According to World Bank estimates, the Global Fertility Rate (TFR) of women has decreased from about 5 births per woman to 2.4. However, progress in different parts of the world varies greatly. For instance, in Pakistan, the TFR was 3.5 in 2020. In African countries like Niger, Chad and Democratic Republic of Congo, the TFR has remained constant between 2017 and 1960s.
“On the other hand, Bangladesh has been a star performer on fertility reduction, reducing its TFR from 6.7 in 1960 to 2.1 in 2017.” In 2020, World Bank exhorted Pakistan and African countries that they should learn from Bangladesh’s experience. What is Bangladesh's experience and how can Pakistan benefit from it? At the time of Independence, West Pakistan and East Pakistan, now Bangladesh, had roughly equal populations at around 59 million and 65 million, respectively. After Bangladesh became a sovereign state in 1971, its political leadership implemented successful family planning initiatives and the country's population growth rate slowed, with the population currently at 172 million. Pakistan's population has increased more than four times since its inception; during the five decades from 1950 to 2001, Pakistan’s population has increased 430 percent.
Both Pakistan and Bangladesh have quite similar political structures and cultures. Both are religiously conservative societies. The clergy in Pakistan and Bangladesh plays a highly influential role at the social and political level. Both the countries have seen direct military rule for prolonged periods through their political history. Economically, both spent the initial years of their independence in conditions in which they were heavily dependent on foreign aid to sustain themselves. Despite all these similarities, how has Bangladesh succeeded in implementing a successful population planning program and Pakistan has not? The answer to this question will determine what kind of lessons Pakistani society and the state could learn from Bangladesh’s population planning program.
Bangladesh was devastated by the year long civil war that gripped East Pakistan immediately before December 1971. Faced with rampant poverty and high population growth, the political leaders of the new nation reached “a Malthusian conclusion that if the population continues to increase at the same pace, it would outpace available resources. This conclusion was reinforced by the deadly famine of 1974.” The new nation immediately embarked on a population planning program, which produced dramatic results over the next five decades. The new country’s Planning Commission produced a central document for population planning, which proposed a whole-of-government approach in pursuing population planning goals in Bangladeshi society. The Plan document identified the involvement of six other ministries, besides the Ministry of Health and Family Welfare’s central role in implementing the program.
For example, the Ministry of Rural Development was tasked with promoting women’s employment, as well as functional and family planning literacy, through rural cooperatives. The Ministry of Agriculture introduced population and nutrition education in their extension programs. The Ministry of Education, incorporated population education in academic curricula and also created a Department of Population Sciences at Dhaka University, while the Ministry of Information disseminated information promoting fertility regulation through various mass media channels. “These ministries developed projects to implement activities supporting family planning, and Population Control Committees were formed at national and sub-national levels to coordinate action across sectors under the broad ambit of a National Population Council, led by the Prime Minister.”
This, perhaps, is the most important lesson Pakistan could learn from Bangladesh's experience—that a successful population planning program requires the backing of a determined political government. In Bangladesh’s history, political leaders have never been shy in discussing policy objectives of population planning in public.
In this way, the population planning programs were not only the headache of one ministry, but it engaged the whole government’s structures and machinery. Bangladesh’s media and politicians often take pride in mentioning the fact that their first prime minister and founding father, Sheikh Mujib-ur-Rehman was passionate about family planning and the successive rulers of the country didn’t waver in their commitment to make population planning the central policy objective of their governments. This, perhaps, is the most important lesson Pakistan could learn from Bangladesh's experience—that a successful population planning program requires the backing of a determined political government. In Bangladesh’s history, political leaders have never been shy in discussing policy objectives of population planning in public. Whereas in Pakistan, experts have been pointing out the shyness on the part of successive political leaders as the central reason for the failure of successive population planning programs.
Bangladesh’s success in family planning and its economic development and progress went hand in hand during the past five decades. Successive governments in Dhakka made women empowerment policies their central concerns. Population planning was not happening in isolation. It was part of an overall economic and social plan to lift Bangladeshi society out of poverty and out of educational and social backwardness. “While population policy dominated in the 1970s and early-1980s, female education and microcredit programs gained priority in the 1980s and 1990s. Bangladesh’s Second Five Year Plan (1980-1985) focused on reducing poverty, illiteracy and unemployment,” reads a World Bank Report.
