The World Population Day is observed all over the world and Pakistan on July 11 every year. The United Nations Fund for Population Activities (UNFPA) announces a theme for each year for advocacy and to focus on the activities being undertaken by countries on population and development areas. The theme for this year is "Vulnerable Populations in Emergencies".

In the under-developed and developing countries, women have always been the most vulnerable group of the society, who are always at the losing end in development share and resources allocations, social advancement and education attainment, general health and reproductive health services and empowerment.

A recent report based on the address of Dr Babatunde Osotimehin, UN Undersecretary-General and Executive Director of UNFPA, truly addresses the issues of this vulnerable population. Dr Babatunde stated that "women and girls are disproportionately affected by hunger and poverty because of discriminatory practices against them. Leaders at this year’s UN General Assembly will focus on progress made since the 1994 International Conference on Population and Development, a groundbreaking moment for women, and their right to control their lives and fertility. But the 20-year review takes place against a backdrop of ongoing violence against women, and attempts to take back control of their bodies."

He further said, "What we are seeing in the news every day is the very visible perpetration of that violence. And the ongoing moves to take away women’s choices and access to contraception and family planning are a grave threat to women’s rights, health and freedom, and the well-being of communities and nations around the world."

As of June 20, 2011, the human population of the world was estimated by the United States Census Bureau as 6.89 billion which is 7.32 billion presently. The Population Reference Bureau, USA reports that it took from the dawn of time to the year 1830 for the world to achieve a total population level of one billion. By 1930, that figure had doubled to two billion which means it took 100 years for another billion. By 1976 it gained four billion, this time it took only 46 years. The addition of next billion took only 12 years. i.e., the world was carrying the load of five billion people in 1988. It took another 12 years to reach six billion in 2009. And now it is over7 billion. The world’s population is expected to reach 9 billion between 2040 and 2050.

The population of Pakistan was 32.5 million in 1951, at which time it was the 14th most populous country in the world. Its population has since increased approximately 5.5-fold, reaching 184.5 million in 2012-13. Pakistan is now the sixth most populous country in the world (Government of Pakistan, 2013). The current population growth rate is 2 per cent. According to estimates, Pakistan will become the fifth most populous country in 2050 at its current rate of population growth (Government of Pakistan, 2013). This scenario presents a picture that could be devastating for the country’s already scarce national resources.

To control the ever increasing population, it is imperative to empower women socially and economically with access to reproductive health services. Pakistan Demographic and Health Survey 2012-13 reveals that contraceptive use is positively associated with women’s empowerment. Economic empowerment gives women an opportunity for increased participation in family making, and it is expected that women who are employed and who receive cash earnings will have more control over household resources.

Currently, women in Pakistan have an average of 3.8 children. This is comparable to Tajikistan, but higher than Nepal, and Bangladesh. Knowledge of family planning methods in Pakistan is universal; 99 per cent of ever-married women and 95 per cent of ever-married men know at least one modern method of family planning. The contraception use is lower than 35 per cent, approximately one-fourth of Pakistani women wish to either delay the birth of their next child or end childbearing altogether.

Public sources, such as government hospitals and lady health workers, currently provide family planning to 46 per cent of current users, while the private medical sector provides methods to 35 per cent of users. Nearly 40 per cent of currently married women and men want no more children. Nineteen per cent of women and 21 per cent of men want to wait at least two years before their next birth. These women can be the potential users of family planning methods, but the problem is the provisions of reproductive health services.

Listed as the sixth most populous country by the United Nations, according to the latest reports by United Nations Population Fund (UNFPA), an estimated 14,000 women die annually in the country due to complications in childbirth. The country’s maternal and infant mortality rate is the highest within the South Asian region.

The implementation of Millennium Development Goal revealed that maternal health facilities in Pakistan were located at an average distance of 12 kilometres in the rural areas, thus making essential services out of reach for a majority of women. Unsafe abortions are also on the rise throughout the country with as estimated 15 per 1,000 women of reproductive age experiencing post-abortion complications.

In such a situation, family planning and reproductive health services need to be made available at the nearest places of the people living in rural areas that can play a key role in checking population growth and maternal mortality rate. It is worth mentioning that there are over 1500 Basic Health Units (BHUs) in Punjab and 1050 People Works Programme Centers (PWP Centres) at village level to generate basic social and economic activities in partnership with local NGOs. The PWP centres in particular can play a vital role in providing counseling on dangers of early child marriage, relating it to maternal mortality.

Presently most of these centres are dormant and lack infrastructure. These centres need to be reactivated as a center-point of family health and family planning services to ‘Vulnerable Populations in Emergencies’, the core objective and theme of this year’s world population day.