Thailand has become ‘An Aging Society’ with aging population of nearly 10 million

BANGKOK, 1 October 2014 (NNT) – Dr. Narong Sahamethapat, the Permanent Secretary for Public Health has urged all sectors to realize the importance of elderly care, in his speech to mark the International Day of Older Persons on 1st October.

In his address, Dr. Narong cited a research recently conducted by Mahidol University as saying there are currently 9.93 million elders, accounting for 15 per cent of total population in Thailand.

However, only 5 per cent of them are healthy and have self-care ability while the rest of 9 million have congenital diseases e.g. diabetes, high blood pressure, depression and osteoarthritis. 200,000 of them lack self-care competence and are also immovable from beds. In addition, there are around 800,000 elders or 8 per cent who have to stay on their own at home.

The Ministry of Public Health, consequently, has provided a better elderly-care system focusing on the integration between internal and external organizations related to the matter including the Ministry of Interior, the Ministry of Social Development and Human Security, local administrative organizations and communities. The improving system emphasizes a long-term care service which is consistent with local culture and way of life in order to encourage the elders to live happily with their own families in hometown.

Meanwhile, all necessary facilities can be accessed locally and closely to their accommodations. Besides, the ministry will establish special clinics for physical and mental consultants and health screening in central hospitals, community hospitals as well as general hospitals. Moreover, buildings should be reconstructed or renovated to become ‘Universal Design’ by installing horizontally-sitting toilets with handles, and replacing stairs with ramps.

In addition, the ministry will promote the establishment of long-term elderly care model in each community with the inter-organizational operation. The system will create elderly-demographic information center both of healthy and impaired ones. Meanwhile, multi-professional staff with voluntary team and the elders’ family will visit them at home. Currently, the project has progressed to cover 2000 districts but needs to increase to 2300 districts and eventually cover all by 2021.

Furthermore, the ministry also manages a pilot project called ‘elderly-friendly city’ in 2 areas namely Pattaya and Nonthaburi’s municipality to be launched during 2014-2016 in order to respond to the need of elders, impaired and disabled people. Not only facilities which all elders can utilize universally such as wheel chairs, parking, buses and hospitals, but the ministry will also do the increase in their higher earnings.

Importantly, they will also be encouraged to participate in community activities so that they can be happier and recognised in the society –
See more at: http://thainews.prd.go.th/centerweb/newsen/NewsDetail?NT01_NewsID=WNSOC5710020010001#sthash.6vvbj9IN.dpuf

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Investing in Young People – World Population Day, 11 July 2104

Inter-Governmental Alliance, Partners in Population and Development (PPD) is Urging Its 26 Member Countries to Invest More in Young Population for Sustainable Development

“Investing in Young People” is the theme of the World Population Day this year. Partners in Population and Development (PPD) is taking this opportunity to reflect on the young population of its 26 member countries, the opportunities associated with them and to urge the governments of its member countries to further invest in this population group to ensure sustainable development.

PPD is a southern-led, southern-run Inter-governmental organization of 26 developing countries representing 58% of world population (http://www.partners-popdev.org/). PPD was established in 1994 following the recommendation of the International Conference on Population and Development (ICPD) Program of Action with the mandate to promote South-South Cooperation on Reproductive Health, Population and Development in developing countries. The organization is a permanent observer at the United Nations; the secretariat is located in Dhaka, Bangladesh, an African Regional Office in Kampala, Uganda, a program office in China and UN liaison offices in New York and Geneva. PPD is celebrating its 20th anniversary this year.

Demographic transitions in the past decades have led to the largest generation of young people (aged 10-24 years) in the world today, comprising adolescents (aged 10-19 years) and youth (aged 15-24 years). The adolescents aged 10-19 years stood about 1.2 billion in 2012, constituting 17% of the total world population. When about 90% of them live in developing countries, over 61% live in 26 member countries of PPD. The proportion of adolescents ranged from highest 25% in Ethiopia and Yemen to lowest 13% in China in 2012 in 26 PPD member countries (Fig. 1).

