09.02.2014

Too good to miss
Pakistan is unlikely to meet most of the targets of the Millennium Development Goals by 2015 due to misplace priorities
By Naseer Memon

A recently issued report “Pakistan Millennium Development Goals Report 2013” has revealed that Pakistan is set to miss most of the MDG targets. The report has been issued by the Planning Commission of Pakistan with the support of UNDP. The previous MDG Report issued in 2010 also indicated the same trend on key targets of MDGs. Situation has remained almost stagnant over the past three years.

According to the report, out of 33 targets, the country could achieve only three, it is on-track on seven targets and the progress on 23 targets is reported as off-track. Except for the goal No 7 “Ensuring Environmental Sustainability”, Pakistan seems less likely to achieve the remaining six goals.

Some of the key indicators showing off-track progress include prevalence of underweight children under five years of age, proportion of population below minimum level of dietary energy consumption, net primary enrolment ration, literacy rate, share of women in wage employment, under-5 mortality rate, infant mortality rate, proportion of fully immunised children, lady health workers’ coverage, proportion of births attended by skilled birth attendants, prevention of malaria and tuberculosis and forest cover. All these vital indicators targets are the key indicators of human development. The report clearly indicates that Pakistan is trailing behind on the agenda of human security.

Under MDG-1, Pakistan aims to halve the proportion of people living below the poverty line, to achieve full and productive employment and decent work for all, and to halve the proportion of people who suffer from hunger. According to official claims, the percentage of population below the poverty line has fallen from 34.5 per cent in 2001/02 to 12.4 per cent in 2010/11. Hence Pakistan is on track to achieve this target.

Skyrocketing inflation, persistent economic stagnation, tumbling foreign investment and a series of natural disasters could actually have pushed a large number of people below poverty line yet the official report claims decline in poverty incidence. Similar claims of decline in poverty were made during Gen. Musharraf’s era and the same were contradicted by Dr Pervez Tahir, the then Chief Economist. Presently, Benazir Income Support Programme is being cited as a major contributing factor to reducing poverty.
Skyrocketing inflation, persistent economic stagnation, tumbling foreign investment and a series of natural disasters could actually have pushed a large number of people below poverty line yet the official report claims decline in poverty incidence.

Malnutrition, measured as prevalence of underweight children under-5 years of age, decreased from 40 per cent in 1990/91 to 31.5 per cent in 2011/12, but is still far off the MDG target of less than 20 per cent. With two out of three targets off-track, the country is unlikely to achieve MDG-1.

Under the MDG-2, Pakistan targets 100 per cent primary school enrolment, 100 per cent completion of education from grades 1-5 and an 88 per cent literacy rate. Corresponding current status is 57 per cent and 50 per cent respectively. The country is thus off-track on all three targets, and therefore not likely to achieve MDG-2.

MDG-3 aims to eliminate gender disparity in primary and secondary education by 2005, and in all levels of education by 2015. Although gender parity in education has improved for primary education, secondary education and youth literacy, it still falls short of the MDG targets set for 2015. The share of women in non-agriculture wage employment is 10.45 per cent in 2010/11, which is short of the 14 per cent target. There has been considerable progress on increasing women’s representation in legislative bodies. Except for this, Pakistan lags behind in remaining four targets and therefore unlikely to meet MDG 3.

MDG-4 aims at reducing the under-five child mortality (U5MR) by two-thirds. Under-five morality declined from 117 deaths per 1,000 live births in 1990/91 to 89 deaths in 2012/13; and the infant mortality rate in this period from 102 to 74 deaths per 1,000 live births. However, both are still short of the MDG targets of 52 and 40 deaths per 1,000 live births respectively.

The coverage for fully immunized children increased from 75 to 80 per cent and of measles immunization from 80 to 81 per cent in this period, yet both are still short of the target of above 90 per cent coverage. Pakistan was able to achieve the MDG target for reducing to less than 10 per cent the proportion of children under five who suffered from diarrhea. However, another target of Lady Health Worker’s coverage stood at 83 per cent against the target of 100 per cent. Pakistan is off-track on five out of six indicators and hence unlikely to attain MDG-4.

