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THE CHALLENGE OF DEMOCRACY

Population Control Remains Top Priority for Bangladesh

Bangladesh faces the challenge of institutionalising democracy after fifteen years of recurrent military and autocratic rule. In this struggle, population control and human resources development are two important factors for moving the country towards sustained economic development and political stability.

by Dr Mohammed A Sattar
BACK In 1975. population was declared by the Go
। vernment as the Number One national problem During the lust sixteen years, sueces
I slve governments have trans luted the policy declaration Into a priority programme of population control and family planning. In November 1975,
। when I took over as the i Secretary to Ministry of Family I Planning, only 7% of the fertile couples were practising family
I planning and the population I growth rate was 3.2%. In 16 | years Bangladesh has made | some significant progress by | increasing the contraceptive prevalence rate (CPR) from 7% to 35% and the population growth rate declined from 3 2% to 2.17%. The total fam Uy size (TFS) has also declined from 7 to 4.5.
These achievements sound good as compared to the neighbouring countries of | Pakistan, Nepal and Myanmar and the Northern Indian
| States of Bihar, Madhya Pradesh. Uttar Pradesh and Rajasthan. However, despite
I the lower rate of growth the | large base of population of 75 • million in 1971 has now in-1 creased to 115 million, an ad 1 dition of 40 million in 20 years. About 2.5 million is be-
. Ing added annually.
[ In spite of the generous external aid of about S22 billton that Bangladesh has received since 1972, economic growth remains low, on the average, 0.4% annually. Bangladesh continues to remain a poor country, at the bottom of most comparative Indices such as the human development Index, education, women's status, per capita Income. Due to the pressure of exploding population, the ecological support system Is breaking down and the environmental protection is giving way to recurring cyclones, : floods, droughts, tidal waves | and other calamities. These
are Indications of the desperate struggle of poor people
I moving to marginal land such . as offshore islands, river banks, low lying areas and getting overwhelmed.
Bangladesh Is almost in the j population trap of high popula-' tlon growth and low level of economic development (Prof
I Mourice King). To come out of ] the desperate situation, radical. bold and strategic interventions in the family planning
programme must be pursued more vigorously by the present democratic regime. Some of the possible strategic Interventions are :
Strong political support must continue in terms of programme priority and resource allocation. By a national consensus family planning programme must be kept above political controversy so that resources arc not wasted un-ncccssarily and social mobilization for the programme progress unimpeded.
It must be understood that there Is a large bottom up un met demand for family planning from the 30% poorest of the poor for sheer survival of themselves and and their living children. A number of pilot projects, such as ICDDR.B (Matlab/SlraJgonJ). GTZ (Mun shiganj), BRAC (Manlkganp and BACK (Panchugram) show that even in low k-vcl of socio-economic development in ini.il Bangladesh up to 50% CPR can be achieved with good quality family planning services.
Areas of direct interven Hons which have shown good results must be sustained, such as, women's education and employment, menstrual regu latlon (MR) on demand, raising age of marriage and encouragement of breastfeeding and natural family planning.
Strong support for women’s education, training, employment and higher status in so cicly must be sustained. With Begum Khaleda Zia as the Prime Minister there should be more enthusiastic support for women's development, employments and higher sta tus.
Raising ages of marriage for
females from present 16 years to at least 18-20 years and for males from present 18 to 21-23 years has to be considered as an imperative.
At present an estimated 17% pregnancies end In abor Uon. Government's support (or menstrual regulation (MR) must be continued more widely In the rural clinics and effort should be made to liberalize abortion law at least to the level of the neighbouring countries of India and Srl Lanka.
An understanding of the donors and right to life groups is needed for provision of bet -ter and easily accessible family planning services to poor and rural people so that desperate demand for abortion Is re dueed.
Breast feeding and traditional family planning methods should be encouraged even if Ilie methods are considered relatively unsafe. The religious groups no longer oppose family planning, although they may differ on methods. Efforts should be made as Is being done in Indonesia, to win positive support of religious institutions for family life education and child spacing.