Fig 1. Proportions of adolescents (10-19 yrs) in PPD member countries, 2012

wpd2014_01

Young people aged 10-24 years were about 1.8 billion in 2013, accounting for 25% of the total world population. Around 88% of them live in developing countries and 26 member countries of PPD is the home of nearly 62% of the world’s young population. In the member countries of PPD, the proportion of young population ranged from highest 36% in Zimbabwe to lowest 22% in China, Sri Lanka and Thailand in 2013 (Fig 2). The proportions of these young people will decrease substantially globally from 25% in 2013 to 20% in 2050. Marked decrease in proportions of young population would be observed in all member countries of PPD by 2050, particularly in the Asia-pacific, MENA, Latin America regions, and in Ethiopia and Zimbabwe in Sub-Saharan Africa region.

Fig 2. Trends of young population (10-24 yrs) in PPD member countries, 2013-2050

WPD2014_02

The Governments’ of the world nations made commitments to improve the lives of young people at both international and regional levels including at the ICPD in 1994, World Program of Action for Youth in 1995, and at legally binding conventions like the Convention on the Rights of the Child in 1990. All these events recognized the importance of young people’s role in poverty reduction and in over all national development process.

However, currently almost half of all young people live on less than USD 2 a day, about 71 million adolescents were out of school, majority of them are girls. Even, despite near-universal commitment to end child marriage, one in three adolescent girls is married before age 18 in the developing countries. Nine out of 10 adolescent pregnancies take place in the context of early marriage. Every year, 16 million adolescent girls give birth and about 70,000 adolescents die of causes related to pregnancy and childbirth in the developing countries. Furthermore, about 8.7 million young women aged 15-24 years resort to unsafe abortions each year and 15% of all these unsafe abortions are among adolescent girls in developing countries. In addition to that, young people aged 15 to 24 accounts for 41% of all new HIV infections, with 2,400 young people infected every day. Young women are particularly at risk, when infection rates are twice as high as young men, representing about 60% of young people in the world living with HIV and AIDS.

Nevertheless, discriminatory laws, unsafe practices, barriers to access and attitudes continue to keep these young people and adolescents from accessing sexual and reproductive health services, including contraception and realizing their reproductive rights. When Sexual and Reproductive Health Rights (SRHR) are fundamental human rights, and adolescents and youths are major rights holders, they remain a huge underserved population group in most developing countries. This situation call for Governments to invest additional resources in adolescent and youth development and to pay explicit attention to their Sexual and Reproductive Health and Rights, education, employment, gender inequalities, in order to provide targeted policies, programs and services.

Evidence shows that investments in adolescents and youth yield positive outcomes for the rest of their lives; with social, economic, demographic and environmental multiplier benefits. In the case of investing in adolescents girls and young women, the positive effects even go beyond employment and productivity. Empowerment of girls and women lead to better maternal health, lower child mortality and an increase in reinvestment to household and communities.

From a population dynamics perspective; the numbers of young people in the developing countries compared to other age groups demand concrete investment. In PPD Member countries, large proportions of youth and adolescents in the population structure are offering windows of opportunity for them. This window of opportunity is termed as the Demographic Dividend, which is defined as the potential economic benefit offered by changes in the age structure of the population during the demographic transition, when there is an increase in working age population (which includes youths) and an associated decline in the dependent age population. The Demographic Dividend does not happen automatically, it depends both on creation, investment and capitalization of the opportunity through adopting specific policies and creating favorable environments dealing with education, public health, and those that promote labor market flexibility and provide incentives for investment and savings.

In the ICPD beyond 2014 and Post 2015 consultations, the young population group emerged as the key population age group which will have a major impact on the Governments’ policies and development strategies for achieving the Sustainable Development Goals (SDGs). In the zero draft of the proposed goals and targets of the SDGs for the Post 2015 Development Agenda, due attention has been given for youths on universal access to reproductive health, access to equitable and inclusive education and training, employment opportunities, poverty reduction, empowerment of women and girls, addressing gender inequalities etc.

With this background, PPD is urging its member countries’ Governments to make adequate investment for adolescents and youths, specifically for their quality education, training, employment, and SRHR services that are free of charge, confidential, accessible and suitable for adolescent girls, boys and young people. The services should include full range of safe, effective, and affordable methods of modern contraception, including access to safe and legal abortion and post abortion services. Also, to make provision for young people to have access to comprehensive sexuality education and youth friendly sexual and reproductive health information and services, which should address barriers e.g. discrimination, social stigma and lack of confidentiality. The Governments also need to adopt rights-based and gender-responsive approaches to maximize opportunities for gainful employment, especially for women, strengthen migration policies, specifically to ensure Sexual Reproductive Health Rights and protection of the rights of the out-migrants youth population.

