Making Family Planning Work in Afghanistan

Afghanistan is a country ravaged by decades of war, internal conflict and strife. It is only in the last few years that a democratically elected government has been able to bring some semblance of stability in the different part of the country, though the situation still remains highly volatile.  The country is getting a lot of support from international community for the rebuilding of the infrastructure and systems which have been almost wiped out by continuous war like situation.

Though Afghanistan is going through a phase of rebuilding and restructuring, yet she still faces huge challenges in providing essential services to its citizens. These difficulties are caused by factors such as geographical remoteness, civil instability, the over-centralization of government, a lack of infrastructure such as transportation systems, and a lack of government resources, among others[1].

All the above mentioned problems have severely hampered the development process which almost stood still form many years in the past and started afresh only recently. The effects are manifest in the population statistics which are a real cause of concern for the development planners in Afghanistan. Using estimates derived from a number of recent surveys, the UN estimates the current Total Fertility Rate (TFR) at 6.6 children per woman and the U.S. Census Bureau estimates 5.7. Not only do these TFRs, as high as they are, represent quite a decline from the past, but the onset of decline has been quite recent. The real question now is: what about the country's demographic future? The UN has quantified the effect of such high TFRs in its constant-fertility projection. If the TFR remains at 6.6, by 2050 the country's population would reach 111 million and be growing at 3.6 percent per year, a rate that would double a population in 19 years[2].

Keeping in view the scarce resources and not so good economic condition, the Afghan government needs to strengthen the family planning and population planning programs in the country in order to check the alarming trends in population increase. However this a challenge as there are many obstacles in way of population planning programs because of typical socio-cultural and traditional tribal set up in Afghanistan. These challenges can only be overcome by bringing together all stakeholders on single platform.

Afghanistan can learn a lot from the other Muslims countries of Asia like Iran, Indonesia and Malaysia who have highly successful FP programs and have succeeded in overcoming the challenges caused by traditional and conservative interpretation of religion. In all these countries governments  initiated dialogues with religious scholars and convince them to look for reinterpretation of religion in the light of the changing requirements of modern times. Regular interaction of Afghan religious scholars with religious scholars of the above mentioned countries can be a right step in this direction. This interaction can be very helpful Afghan religious scholars and would help in overcoming the resistance which is mostly caused by narrow and traditional interpretation.

NGOs are also an important stakeholder and can play a very important role increasing effectiveness and efficiency of the family planning programs in the country due to their unique advantages. In all South Asian countries and similarly in neighboring countries of Pakistan, Bangladesh, Nepal and India, NGOs have emerged as alternate providers of public services, particularly within poor and rural communities.

Many lessons can be learnt from the neighboring country of Pakistan, which has successfully involved NGOs in the family programs to enhance the reach, quality and effectiveness of the service delivery. Pakistan is also similar to Afghanistan in many respects as both countries share similar socio-cultural background, traditions and the recent history of conflict. Though Pakistan has an area slightly bigger that Afghanistan and contains a population nearly six times the size Afghan population yet the challenges faced by both the countries are very similar. Many Pakistanis do not have access to government services, due different factors including geographical remoteness, lack of resources, lack of capacity in public sector and an ongoing conflict situation in northern areas of Pakistan. So the role of NGOs has increased manifold which have stepped up to fill the gap. NGOs have emerged as alternate providers of public services, particularly within poor, rural and hard to reach communities. The role of NGOs in provision of family planning services is even more prominent as NGOs have been involved in the family planning program since the beginning.

In Pakistan the early programs on family planning were started in late 1950s and early 60s. Provision of family planning services was started through setting up of FPAP which today in one of the largest organizations working in the sector of family planning[3]. NGOs have played a pioneering role in establishing family planning in all countries of South Asia and in setting the reproductive health agenda. NGOs have provided important clinical services, including contraceptive surgery. Apart from service delivery, there has been a considerable role for NGOs and CBOs in advocacy, BCC and community mobilization, where they have advantages. They have also been used as agents of information and advocacy to support the national program.  Some other roles of NGOs also include: ensuring quality of services being delivered, community mobilization, social Marketing and facilitators of Family planning education, training and linkages development.  

