenda, FP lost some of <strong>the</strong> focus.Even <strong>the</strong> MDGs ignored FP until <strong>the</strong><strong>in</strong>troduction of (Target) 5b, which isstill universal access to reproductivehealth broadly, <strong>and</strong> not FP specifically.In 2005, <strong>the</strong>re was a shift <strong>in</strong> <strong>the</strong> IPPFframework to five As with<strong>in</strong> <strong>the</strong> area ofsexual <strong>and</strong> reproductive health (SRH)– Access, Adolescents, AIDS, Advocacy<strong>and</strong> Abortion. S<strong>in</strong>ce Rahnuma/FPAPis a member association of IPPF, it hadto address all <strong>the</strong> As <strong>and</strong>, <strong>the</strong>refore, <strong>in</strong>our performance FP was also a little “defocused”.CEO, <strong>Family</strong> <strong>Plann<strong>in</strong>g</strong> Association ofPakistanNaturally, Pakistan, a country largely dependent on<strong>in</strong>ternational funds for social spend<strong>in</strong>g, <strong>in</strong> particular,suffered f<strong>in</strong>ancially. To <strong>the</strong> credit of <strong>the</strong> Pakistangovernment, however, it did not allow fund<strong>in</strong>g for <strong>the</strong>population programme to suffer; <strong>in</strong> fact, <strong>the</strong> entire amountof funds necessary has come from <strong>the</strong> public exchequerfor <strong>the</strong> last 10 years. None<strong>the</strong>less, <strong>in</strong> <strong>the</strong> very recent past,development funds have been more scarce <strong>and</strong> populationissues somewhat lagg<strong>in</strong>g <strong>in</strong> <strong>the</strong> country’s long list ofpriorities.L<strong>in</strong>kages <strong>and</strong> <strong>in</strong>tegration withhealth <strong>and</strong> o<strong>the</strong>r sectorsOne of <strong>the</strong> ma<strong>in</strong> constra<strong>in</strong>ts faced by <strong>the</strong> populationprogramme <strong>in</strong> Pakistan has been <strong>the</strong> lack of l<strong>in</strong>kageswith o<strong>the</strong>r sectors. <strong>Family</strong> plann<strong>in</strong>g has been as a st<strong>and</strong>aloneresponsibility of MoPW <strong>and</strong> not of <strong>the</strong> M<strong>in</strong>istriesof Health, Education or Social Development. The lack of<strong>in</strong>tegration <strong>and</strong> cooperation has meant limited outreach,limited consensus, lack of <strong>in</strong>novation <strong>and</strong>, <strong>the</strong>refore,extremely m<strong>in</strong>imal impact.MoPW has tried to rope <strong>in</strong> o<strong>the</strong>r socialsector m<strong>in</strong>istries. However, <strong>the</strong> frequentchange of government <strong>and</strong> secretariesmeans efforts need to be repeated over <strong>and</strong>over aga<strong>in</strong>.Director-General Technical, M<strong>in</strong>istryof Population WelfareIt is be<strong>in</strong>g seriously felt that <strong>the</strong> actual partners whowere <strong>the</strong> ma<strong>in</strong> players expected to contribute towardsfull coverage have failed. MoPW cont<strong>in</strong>ued with its ownservice delivery system, <strong>in</strong>clud<strong>in</strong>g 3,853 <strong>Family</strong> WelfareCentres, which are community based, 182 ReproductiveHealth Services A-Centres located <strong>in</strong> district/tehsil(subdistrict) headquarters hospitals, 104 ReproductiveHealth Services B-Centres located <strong>in</strong> private hospitals,292 Mobile Service Units for extension camps <strong>and</strong> 4,835social mobilizers at <strong>the</strong> union council level, all parts ofwhich have been operat<strong>in</strong>g ma<strong>in</strong>ly as st<strong>and</strong>-alone units,<strong>and</strong> <strong>the</strong>y are now expected to be <strong>in</strong>tegrated <strong>in</strong>to prov<strong>in</strong>cialhealth departments.The strong <strong>in</strong>terl<strong>in</strong>kages <strong>and</strong> re<strong>in</strong>forc<strong>in</strong>g relationshipsbetween education <strong>and</strong> population have not beencapitalized upon, with <strong>the</strong> exception of some small effortsat <strong>in</strong>troduc<strong>in</strong>g population education <strong>in</strong>to schools <strong>and</strong>colleges. Several opportunities for jo<strong>in</strong>t programmeshave been overlooked, <strong>and</strong> this has impeded ga<strong>in</strong>s <strong>in</strong>both sectors. In short, if education problems were to beimproved, family plann<strong>in</strong>g programmes would get a bigboost, <strong>and</strong>, conversely, with lower fertility <strong>the</strong> school-agepopulation would shr<strong>in</strong>k, thus reduc<strong>in</strong>g challenges fac<strong>in</strong>g<strong>the</strong> education sector.There is a need to l<strong>in</strong>k education<strong>and</strong> population behaviour. School<strong>in</strong>gcan delay age at marriage. L<strong>in</strong>kagesbetween fertility, education <strong>and</strong> femaleemployment need to <strong>the</strong> promotedtoge<strong>the</strong>r. “Healthy educated girls can doproductive work”.Shirkat Gah (Advisor, Women’s RightsOrganization)Ano<strong>the</strong>r major loss is <strong>the</strong> l<strong>in</strong>k with <strong>the</strong> environment. As<strong>the</strong> recent floods <strong>in</strong> Pakistan have clearly demonstrated,<strong>the</strong> most unsusta<strong>in</strong>able settlements, particularly thoseon riverbanks, were <strong>the</strong> ones to be most adverselyaffected. Scant attention has been paid to environmentalissues s<strong>in</strong>ce <strong>the</strong> comprehensive efforts that were made<strong>in</strong> develop<strong>in</strong>g <strong>the</strong> National Conservation Strategy <strong>in</strong>213