PPD is planning to offer a platform for dialogues on increasing investment in young population for sustainable developing in developing countries during its 11th International Inter-ministerial Conference to be held in November 2014. PPD also wish to facilitate the continued discussions on updating policies and strategies through effective use of evidence-based population analysis, and its impacts on sustainable development by expanding access to gender-sensitive, life skills-based sexual and reproductive health education, promoting a core package of sexual and reproductive health services integrated with HIV/AIDS in its member countries.

References:

  1. International Conference on Population and Development – ICPD – Programme of Action
    https://www.unfpa.org/webdav/site/global/shared/documents/publications/2004/icpd_eng.pdf
  2. United Nations, Department of Economic and Social Affairs. Population Division, Population Estimates and Projection Section.
    http://esa.un.org/unpd/wpp/unpp/panel_indicators.htm
  3. World Youth’s Data Sheet 2013, Population Reference Bureau (PRB). http://www.prb.org/pdf13/youth-data-sheet-2013.pdf
  4. The State of the World’s Children 2014 in Numbers
    http://www.unicef.org/sowc2014/numbers/documents/english/SOWC2014_In%20Numbers_28%20Jan.pdf
  5. Policy Brief: Priorities for the Post-2015 Development Agenda.
    http://www.who.int/pmnch/media/news/2012/policybrief_post2015.pdf
  6. Policy Recommendations for the ICPD Beyond 2014: Sexual and Reproductive Health & Rights for All.
    http://www.icpdtaskforce.org/pdf/Beyond-2014/policy-recommendations-for-the-ICPD-beyond-2014.pdf
  7. Population Dynamics in the Post-2015 Development Agenda. Report of the Global Thematic Consultation on Population Dynamics.
    http://unfpa.org/webdav/site/global/shared/documents/publications/2014/Population%20Dynamics%20in%20Post-2015%20FINAL.pdf
  8. Population Dynamics Realizing the Future We Want for All: The Post–‐2015 Development Agenda. Global Thematic Consultation. Population Dynamics in the context of the post-215 development agenda, February 2013
  9. Opening remarks of Dr. Babatunde Osotimehin, UNFPA Executive Director at the Opening of 47th Session of the Commission on Population and Development, 7 April 2014,
    http://www.unfpa.org/public/home/news/pid/17041
  10. Zero Draft of the Proposed Goals and Targets on Sustainable Development for the Post2015 Development Agenda.
    http://sustainabledevelopment.un.org/focussdgs.html

 

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New Kenyan Population Policy a Model for Other Countries

(March 2014) In 2012, the government of Kenya passed a landmark policy to manage its rapid population growth. The new population policy aims to reduce the number of children a woman has over her lifetime from 5 in 2009 to 3 by 2030.2 The policy also includes targets for child mortality, maternal mortality, life expectancy, and other reproductive health measures.

Participatory Process a Formula for Success

Between 1999 and 2009, Kenya’s population added 1 million people every year, growing to 41 million, and was expected to hit 77 million by 2030.1

Kenya’s long-term development plan, known as Vision 2030, recognizes that rapid population growth could severely derail progress in reaching its primary goal: To achieve a high quality of life for all Kenyans that is sustainable with available resources.3 The National Council for Population and Development (NCPD), under the Ministry of Planning, National Development, and Vision 2030, initiated a series of consultations to achieve a population policy that would bolster this vision. Although Kenya has made great strides in increasing contraceptive coverage, from 27 percent in 1989 to 46 percent in 2009, concerns over worsening unemployment, food shortages, and a large youth population threaten Kenya’s economic future.4

The Population Reference Bureau (PRB) has a long-standing relationship with NCPD, dating back more than 15 years. PRB assisted NCPD, at the request of and with support from USAID’s mission in Kenya, to stimulate institutional reform to become a stronger and more effective policy advocacy organization in Kenya. Through this partnership, NCPD has developed multimedia presentations, videos, and a variety of publications, as well as conducted policy communication workshops, to more effectively consolidate strategies to influence population policy decisions. Key among these tools are the PRB ENGAGE presentation, “Kenya Leading the Way,” and the Kenya Population Data Sheet 2011, developed through PRB’s IDEA project. PRB also helped NCPD write policy briefs on national priority themes such as youth and reproductive health, family planning and religion, and other topics. NCPD was among the first to disseminate the results of the 2008-2009 Kenya Demographic and Health Survey. These materials have been shared at the national and county levels to raise awareness about the relevance of family planning.

