Ask any one about Pakistan's biggest problem right now and you will get a myriad of answers. America, Nato supplies, Indian threat, employment generation, education, health services, economic infrastructure, law and order, militancy and depleting ecology, food and water resources. Very few will actually say population growth. In fact, silly people even comment that we need a high population to replace those dying due to terrorism. Little attention is being paid to the issue, officially or privately. Overpopulation is a major concern at a global level.

When in October 2011, the global population crossed the 7 billion mark, it didn't alarm us Pakistanis. In 1947, united Pakistan i.e., former East Pakistan and West Pakistan was the 13th most populous country in the world with a population of 32.5 million. Today, Pakistan is the sixth most populous country in the world with a population of approximately 180 million. By 2050, we will be the fourth most populous country in the world. We have the highest population growth rate (2.03 per cent) amongst SAARC countries.

After the disintegration of the eastern wing, Bangladesh's population was recorded to be 71 million whereas Pakistan's population was 62 million at that time. However, after 40 years, Pakistan's population has crossed 180 million whereas Bangladesh's population is 150 million. The reason behind Bangladesh's controlled fertility is its successful family planning programme, which wouldn't have been possible without serious government commitment. In Pakistan, governments have been launching family planning programmes dating back to General Ayub Khan's era. Ever since the beginning, it has met with severe resistance as the population is largely conservative. Religious sections have also been very active in denouncing and forbidding offspring control, claiming that it is blasphemous to meddle in the works of God. However, population control has been successful in Indonesia, Iran and Bangladesh, all predominantly Muslim countries.

The government is not popular so neither are its policies, even if they are good-intentioned. I recall once at a conference, Humera Alwani, MPA of PPP, shared an encounter; she was visiting a flood camp in the interior Sindh when she came across a woman who had given birth to her 22 child. Alwani was shocked and asked the woman how would she feed the child? The woman took offence at Alwani's question and reaction and replied that the government hadn't given her anything and now the government was trying to jinx her only asset - producing offspring. Here one can blame illiteracy and low-status of women. Women are accorded respect as per the number of children they have. Besides, in lower-income groups, children are treated as units of production, where their hands are used in family labouring. Thus the demand for children remains high in rural and slum areas. It doesn't matter if later those children live a dehumanised life - their parents would curse the government and society for their impoverishment.

However, a major factor for our population growth is unwanted births due to lack of contraception. Actual usage of contraception has stagnated at just 30 per cent for several years. At a conference organised by a local NGO recently, there were young brides who had one or two children and didn't want anymore. Unfortunately, they didn't know anything about condoms, birth control pills etc. However Jinnah Institute's report 'Population in Pakistan: Holding the seams together' claims that women are aware of contraceptive methods, even the modern methods but it is the un-availability of contraception and lack of female mobility that stops them from using it. It is an established fact that men have higher bargaining power in the Pakistani household. Having their permission when it comes to contraception and spacing of births is deemed necessary by women in our society. The permission is not always granted.

Early marriages and lack of sufficient birth spacing are also major culprits. Son preference plays its part too. In Pakistan, a common statement at a daughter's birth is that 'don't worry, next time it will be a boy'. This puts pressure on the women to conceive again till she finally gives birth to a son. According to Pakistan Demographic and Health Survey it was found that 65 per cent of women with three boys did not want any more children while only 14 per cent of women with three daughters said the same.

Population explosion is a root cause of the intergenerational poverty cycle, which in turn feeds both social and economic issues in developing countries. Population bomb places pressure on land, water and food. With rising consumption, more resources are utilised and more trash is produced, which causes environmental degradation. While the poor segments of the society hardly consume the way the upper class does, their dependence on nature for basic needs strains the ecology. Population burden has already caused shortage of gas (of course the blame lies in mismanagement too). Unavailability of gas means poor communities will use wood as fuel and sell tree wood to eke a living.

Besides Pakistan is rapidly urbanising, which means consumption patterns are rising greatly. Crowded cities and congested towns lead to fight for space and unemployment, which is giving rise to more criminal activities. Also, as being witnessed in major cities of Pakistan, apartments are being built on every open space the builders can get their hands on. This accommodates the people but leaves us with little breathing spaces.

Migration of refugees from Afghanistan has also put pressure on our population. Despite all the government efforts, no proper registration of Afghan refugees has taken place.

Mehtab Karim, senior fellow and affiliated professor at George Mason University conducted a survey last year among college and university students of Pakistan, which he presented at a seminar organised by Rahnuma in November 2011. Although, the research sample is too narrow but still it gives us a picture of the prevailing mindsets. Only 50 per cent thought that population growth was a problem and 32 per cent thought family planning to be un-Islamic. Only four per cent girls wanted more than five children. It is important to mention that the youth of Pakistan makes up approximately 65 per cent of the population.

Lack of family planning puts severe pressure on women's health. To terminate unwanted pregnancies, women resort to unsafe abortions, as abortions are illegal under the Pakistani law. This accounts for a major chunk of maternal deaths. It would be better if contraception is used before-hand.

Rahnuma is an NGO working for Sexual and Reproductive health rights. It started off as Family Planning Association of Pakistan in 1953. Over the years, its network has expanded greatly and it relies heavily on youth volunteers through engaging them in various activities. One such youth member, Ali Rizvi based in Karachi, shares that once he went with the Rahnuma team to facilitate a workshop at a government school in Hub area on the outskirts of Karachi. The attendees were made aware of the hazards of unchecked population growth. The majority of the staff equated family planning to abortion and termed it un-Islamic. However, such attitudes are rampant and the NGOs have to exercise great patience while changing mindsets. Since most NGOs get their funding from abroad, mostly international organisations, they are eyed with suspicion. Nonetheless, we can't deny the fact that there are certain people and NGOs who are genuinely working hard to create awareness among women regarding family planning. 

Agha Khan Hospital's role has been positive in promoting Planned Parenthood. Women are tutored on benefits and methods of planning their offspring count soon after they deliver their first baby. Such an approach should be replicated in public and charity hospitals. It is also important to include the husbands in the whole process so that they are also aware of the situation.

With depleting environment and a despicable law and order situation, it is high time that family planning gets the attention that it truly deserves.