In the 1990s and 2000s, Bangladesh achieved notable success in ensuring access to school for girls and poor children. This successful campaign was based on an acknowledgement by the government of the importance of mass education for national development. The majority of the beneficiaries of these microfinance programs were women, who had no prior access to credit.
The growth of Bangladesh’s garment industry was a central factor that made population planning a success. Women in Bangladeshi society provided a ready workforce for the garment industry, and international organizations like the World Bank clearly identify women’s participation in the labor force as an impetus for the reduction of the fertility rate. “Fertility reduction can be driven by different factors, such as female education and labor participation, reductions in child mortality, economic development and urbanization (Kabeer, 2001; Mohanty et al., 2016). These drivers of fertility are themselves interrelated. Female education and employment reduce the desired level of fertility by increasing the opportunity costs of having children. Female education is also associated with reduced child mortality, which has been found to be associated with reduced fertility,” reads a World Bank Report.
The international trade agreements that the Bangladesh government entered into in the 1990s enabled the establishment of large export-oriented garment factories, which employed mostly women, as sewing was traditionally reserved for women in Bangladesh. The rise of the ready-made garment manufacturing sector from 1985 to 2015 has been empirically shown to explain the sustained decline in fertility, the rise in age at first marriage and rapid increase in girl’s education attainment - both in absolute and relative terms. “This is because the garment industry rewarded cognitive skills and increased the returns to education. Altogether, the improved economic position of women and social acceptance of female mobility and employment laid the groundwork for changing fertility preferences,” reads a World Bank report.
Overall improvement in the provision of health facilities in Bangladeshi society played a critical role in reducing the Total Fertility Rate. A World Bank report on Bangladeshi family planning program indicated this fact in the following words, “In areas where child mortality is common, parents give birth to a higher number of children than their desired level of fertility to replace deceased children. Improved health conditions reduce this ‘replacement motive.’” The report also noted that one of the goals of Bangladesh’s Third Five-Year Plan (1980-1985) was to reduce maternal and infant mortality. The government allowed various NGOs to operate in this domain, with support from external aid agencies.
Bangladeshi women played a critical role in the success of population planning programs in their society. An educated and skilled women’s workforce facilitated government plans to reduce fertility rate.
For instance, there was a reduction by two-thirds in the under-5 mortality rate in the 1970s and 1980s, which was attributed to reductions in diarrhea and the administration of vaccines for preventable diseases. “The NGO Bangladesh Rural Advancement Committee (BRAC) contributed to this achievement by scaling up the Oral Therapy Extension Program (OTEP), which taught mothers how to make homemade oral rehydration solutions (Chowdhury, 1996) and helped increase child survival. Gains made in immunizing children contributed to increased child survival, which in turn has been established to contribute to fertility decline in Bangladesh.”
Bangladeshi women played a critical role in the success of population planning programs in their society. An educated and skilled women’s workforce facilitated government plans to reduce fertility rate. Secondly, the government relied on massive utilization of “married, salaried female outreach workers, which were designated as Family Welfare Assistants (FWA) recruited from the communities that they served. “Since FWA belonged to the communities, they enjoyed the trust of rural women, and their jobs gave the FWAs an identity and authority, in addition to empowering them financially. At the peak of the program, 28,000 FWAs were working throughout the country. These women went door to door in their villages and delivered information to improve knowledge about family planning and shift fertility preference to smaller numbers of children. They also provided a range of contraceptive supplies at home. In addition, clinics where FWAs could refer their clients for long-term or permanent contraceptive methods were established,” reads a World Bank report. This program did involve a high financial cost of $120 million in 1995.
Few years ago, the Bangladeshi government invited officials and experts from African countries to study the Bangladesh model of population planning in order to familiarize them with the main features of the program and its successes. A week-long study familiarized experts from African countries with the technical details of the program. Learning about the technical details of the program is the easier part. What is more difficult in the case of Pakistan will be to copy the political determination of successive Bangladesh governments to remain committed to the success of the program. If Pakistan emulates this, the rest will come in due time.