Kenya’s population policy proposes a multisectoral approach.5 Key to passage of the policy, according to George Kichamu, NCPD deputy director of communication, advocacy, and public education, and Lucy Kimondo, NCPD senior program officer in the same department, was the patient, inclusive nature of the consultative process they employed that solicited input from stakeholders from the very beginning.6 As part of the process, NCPD hosted a national conference for 1,300 public- and private-sector leaders; forums for members of Parliament; meetings with district and regional leaders of churches, civil society, and the government; and supported ongoing nationwide mobilization. In particular, engaging two key groups—religious leaders and parliamentarians—was key to crafting a policy in which all citizens felt ownership.7 A major outcome of the national conference was an increase of more than 10 percent over the previous year in resources allocated to family planning.

NCPD translated the policy into accessible language and reviewed the policy thoroughly as they met with different groups, in order to achieve buy-in from as many people as possible.8 For their efforts, in 2013, NCPD received the Resolve Award, granted by the Global Leaders Council for Reproductive Health, a group of 18 sitting and former heads of state, high-level policymakers, and other leaders who advocate for increased support of reproductive health.

Dissemination at the Top of Action Plan

According to Kimondo, the challenge is getting the word out about the policy. “The big task has now begun,” says Kimondo, and NCPD must develop strategies to implement this policy while at the same time address the issue of access to services, “to make sure that every woman who wants services can access the services, [and] any man, because I believe family planning is for both men and women.”9

Kenya recently decentralized to a 47-county system of government. Since this system is relatively new, it is a good time, according to Kichamu, to make sure the leaders at the county level understand the population policy and their role in implementing the policy to support local communities. The ENGAGE presentation has already been shown in over 30 counties, which puts NCPD on the front lines of bringing national development goals to local policymakers.

Kichamu also notes that it is important to balance rights with development to create the environment for a successful transition to smaller families in Kenya. The new policy, he says, reaffirms that reproductive health is a human right, and that choosing the number and timing of their children is important for all couples.10


References

  1. Kenya National Bureau of Statistics, Kenya Demographic and Health Survey 2008-09, Final Report (Calverton, MD: Kenya National Bureau of Statistics, Nairobi, Kenya, and MEASURE DHS, ICF Macro, 2010); and Population Reference Bureau, Kenya Population Data Sheet 2011 (Washington, DC: Population Reference Bureau, 2011).
  2. “Minister Oparanya Launches Population Policy,” Kenpop News 5, no. 1 (2012), accessed at http://ncpd-ke.org/ncpdweb/News-Letters%20, on Feb. 11, 2014; and National Council for Population and Development (NCPD), Ministry of State for Planning, National Development, and Vision 2030, “Sessional Paper No. 3 of 2012 on Population Policy for National Development, Popular Version” (Nairobi: NCPD, 2012), accessed at http://dataspace.princeton.edu/jspui/, on Feb. 11, 2014.
  3. NCPD, “Sessional Paper No. 3 of 2012.”
  4. “Minister Oparanya Launches Population Policy”; and NCPD, “Sessional Paper No. 3 of 2012.”
  5. NCPD, “Sessional Paper No. 3 of 2012.”
  6. Video interview with George Kichamu, deputy director of communication, advocacy, and public education, and Lucy Kimondo, senior program officer, communication, advocacy, and public education, NCPD, Resolve Award recipients, The Aspen Institute, Dec. 5, 2013, accessed at www.youtube.com/watch?v=KBjA-iVvn9Y&feature=youtu.be, on Feb. 11, 2014.
  7. Video interview with George Kichamu and Lucy Kimondo.
  8. The Aspen Institute, “Global Leaders Honor Kenya for Visionary Population Policy for National Development: 2013 Resolve Award Recognizes Kenya’s Rights-Based, Inclusive Policy,” press release (Geneva: Global Leaders Council for Reproductive Health, 2013).
  9. Video interview with George Kichamu and Lucy Kimondo.
  10. The Aspen Institute, “Global Leaders Honor Kenya.”