NGOs and civil society organizations have many advantages over the public and private sector which can contribute in enhancing effectiveness, efficiency and reach of the FP program. The foremost advantage which the NGOs and CSOs enjoy is their capacity to work at the grassroots level at very low costs. Since most of the NGOs have strong community linkages and presence, therefore they find it much easier to work at the community level and to overcome barriers and resistance which is often faced by public or private sector. Moreover, they often operate without a lot of overheads which keeps their cost very low which is a very important factor in resource constraint situations.

The slightly informal structure of NGOs gives them a flexibility which the public sector often lacks and which is of utmost importance in socially and culturally sensitive programs. They can adopt and review their program according to the changing ground realities. They do not have to go through the bureaucratic channels to review and redesign their program to meet the needs of community. This reduces the time required for taking necessary decisions and for taking prompt actions when required. Since most of the NGOs have to report back to donors and government and go through the rigorous audits conducted by donors and governments, they have to maintain high levels of transparency and accountability which is another argument for employing NGOs in FP programs. Of course, there have been studies and researches which prove that NGOs have proved more effective in implementing FP program because of higher quality of services, high rates of success, better outcomes, presence of more female workers and their capacity to scale up when pilots have proved successful[4].

However this does not mean that there are no disadvantages or challenges while working with NGO. There are several challenges which should be considered before going ahead with the decision. It is a common issue that most CSOs and NGOs have limited resources and sustainability problems, and do not have the capacity to locally raise funds for themselves. There exists a certain amount of distrust for NGOs among stakeholders due to the religious and cultural norms and they are often seen as working on foreign agenda which leads to unfavorable working environment for NGOs. NGO have also been criticized for their heavy reliance upon donors and sustainability issues of the projects. NGOs have also suffered in recent times because of the shifting trends of donor funding and lack of focus on FP. In the last decade or so the funding for FP program has declined considerably which has adversely affected the effectiveness or FP program and has resulted in stagnant indicators like unmet need and CPR.

Despite the above mentioned disadvantages and drawbacks, NGO remain the most important stakeholders in FP and population planning programs. No FP program can succeed without active and meaningful participation and support of NGOs in Afghanistan or for that matter anywhere else. This fact has been proven time and again through many studies. Learning from the experience of Paksitan with similar challenges and factors can be very helpful for the success of FP program in Afghanistan. This can be done through exchange visits, brining technical expertise from region or through involving NGOs from other countries of the region for capacity building of NGOs and civil society organizations in Afghanistan. 

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[1] (Evaluating NGO Service Delivery in South Asia: Lessons for Afghanistan: Laura Antuono, Chris Meeks Melissa Kay Miller, Jean Rene Watchou, Robert M. La Follette School of Public Affairs University of Wisconsin-Madison, 2006)

[2] http://www.prb.org/Articles/2009/afghanistan.aspx

[3] http://www.icomp.org.my/new/uploads/fpconsultation/Pakistan.pdf

[4] Evaluating NGO Service Delivery in South Asia: Lessons for Afghanistan; Laura Antuono, Chris Meeks, Melissa Kay Miller, Jean Rene Watchou, Prepared for Workshop in Public Affairs, International Issues Public Affairs, 2006

Dark Ages of Islam

20^th January 2012

There is nothing of interest on political scene to discuss today. So let’s discuss some matters of far more importance than these trivial routine matters. Instead of discussing what, let me focus today on why.  Why are we averse to listening, let alone tolerating, any voice of reason today? Why are such brutalities being committed and endorsed in the name of a religion which once proclaimed to be the religion of peace and harmony? Anybody with a different view is either eliminated like Taseer or is forced to run away like Ghamdi. People are beheaded and the acts are videotaped and widely circulated. Religious scholars endorse suicide attacks through their abject silence and common people glorify terrorists like Usma and Fazal Ullah.

When you look closely, you will find uncanny similarities in what is being done today in the name of Islam and what was once done during Inquisition in the name of Christianity. The term Inquisition refers to a number of historical expurgation movements against heresy (orchestrated by some groups/individuals within the Catholic Church or within a Catholic state). This period also coincides somewhat with the dark ages. Heresy was suppressed by Catholic Church even before 12^th century but the use of torture and executions was not common. But around 12 century the trend changed and due to some decrees of Church. It started and era or utter brutalities, which continued for many centuries and cost numerous innocent peoples their lives. This went on for three centuries till 15^th century. By the end of period, only thing which had been achieved by the church was to considerably weaken the grip of religion on the lives of people. People had got so fed up with religion that Christianity could never gain the same hold on the lives of people again and religion become almost a non operative part of the lives of the people.

