Take the population boom by the horn

Alpha Arzu

Photo: Amirul Rajiv

Family planning not only allows couples to plan their families, it also saves lives as it provides couples the ability to plan to have their children not too early in life, not too late in life, not too soon after another child and not too many. It is estimated that family planning alone could reduce the number of maternal deaths by as much as 40 per cent. Access to contraception is the way to prevent unplanned pregnancies.

Family planning and population issues must continue to be priorities. If we are serious about saving women's lives, family planning must remain at the centre of the nation's agenda.

Also family planning greatly contributes to our vision of a Bangladesh where every pregnancy is wanted and every birth is safe, according to a UNFPA statement about the family planning, which opens our eyes to think and re-think about the population and family planning issues.

Though the government and other national and international institutes have identified “over population” as number one problem in the country, there is no significant attempt to make them skilled or bring them in the mainstream development activities of the country.

Bangladesh appears as most unstable country due to soaring population density, poor land-man ratio, slow economic growth, massive unemployment and huge working age population relative to the size of job market.

Ours is the eighth most populous country with about 160 million people in 147,000 square kilometer, which has drawn considerable attention in the world. The social scientists, non-government and international organizations and policy makers are giving their emphasis on the population issues.

At least 2.3 million people are currently being added to its existing population, that will continue in the next one and a half decade, even if Bangladesh achieves two- child family, said a researcher working in the area of population in past two decades, Prof Mohammed A Mabud.

Young population (below 15 years) make sup 40 percent of total population and reproductive women aged between 15 and 49 years account 39 percent of all women.

As life expectancy is gaining, the size of the elderly population will increase and thereby, increasing the dependency burden. In recent years, there has been tremendous improvement in some demographic parameters.

Urban- rural difference in fertility is quite substantial. As expected, TFR for rural woman is 2.8 and that of urban woman is 2.4. TFR was platitude 3.4-3.3 during 1991-2000, followed by sharp decline by 0.6 during this decade. It varied widely by administrative Divisions. Khulna reached replacement level of fertility (2.1), followed by Rajshahi (2.4), Dhaka (2.7), Barisal (2.8), Chittagong (3.2) and Sylhet (3.7), according to the Bangladesh Demographic Health Survey, 2007.

Photo: Amirul Rajiv

The 2001 Population Census revealed rural-urban population distribution was 77:23. In recent years, rural-urban migration has increased steadily. Expert opinion is that current rural urban population distribution is 73:27. Almost 85 percent of the rural migrants are absorbed in four main cities in Dhaka, Chittagong, Khulna and Rajshahi.

Death matters no less than birth indeed more, to demographers. As public health measures are likely to further improve, deaths decline particularly among the infants and thus, more babies will live to grow up. So a country's population becomes more youthful as in the case now in Bangladesh. More young adults mean more births. Birth rate may decline further through family planning program efforts reinforced by non-family planning measures like female education, skill training, use of media etc.

All these measures will eventually help create conducive environment to reduce birth and death rates leading to population stabilization.

Population, maternal and child health experts expressed that the family planning programmes is now more concentrated on maternal and child health issues, but which should concentrate to popularize usages of contraceptives methods among all, just similar to 80's or 90's family planning methods campaign.

In 1980-90, family planning programme was more concentrated to provide contraceptive methods among all eligible couples, which is now diverted to ensure maternal and child health rights which is ultimately causing to increase the population and unplanned families. Family planning field officials and health service providers went door to door to give the message of family planning and its services including pills, condoms to the couples directly.

In Bangladesh, women are still the main stakeholders of the family planning methods and they are shy to talk about it with their family members and in most cases, they do not know about the contraceptives usages and it's availability. They need to depend on their husband or partners.

Illiteracy, ignorance, shyness and poverty mostly deprive the women from all sorts of facilities including their access to a clinic or pharmacies to buy the contraceptives. This is not only the picture of rural areas of the country, but also of urban areas.

The size of the school age population in absolute number shall decrease to 32.4 million against 34.2 in 2001; while the working age population (15-64) will increase up to 155 million (as against 85 million now), aggravating further the strained labour market; and number of elderly population (65 year+) shall be 29.8 million as against 5.8 million now requiring old age supports and medical care. The other obvious implications include: population density of 4157 persons per square mile as against the present density of 2591 persons. The existing man-land ratio of 1:14 decimals shall be reduced to a half.

