Reproductive Goals and Family Planning Attitudes in Pakistan: A Couple-level Analysis

Based on the responses of 1260 matched couples in the 1990-91 Pakistan Demographic and Health Survey, this study examines how congruent wives’ and husbands’ attitudes towards fertility and family planning are, and to what extent the similarity or difference in attitudes affects their reproductive control behaviour. The results show that about 60 percent of the couples have given similar responses (agreeing either positively or negatively) to several fertility-related questions, whereas the remaining 40 percent differ in their attitudes. Multivariate analyses indicate that a couple’s joint approval of family planning, husband’s desire for no more children, and spousal discussion about family planning stand out as the strongest predictors of contraceptive use. These findings clearly suggest that the role of couple agreement is important in promoting the use of family planning, and that men should be made as equal targets of such programmes in Pakistan.

Transition in Primary and Secondary Schooling in Pakistan: Gender and Age Cohort Analysis

This study assesses the changing pattern of school attendance through age cohort analysis for both males and females in Pakistan. Based on the 1998 census data on educational attainment, the results indicate a profound rise in school attendance among younger age cohorts contributing to elimination of gender gap in primary-level schooling in urban areas only. The disadvantaged situation of rural females is reflected by a combination of low school entries/attendance to begin with, and high chance of discontinuing education before completing primary levels. The pattern of school transition reveals that among those few who have completed Class Five, the chances of staying through the secondary level are much higher—after which dropout accelerates rapidly. Two overall conclusions emerge from these results. First, the bulk of the deficit from universal primary education comes from females population, especially in rural areas. Second, the key to reducing dropouts and gender gap in school attendance lies in actions that raise the demand for schooling of girls, with equally matched availability of quality primary- and secondarylevel schools. It appears that achieving universal primary education by 2015, as mandated in the Millennium Development Goals (MDGs), remains a tall order for Pakistan.Primary Education, Secondary Education, Schooling, Pakistan

Gender Differences in Child Health-care Practices: Evidence from the Pakistan Demographic and Health Survey, 1990-91

Among other factors, health care utilisation is important in determining the health status and survival chances of children. The patterns of childhood mortality, in general, indicate that deaths of male children have consistently exceeded those of females, with a much greater difference in the first month of birth (NNR). This has largely been attributed to differences in the genetic and biological factors between the sexes [Lopez and Ruzika (1983)]. The mortality level, thereafter, is influenced more by the socio-economic, environmental, and health care factors, indicating a mortality disadvantage for females in some populations. It has therefore been postulated that gender-based differences in health care practices partly explain the sex differentials in child mortality in some countries of South Asia, where healthseeking behaviour of parents discriminates against female children [Chen, et al. (1981); Das Gupta (1987); Sathar (1987); Ahmed (1990)]. Using data from Bangladesh, Chen, Haq, and D’Souza (1981) found that girls’ mortality risk was nearly 60 percent higher than that for boys after the neonatal period, and that girl children suffered more malnutrition and received lesser treatment for various infections. Das Gupta (1987) and Muhuri and Preston (1991) also explained the excess mortality of girls with a surviving elder sister in terms of conscious, selective neglect of the second daughter. Waldron (1983) in her extensive review of child mortality patterns in developing countries concluded that besides relative contributions of specific causes of death with different impact by sex, the variability in discrimination by gender, primarily in nutrition and health care utilisation, also contributes to excess female child mortality.

Factors Affecting Contraceptive Use in Pakistan

Using data from the Pakistan Demographic and Health Survey of 1990-91, this study examines the effect of selected socio-cultural and supply factors on contraceptive use as reported by married women of reproductive ages. In addition to the expected positive relationship of woman’s age, number of living children, education, and place of residence with contraceptive use, it is theorised that there are five factors potentially affecting fertility regulation in the socio-structural context of Pakistan. These include the extend of communication between husbands and wives, religious beliefs, female autonomy, son preference, and the family planning service and supply variables. Using logistic regression analysis, the results of the study indicate that the explanatory power of these five factors is significant in affecting the use of contraception in both urban and rural areas. While knowledge of a source for family planning is the strongest predictor of contraceptive use, husband-wife communication and religious attitudes are also significant. The fact that the inclusion of the theoretical variables dampens the predictive effect of the primary and secondary education for women leads to the speculation that while the extremely low levels of literacy among women must be addressed through government commitment to universal education, scarce family planning programme resources can be focused more effectively on promoting spousal communication, about family size and contraceptive use, and on soliciting the support of religious leaders to counteract the misperceptions about Islamic teachings on family planning and reliance on fate. With high quality and accessible services, these measures could go a long way towards providing couples with the means to meet their reproductive goals.