Under MDG-5, Pakistan intends to reduce the maternal mortality rate (MMR) by three-quarters. MMR has been reduced to 276 per 100,000 births but it is still much higher than the target of 140. Similarly, contraceptive usage has almost tripled (up to 35.4 per cent) yet still less than 55 per cent. Proportion of births attended by skilled birth attendants stood at 52.1 per cent and antenatal consultations have more than quadrupled (up to 68 per cent) since 1990/91. However both targets are below the committed levels of over 90 and 100 per cent. The total fertility rate at 3.8 remains considerably higher than the target of 2.1. Underperforming on four targets, Pakistan is off track and therefore unlikely to achieve MDG-5.

MDG-6 strives to reverse the spread of HIV/AIDS and the incidence of malaria and other major diseases. Pakistan has achieved target of detection and cure of TB and it is on track to reduce HIV prevalence among pregnant women. However, it trails behind on the targets of reducing proportion of population facing malaria risk and incidence of TB. Against the target of reducing 75 per cent population at malaria risk, Pakistan has achieved only 40 per cent. Similarly, TB incidence stood at 230 per 1000 people against the target of 45. Pakistan is off-track on three out of five indicators and, therefore, unlikely to achieve MDG-6.

Of the seven MDG-7 indicators, Pakistan is on track to achieve four. These include protecting areas for wildlife conservation (11.6 per cent against the target of 12 per cent), reducing sulphur content in high speed diesel, improving energy efficiency and improving access to safe drinking water (89 per cent against the target of 93 per cent). However, it is lagging behind on access to sanitation which is currently 72 per cent against the target of 90 per cent. Pakistan has also made progress on increasing forest cover – currently 5.2 per cent – but is still short of the 6 per cent target. Overall, with four out of seven indicators on track, Pakistan is likely to achieve MDG-7. This is the only goal where progress is promising.

Apart from national status of targets, there are glaring inter-provincial and intra-provincial disparities that entail complex political repercussions. For example, proportion of people under poverty in Balochistan is 49.7 per cent, which is much higher than 36.4 per cent of Punjab. Proportion of underweight children stood at close to 40 per cent in Sindh and Balochistan, alarmingly higher than 29.8 per cent underweight children in Punjab.

Similarly, the share of wage-employed women in Balochistan is only 2.32 per cent, outshined by 13.25 per cent in Punjab, followed by 7.33 per cent in Sindh. Infant Mortality Rate in Balochistan is 104 per 1000 live births, which is much higher than 71 per cent in Sindh and 82 per cent in Punjab. Likewise, under-five child mortality in Balochistan is 158 per 1000 live births which is far higher than 104 in Punjab. Balochistan has only 37 per cent fully immunised children compared to 86 per cent in Punjab, 90 per cent in KP and 71 per cent in Sindh. Balochistan also registered 758 mothers dying per 100,000 live births which is three times higher than 227 in Punjab.

Within provinces, disparities between urban and rural areas are also discernible. In Sindh, Karachi ranked number one on eight out of 13 indicators. Hyderabad stood number one on three indicators. In Balochistan, Quetta has been ranked top on five out of 13 indicators. In Punjab, bottom districts under all indicators except one belong to South Punjab.

Gender disparities also prevailed in every sector. For example, the literacy rate is 58 per cent overall, which is highly skewed towards males i.e. 70 per cent of males are literate compared to only 47 per cent of females. The report does not provide sex disaggregated data under various indicators e.g. Infant Mortality Rate and immunization. Apart from such shortcomings, the MDG report is a highly valuable reference for policy makers, civil society, researchers, academicians and funding organisations.

Achieving MSG targets is a matter of political will. The country-managers, since inception, preferred border security over human security, which persistently hemorrhaged scant resources of the country. Annual report 2009-10 “Social Impact of the Security Crisis” of Social Policy and Development Centre reveals that the combined federal and provincial expenditure on security reached Rs800 billion or 4.7 per cent of GDP compared to Rs177 billion or 4.2 per cent of GDP in 2000-01.

The report succinctly explains these misplace priorities as “higher spending on security during war on terror has reduced public spending on social services and caused slowdown in the pace of social development. It appears that Pakistan is unlikely to meet most of the targets of the MDGs by 2015.