The same is happening today in Pakistan in the name of Islam. Every effort is being made to curb the fresh ideas and thoughts in the name of fighting heresy. Anyone with different opinion or thought is either eliminated or harassed. And all is being done to maintain the sanctity and purity of original Islam thought. I am afraid that results are also going to be the same. If we continue in this vain, after some time, I am afraid, we will also succeed in making Islam irrelevant for modern world. Another stark reality is that Islam today is more or less of the same age as Christianity during age of inquisition. Does it mean that religions also go through the same life cycles? 

Well more of this some other time. It is a topic on which I intend to write a book some day. Hope that will be not be in too distant future.

Diary of a disgruntled Pakistani

19^th January 2012

Media had gone berserk over the appearance of Prime Minister in the Supreme Court in contempt case.  Some had great hopes that PM will be dislodged through disqualification and government will plunge into crises. But the hopes begin to dampen when Barrister Aitizaz was requested to represent PM in the court. In desperation some even started blaming Aitizaz for doing a double face and changing his earlier stance. Well today PM with his advocate appeared in the court. Couldn’t have asked for a better anticlimax! The defendants reiterated their commitment to respecting the decisions of the court. The judges appreciated the act of PM in appearing before the court and after some time next date for hearing was given and all the buzz fizzled out.

Hardly has anyone paid attention to the fact that case has nothing to do with upholding the principle of supremacy of law in the country. It can better be viewed as a turf war. Another institution is trying to assert that it is also a stakeholder in the power game. Once that is established, all will be well in the country.

Another thing getting lost in the chaos is the fact that how successfully PPP government has diverted the discussion from the tales of its corruption to the civil military relationship and the supremacy in the parliament.

Now that Supreme Court has asserted itself and its authority and PM has humbly presented himself to the court, be rest assured that matter will slowly dissipate like many others or buried under thousands of other cases awaiting attention from the honorable court. 

Out of Sync

5000 People have so far been killed in clashes between protesting masses and tyrannical Asad regime in Syria. The government is using the iron fist to put down the uprising but has failed to do so until now. Arab league has approved sanctions against Asad government in Syria and has repeatedly appealed to Aasd to stop the military action but to no avail. Despite repeated requests from the leaders of protestors NATO and Europe have until now have shown no interest in intervening, though they have been using other means like resolutions in security council to pressurize the government to stop the atrocities and human right violations.

Nobody in Pakistan is interested in killing of 5000 thousand people in Syria by the government and obviously they should not be, as we have our own problems to cater to. But if by any chance, NATO and American or anyone else will decide to intervene, pseudo intellectuals, columnists, Mullahs and religious parties in Pakistan will at once start criticizing the action as an American conspiracy to destabilize Middle East. It will be termed as Jewish agenda to over throw Muslims rulers. In fact different writers have already termed ‘Arab Spring’ as western conspiracy. Nobody will try to understand the simple fact that people of Syria, like the people of other Middle Eastern and Arab countries, have turned against their dynastic oppressing rulers and don’t want to carry on with them. We will call the protesters agents of America, West and Jews. Intellectuals in Pakistan, like rulers of the Muslim world, are failing to read the writing on the wall and are paying the price.

Pakistan was only country in the world where columnists were writing columns in favor of Gadddafi of Libya and religious parties were taking out processions in his favor and against NATO attacks. While on the other hand people of Libya were engaged in fierce and bloody struggle against the dictator. Thousands were killed in the bloody clashes which forced Gaddafi tit un for his life and hide in hole in a far flung town. His last video showing him begging his captors for mercy told the whole story of his popularity.

The mood in Pakistan about the Libyan revolution was a just a continuity of the long tradition of misguided and ill informed movements about the happenings in Muslim world. When Turks were busy in kicking out their Ottoman Caliphs, our elders were advocating with the British for safeguarding caliphate. One words of a popular Urdu writer, it is difficult to imagine a more sincere yet a more useless movement. When Afghans were themselves going through the worst crisis, our religious scholars were declaring united India as land of conflict and war (Darul Harab) and motivating Muslims to migrate to land of Islam (Darul Islam). What happened to those who headed to the advice and migrated to Afghanistan is now a bitter part of our checkered history. We in Pakistan still consider the termination of Ottoman Caliphate as a conspiracy by Jews and Christians where as Turks themselves have never bothered to look back and remember those incompetent rulers.