A strong political will should be able to Induce an Integrated health/family planning service delivery system to work efficiently. Constant bickering and conflicts between these two departments waste most scarce of human and physical resources.
With donor and government support NGOs have played an important role in providing primary health care and family planning services and mobilizing strong community support
to family planning. This move should be encouraged more vigorously.
Human Resources Development
NARROWER CONCEPT OF 11 RD : The narrower concept of human resources development refers to the HRD for the population programme Itself. With generous assistance from donor agencies such as the World Bank. USAID. ODA (UK), etc. Population Programme in Bangladesh has developed a series of 32 training institutes for Ils 40,000 paramedical and field workers under the um brella of the National Institute of Population Research and Training (NIPORT), The programme has well-trained and cupibk- clinical and managerial professionals. Similarly the NGOs have their own training facilities supported by donor agencies.
BROADER CONCEPT OF HRD : Human development under a dynamic state of economic growth meets the ever Increasing demand for basic needs of education, health, training, employment, income and freedom of choice. Adequate Income earning op portunltics and public spending on human priority needs arc essential for human development. The UN Human Development Index (HDD 1991 shows Bangladesh ranking at 136 (out of 160 countries) with life expectancy al 52 years, literacy at 32.2%. The HDI Index 0.186 (out of 1.00) for Bangladesh. Is just above Nepal, Bhutan and Afghanistan.
Population control and hu man resources development arc closely related. In Bangladesh, population pres sure on scarce development opportunities and social services will continue to limit policy options when an estimated 80% of the population live below the poverty line and 50% of the rural population are landless, public sector will have to play the crucial role in human development The new democratic regime has taken some Initiative and continued to support the on going (HRD) programmes.
Some of these are :
Primary education Is a basic human right. The government has declared primary education as compulsory. BRAC and BACE provide cost-effcctlvc models of primary education.
To encourage female education school fees have been made free for girls up to class Vlll. BACE stipend programme shows that .one pound a months stipend can keep a girl at the secondary school.
To encourage adult literacy and Informal vocational training for rural unemployed, community education system has been Introduced.
To empower the poor rural and disadvantaged groups "Gram Sarkar" system has been reintroduced.
To channel credit to the poor, particularly for women the Grameen Bank activities are being supported.
Employment of women has been encouraged systematically — 15% of the government Jobs. 50% of primary school teachers have been reserved for women. In the private sec lor garments Industry is now employing about 250.000
women. Time have far reach tng Impact on social mobilization. providing Jobs outside homes and strengthening ■omen's status.
The Government Is encour aging manpower export Thousands of educated young people are on the move seek tng opportunities abroad lor work and Income They need to be supported with training in language and skills
The political base for hu man development has definitely improved under the democratic regime But In a stagnant economy, resources must be mobilized both Internally by economising on resource utilization and externally by a better use of funds. The pledging of 82.3 billion in the April 1991 consortium meeting Is an indication of continued support to Bangladesh by donor agencies.
The internal resources must be utilized more efficiently. The UN Human Development Report 1991, shows thal Bangladesh spends 12% of GNP for health and education and 1.5% for military expenditure. Il suggests a freezing of military expenditure. reduction of subsidy on public enterprise and hard measures on eliminating cor ruption In public offices, thus releasing resources for human development. This will in turn facilitate sustained economic growth
People arc ready to act and build up the country and reap the fruits of freedom. Transition to democracy has freed the spirit of man and raised hopes, the leadership must not fall again Bold leadership and decisions arc needed In the area of population and human resources development.
The writer. a dlsttnguisfed economic expert who served as the head of the International Committee for Population Management IICOMI1 In the last years of his career, passed away tn Islamabad last month during an official visit to Pakistan. The article here, published for the first time, has been made available to this paper by the writer's wife, Dr Ellen Sattar. It is based on a talk given by the writer at the South Asian Studies Centre, London University last February.