Women’s Role In Domestic Decisionmaking In Pakistan: Implications For Reproductive Behaviour

Women’s involvement in domestic decision-making is recognized as a distinct aspect of her autonomy that has its implications for reproductive behaviour. Using data from the Pakistan Fertility and Family Planning Survey 1996-97, this study examines the extent of Pakistani women’s participation in household decision-making relative to their husbands and other family members, and determines its effects on the demand for children and higher contraceptive use in both urban and rural settings. The findings reveal that women’s decision-making authority is clearly related to the context in which they live as urban women have an almost equal say in household matters, as their husbands, whereas most rural women report that their husbands and other family members have a predominant role in household decisions with regard to seeking medical treatment for a sick child or to make purchases of household items. The results also indicate that women with greater freedom to go outside home alone are also more likely to participate in domestic decisions, and the linkage is stronger for rural than urban women. The multivariate analysis reveals that the effect of decision-making variables on measures of reproductive behaviour is strongly conditioned by socio-economic and demographic factors, implying that measures of women empowerment give only a partial explanation of women’s likelihood to desire fewer children and increase contraceptive use. The results in all suggest that Pakistani women’s enhanced role in household decision-making has its effects relevant to achieving gender equality and fertility reduction outcomes - the goals that are central to population and development policy

Noriyuki Takayama (ed). Pensions in Asia: Incentives, Compliance and Their Role in Retirement. Tokyo: Maruzen Co. Ltd. 2005. 256 Pages. Hardbound. Price not given.

In view of the rapid ageing of population in many Asian countries due to a longer life expectancy and a fast decline in fertility, the concerns about the sustainability of public pensions and social security systems have gained increased relevance both at policy and planning levels. Countries that have already experienced demographic transition and indicate rising trends in old-age dependency rates are facing a challenging situation not only to improve their pension systems but also to comply with the financing of retirement and old-age benefit schemes. The effects of an ageing population in these countries are becoming apparent in terms of increasing costs of the health-care system, social security schemes, and changing social attitudes towards older people that demand an assessment of the support base to meet their socio-economic needs

Reproductive Goals and Family Planning Attitudes in Pakistan: A Couple-level Analysis

Based on the responses of 1260 matched couples in the 1990-91 Pakistan Demographic and Health Survey, this study examines how congruent wives’ and husbands’ attitudes towards fertility and family planning are, and to what extent the similarity or difference in attitudes affects their reproductive control behaviour. The results show that about 60 percent of the couples have given similar responses (agreeing either positively or negatively) to several fertility-related questions, whereas the remaining 40 percent differ in their attitudes. Multivariate analyses indicate that a couple’s joint approval of family planning, husband’s desire for no more children, and spousal discussion about family planning stand out as the strongest predictors of contraceptive use. These findings clearly suggest that the role of couple agreement is important in promoting the use of family planning, and that men should be made as equal targets of such programmes in Pakistan

Transition in Primary and Secondary Schooling in Pakistan: Gender and Age Cohort Analysis

This study assesses the changing pattern of school attendance through age cohort analysis for both males and females in Pakistan. Based on the 1998 census data on educational attainment, the results indicate a profound rise in school attendance among younger age cohorts contributing to elimination of gender gap in primary-level schooling in urban areas only. The disadvantaged situation of rural females is reflected by a combination of low school entries/attendance to begin with, and high chance of discontinuing education before completing primary levels. The pattern of school transition reveals that among those few who have completed Class Five, the chances of staying through the secondary level are much higher—after which dropout accelerates rapidly. Two overall conclusions emerge from these results. First, the bulk of the deficit from universal primary education comes from females population, especially in rural areas. Second, the key to reducing dropouts and gender gap in school attendance lies in actions that raise the demand for schooling of girls, with equally matched availability of quality primary- and secondarylevel schools. It appears that achieving universal primary education by 2015, as mandated in the Millennium Development Goals (MDGs), remains a tall order for Pakistan

T. Nirmala Devi. Population Growth and Development in SAARC. New Delhi: South Asian Publishers, 1996. Hardbound. Indian Rs 160.00

The complex relationship between population growth and socio-economic development has long been debated. The arguments about the direction and causality of the relationship between population growth and development indicators remain inconclusive. The available literature on the subject reflects three main ideological groups. Nationalists see population growth as a stimulus to economic development, whereas the neo-Malthusians see it the other way round. The Marxists, however, see the population problem being solved in terms of development through a socialist model

Pension and Social Security Schemes in Pakistan: Some Policy Options

An examination of the public pension and social security schemes in Pakistan reveals that the provision of regular pensions is limited to formal sector employees only. A number of social security schemes that are operational in the public and private sectors cover a small proportion of old-age population, whereas a significant proportion of the elderly population working in the informal sector remains largely unprotected by social security schemes. As such, the challenge of meeting the needs of the increasing elderly population demands an improvement of the support base and social security system in Pakistan that emphasises the need to implement reforms of public pensions and programmes of social protection. Efficient deployment of resources and improvement of the governance structure are needed for effective welfare of the eligible sub-group of the elderly and the economically disadvantaged population.Social Security, Pensions, Pakistan