When students and masses were gathered in Al-Tahrir square for agitating against Husni Mubarak of Egypt, we were looking for the hidden hands of America in the uprising. I wonder what our religious leaders would say now about the change in Egypt, when AlIkhwan and Salafis have won the first round of elections. Will they also be calling Al-Ikhwan and Salafis the American agents?

Why is it that we always fail to understand what is going on in other Muslims countries and as a nation take wrong sides? We always side with the dictators and not with the people of those countries who are struggling to rid themselves of those tyrants? Rather we term these movements of the people as western and Jewish conspiracies. From Indonesia to Morocco, we have never been able to objectively analyze the ongoing people movements and public sentiments.

What is the reason behind this mindset of ours and this intellectual failure? The fact of the matter is that we doubt all these movements and struggles because of the experiences which we have had at home. Our political, social and even religious movements have a long history of foreign funding, sponsorships and backing. If our Madrassah was and is getting financial support from Arab world, then our leftists were getting equal support and patronage from Moscow which was their beacon. Our political movements to get rid of popular leaders like Bhutto were sponsored by C.I.A. Our Jihad was fully funded and sponsored by Pentagon. Our NGOs working on human rights are blamed for working on western agenda for American dollars. Even the movement for the restoration of Chief Justice is said to be heavily funded by parties interested in achieving some other goals. The opinions of many journalists have known to sway with sway in fortunes of governments or with the fatness of envelops which they receive. We are never sure whether a politician is actually popular in the masses or the show of power have been orchestred by hidden hands to force other parties to follow their agenda.

With this metal baggage and background, it is difficult for our analysts and intellectuals to imagine the some movements can be indigenous and can gather momentum without foreign invisible hand and support. This makes our analysts look at the movements in other Muslim majority countries with doubt and suspicion. Whenever our masses managed to get rid of some people at the helm of affairs, afterwards they came to know that ouster was not result of their struggle; rather decisions had been made somewhere else even before their struggle had started and that their struggle actually meant nothing and they were mere pawns on the board.

While trying to analyze these movements in other countries, we need to overcome these mental and psychological barriers and look at them objectively. We should also try to have a look at the history and background of these countries and societies. Most of the Muslim world countries across the world are rules by families or persons who have been at the helm of affairs for very long time. Most of the rulers who have been thrown away had been ruling their countries for at least two decades. This situation is very different from Pakistan, where democratic governments do not manage to last for four years and even military dictators with all their might cannot go beyond ten years. So the discontent of the people in other Muslims countries with their rulers and the desire to change is not surprising. In few Muslim countries where there is regular change of faces and rulers, the situation is quite stable. Many Muslim countries are ruled by dynasties or by individuals trying to convert democracies to dynasties. Husni Mubarak and Gaddafi both were grooming their sons to take their place which causes lot of resentment. Though Bashar ul Asad claims to be an elected president, his rule is nothing but a continuity of regime of his father Hafiz-ul-Asad. Same is the case in many other Arab countries and sooner or later we can expect to see similar movements emerge in those countries as well. It is not a matter or ‘if’, it is only matter of ‘when’. Term these movements ‘Western or American conspiracies’, is in fact like insulting the commitment and struggle of the people of those countries.

So my request to respected analysts in Pakistan is to stop looking of hidden hands in the Arab spring and other similar movements and try to understand the changing dynamics of the Muslim world which is on the brink of a major shift.  People living in the Muslim countries are fed up with the archaic and outdated systems and want change. They want to enjoy the benefits which are being enjoyed by the people of  developed countries and this is not possible till our countries are ruled by these corrupt to the core rulers. Failure to understand these shifts will leave us stranded and alone even in the Muslim world. It will not be long before we shall be witnessing the same uprising in our own country and then we shall not be able to able to explain or understand that either. 

Hot Features: Such Gup

Hot Features: Such Gup

How could Mush ever think that he going to be welcome in Pakistan. Why do people lose all their contact with reality. Didn't he read any news papers or listen to any news channels. Only if our leaders have a look into the headlines of the one Urdu and one English paper daily instead of listening to only their cronies, they would be able to get a much better understanding of what is really going on.

Arbab ghulam Rahim! What a precious addition to the members of PTI. Just the kind of person Imran needed. didn't he?

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10 things I hate about ET blogs

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