Alarm bells are ringing over the sharp rise in population. The Ministry of Public Health and UNICEF, the UN children’s agency, warn the number of people in Afghanistan could double in the next 20 years.
Alarm bells are ringing over the sharp rise in population. The Ministry of Public Health and UNICEF, the UN children’s agency, warn the number of people in Afghanistan could double in the next 20 years.The country’s total population is an estimated 26.5 million, according to the central statistics. The number of women is 12.9 million. Afghanistan is the worst off in Asia in an index that measures human development or a country’s well-being, especially child welfare.
Sadia Fayeeq Ayoubi from the Ministry of Public Health says: “In the first months of the current year, around 104,191 normal births and 5,015 abnormal births were registered, while the figures for 2010 was 384,309 normal births and 17917 abnormal births.” This indicates a 15 to 20 percent increase in child births this year, she says.
Afghanistan has an average birth rate of 6.27. The rate in the rural areas is 6.49.
Zarsanga, a resident in Shuhada-e-Salehin in Kabul city, says: “This is my twelfth son. My husband is of the opinion that a break in child bearing is a sin”.
Freba lives in the Arzan Qimath area of Kabul city. She says: “I have given birth to nine children and fortunately, seven of them are alive. I have four sons and three daughters. My husband is a cloth seller. My sons go to school and my daughters don’t go due to the reason that school going for girls is stigma”.
Guldana resides in the Bagrami area, and has given birth to her twelfth child at Rabia Balkhi Hospital. She says: “After nine consecutive female children, I gave birth to a male child that died unfortunately. Then, I gave birth to two more male children. My husband is seriously against my having female children. That’s why I became pregnant again. Fortunately, now we have two (more) male children.”
Asked how the family will take care of so many children, she replies, “I am in deep trouble with so many children. It’s very hard to keep them clean. Also, our financial situation is very bleak.”
No break in child birth
Roughly 85 percent of women are not allowed to space out pregnancy. This is a major factor for the rising birth rate. The WHO (World Health Organization) has advised a 24-month gap before a woman is pregnant again as ideal for both the mother and the child.
High maternal mortality
Equally worrying is the high maternal mortality rates. Dr. Ghulam Sakhi Noorughli, spokesman of the Ministry of Public Health, says: “According to the latest figure recorded by Ministry of Public Health, every half an hour a woman dies from child birth or pregnancy related complications.
This is causing us concern.” According to him there has been some improvement in the time between births, “but this is not the case in villages and in the rural areas”. The government has set up clinics to instruct families about spacing pregnancy and other issues, and midwives are trained to instruct women at child birth. “We expect to train 3,000 midwives in the next three months. This would have a positive impact on reduction in mortality of children and mothers,” he says very optimistically. About 80 percent of births still take place at home.
Risky child births
There is an unusually high rate of difficult child births. This could be a result of the position of the foetus at the time of labour, or complications because the woman has had repeated and quick pregnancies. Dr. Mohammad Dawood Shinwari at the Rabia Balkhi Hospital says: “The average number of children in a family is seven, but we have seen a case where a woman has given birth 21 times.” This is terrible from the point of view of both the mother and the child. It has been found that 24 percent of women suffer from some painful condition that is related to repeated pregnancy including prolapsed uterus.
Illiteracy continues to be a serious obstacle to raising awareness. Currently only 34 percent of people are able to read and write. “Illiteracy level in rural areas is of great concern. Ninety percent of women and 63 percent of men in rural areas are illiterate,” according to the Department of Central Statistics. Only seven of Afghanistan’s 12 million children have schools to go to.
The population explosion is a serious problem. Esmatullah Ramzi, an advisor in the Department of Central Statistics says: “Trained people are a serious need. However, more people is not a solution. We have serious poverty and security problems; there are problems with education and health. Mortality figures have reduced but not population.”
Planned pregnancy
Marghalri Khara, head of Health Affairs in Ministry of Women’s Affairs (MOWA), says: “We have done a lot to control population. Also, we have a lot of plans. Giving birth is the right of every woman, but breaks should be observed so that the first and second child should be taken care of. There is no problem in this regard both from the Sharia and human rights point of view.” According to her, MOWA in cooperation with international agencies, the Ministry of Public Health and other organisations have been spreading the message of spacing births. “The messages are delivered through campaigns and workshops, at mosques and through the media,” she says. “Women (and men) are advised to bear as many children as they can take care of,” she adds. With only 20 percent of land in the country under agriculture, an explosion in population can worsen the present problems of economic insecurity.
