Population control in the world’s sixth most populous nation: Targetting men may be the key

In Pakistan, decisions regarding families and their destinies are made by men. But when it comes to taking responsibility, such as the decision to use family planning methods, the entire burden suddenly shifts on to women.

That trend may be changing, as a recent World Bank-funded study has found that Pakistani men appear ready to shoulder some responsibility. Worried about economic factors, men from middle and lower-middle social classes are eager to learn about family planning methods and want to limit family size.

This qualitative study, carried out by a New York-based nonprofit Population Council, was conducted in four districts of Punjab. The province is a good choice to conduct such a study as Punjab houses approximately 56% of Pakistan’s 180 million people, making it the country’s largest province by population. Furthermore, Punjabi men’s perception of contraception and the concept of family planning has been largely negative. Statistically, this makes Punjab a good representative sample of the general population of Pakistani men, allowing policymakers to use these findings as the basis of national population control initiatives.

The authors, Iram Kamran, Mumraiz Khan, and Zeba Tasneem, conducted one-on-one interviews with men and focus groups with families, and arrive at some fascinating conclusions. Two of the study’s findings have particularly important policy implications.

Firstly, they find that over the past two decades, there has been an increase in desire among men to gain more knowledge about fertility and birth control methods. Usually the sole breadwinners in the family, men have come to recognize that raising large families is financially unsustainable and thus having less children could be economically advantageous.

Secondly, the study found that it is not a lack of will but supply-side problems that are impeding men’s use of contraceptives. Subjects said that they were unable to find avenues for more information on these matters and expressed demand for male health workers, along the lines of the lady health workers program for women.

This second finding is particularly important from a policy perspective. Population control initiatives in Pakistan have largely focused on women, primarily due to the social belief that all things related to children are a woman’s domain. However due to deeply-entrenched patriarchy in our culture, when it comes to making a decision,the word is the man’s. This means that although women are more aware of the concept of contraceptives and family planning than men, the success of Pakistan’s population control initiatives remains low because their focus is on a group of people who, although should be, are in reality not in the position to make the decisions. Research conducted in 2013 among women in Punjab found that one of the main obstacles to contraceptive use among women is the perception that such behavior would conflict with their husbands’ fertility preferences.

The findings of this study could mean a reverse of that trend, even though the change in men’s attitudes towards family planning and contraception has not happened for social reasons.

It may seem overly optimistic but involving men in the process could not only lead to higher success rates in the use of family planning methods, but also an attitudinal change in men that is much needed in Pakistani society. I make that claim by combining two findings of the study: men are wary of contraceptives because of perceived side effects of modern methods, and fewer men than women believe that religious leaders should be involved in the debate on contraception. This means that one of the reasons that Pakistani men are currently not using contraception is a lack of information, not will to do so. Further, they feel that contraception is a scientific or cultural topic that does not require religious intervention for legitimacy. This could make them a ripe target group for future population control initiatives that may see more success than those in the past.

This blog first appeared at The Word Theatre here

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