Population growth momentum has already started; and various pressures have already been generated. In our present case, if Bangladesh can achieve NRR=1 by 2016, population will stabilize by 2070 at around 230 millions, followed by a stationary population in next 12-15 years.

Population momentum is coming from low-income families, such as poor, ultra poor and other lower income groups who together comprise 50 percent of the society. These are the people among whom infant mortality and maternal mortality rates are the highest. Total fertility rate is twice as much of the upper, middle and high-income groups. They are the ones who have very little access to education beyond primary, health care services and other benefits which government and society usually offer to the individuals.

Prof Mabud who works in the area of population for the past three decades said that managing population would require some deliberate planned actions, including balanced distribution of rural-urban migrants and relocation of industries from the cities, increasing people's mobility.

Managing urban population in four big cities in Dhaka, Chittagong and Khulna shall be one of the major tasks of the government. At present, urban-rural population distribution, as noted elsewhere in this paper is 27:73. Among the rural migrants, about 80.0 percent are absorbed in these these cities and the rest in the remaining 60 district towns of the country.

More schools, more spacious roads and public transportation facilities, more supply of gas, electricity, pure water etc is to be afforded for the city dwellers. All these shall require 15-17 times larger investments than the government's current spending.

As a part of government's population management strategy in urban area, government may attempt to reverse the current trend through planned infra-structural development in remaining district headquarters and selected Upazilas to upgrade them as the second tier modern cities and towns in a period of ten years.

Photo: AFP

These emerging cities and towns should have proper connectivity with big cities along with all modern facilities so that rural migrants become attracted to go there for employment, business and education and eventually for settlement. The emerging cities and towns should have education, business, industries, spacious roads, public transportation facilities.

It is assumed that 70 percent rural migrants may go to newly emerging towns and the rest 30 percent may come to the big cities. This kind of shift may take time, but eventually it will happen, provided we pursue the above policy.

One of the reasons for overcrowding, congestion and pollution is the location of many industries in the heart of the big cities and their adjoining areas.

Of the factors of population growth- birth, death and migration, Bangladesh has quite a number of programs to reduce birth and death rates, but nothing to influence migration, which is third factor of population growth, experts opined.

The Directorate General of Family Planning of health and family welfare ministry initiated to amend the National Population Policy (draft) 2010 to popularize the one-child policy. The policy is initiated to improve the status of family planning and maternal and child health, including reproductive health services, and to improve the living standard of the people of the country by striking a desired balance between population and development in the context of the Millennium Development Goals (MDG).

The objectives of the population policy are to reduce the total fertility rate (TFR) and increase the use of family planning methods among eligible couples by raising awareness of family planning.

An important aim of the policy is to provide food, social security, and shelter for the disadvantaged, including the elderly, destitute, and physically and mentally retarded persons. The policy also emphasis to regulate and reduce rural-to-urban migration, ensure safe drinking water,

Family planning was introduced in Bangladesh in 1950s through the voluntary efforts of social and medical workers. The government, recognizing the urgency of moderating population growth, adopted family planning as a government-sector program in 1965.

The policy to reduce fertility rates has been repeatedly reaffirmed by the government of Bangladesh since independence in 1971.

In 1976 the government declared the rapid growth of the population as the country's number one problem and adopted a broad-based, multisectoral family planning program along with an official population policy.

The government's present focus of population program includes ensure safe motherhood including Emergency Obstetrics Care (EOC) services with provision of Skilled Birth Attendants (SBA), increase male involvement in reproductive health especially in Family Planning, increase acceptance of long acting and clinical FP methods with male participation

The country faces many decades of continued population growth. Efforts to slow that growth need to continue, both through the family planning program and, increasingly, through social and health interventions that will facilitate further fertility decline, so that progress towards economic development is not hindered.

Sources: BDHS 2007, Bangladesh Population: Prospects, problems and remedies of Professor Mohammed A Mabud and State of World Population of UNFPA

The writer is Senior Correspondent, The Daily Star.