 

By: Heidi Worley
Source: http://www.prb.org/Publications/Articles/2014/kenyan-population-policy.aspx

 

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Indonesia’s Population Boom Unsustainable, Experts Warn

JG-21Jakarta. When the National Population and Family Planning Board, or BKKBN, held its annual meeting on Monday, there was a palpable tension in the room.

The BKKBN’s partners — such as the Indonesian Employers Association (Apindo) and Muslimat NU, the women’s wing of Nahdlatul Ulama, the country’s biggest Islamic organization — seemed particularly insistent that the BKKBN this year delivers on its family planning programs, amid projections of a population explosion that could severely strain Indonesia’s economic growth and development.

A problem of numbers

The Central Statistics Agency (BPS) predicts that the country’s population will increase from 238 million in 2010 to more than 305 million by 2035 — an average increase of three million people per year.

That, the BKKBN’s partners say, poses a serious question of how to feed, educate and provide sufficient jobs for everyone.

“Things did not happen as we expected. We expected lower growth,” says Mayling Oei-Gardiner, a demographics expert from the University of Indonesia.

“Also, the fertility [rate] did not really decline. It stayed relatively constant, while the maternal mortality rate soared. So I am not very optimistic now.”

Indeed, the outlook seems far from positive at present. The latest data from the BPS show that between February and August 2013, there was a net increase in unemployment of 220,000 jobs.

The maternal mortality rate, already the highest in Southeast Asia, surged by 57 percent between 2012 and 2013, from 228 out of every 100,000 live births to 359 per 100,000 live births.

“The maternal mortality rate these days is shocking,” says Nurhayati, the chairwoman of Muslimat NU.

Premature marriages

The problem of early marriage underlies both the problems of increased maternal mortality and unsustainable population growth.

“The proportion of couples who got married under the age of 19 years is about 45 percent,” says Abidinsyah Siregar, the deputy health minister.

Nurhayati says many young couples are not aware about the seriousness of starting a family prematurely. She says they need to be counseled and engaged.

“They need counseling. The PLKB program” — Field Workers for Family Planning — “needs to be reintroduced. We need to have a continuing relationship with the people,” she says.

The field workers are the ones responsible for promoting the BKKBN’s family planning programs to the public.

The BKKBN reported that it lacks the much-needed manpower to address the lack of family planning among young couples. It currently has 15,000 field workers throughout the country, but it says that given the sheer size of Indonesia’s population it needs at least 40,000.

Sofjan Wanandi, the chairman of Apindo, shares the view that raising awareness about the importance of family planning is crucial.

“Businesses are working in partnership with the family planning [programs]. We know very well how there are multitudes among our workers who don’t know about family planning yet,” he says.

“The population growth will be unsustainable if we don’t lend our support to the government. What businesses can do, concretely, is to give a proper education [about family planning]. First, we will help our own employees. We need to speed up the process,” he adds.

Mayling emphasizes the importance of teaching young women about family planning.

“The BKKBN has to work harder to spread the message to high school girls that they shouldn’t have too many children. Education is going to be more and more expensive, and health care will be more expensive too,” she says

The experts say the population boom is a double-edged sword for Indonesia. But whether Indonesia can capitalize on its growing population will be determined by how well it can develop its workforce.

“We can benefit if and only if we have made sufficient investment in education and the economy keeps moving,” Mayling says. “The investment is in the human resources. Then you can get the benefits. Then we can become a middle- to high-income society. But that needs investment, that does not come freely.”

But improving the quality of the nation’s human resources is no easy task, the experts agree. The impending population boom will inevitably drain more of the nation’s resources. Yet maintaining the quality of health care and education for the new generation cannot be compromised, presenting policy makers and other stakeholders with a serious quandary.

“Children under the age of three years who are malnourished can become permanently impaired with low intelligence level,” Abidinsyah says. “Their competitiveness will be very low. The point is, we need to maintain the quality of families.”

Cycle of poverty

The importance of raising awareness about family planning is bolstered by the fact that it is those who can least afford to have children who tend to be the ones who have the most children.

“What I am most concerned about is the fact that it is those who are poor who often have too many children,” Sofjan says. “Conversely, those in the upper and middle classes with a lot of money don’t want to [have too many children]. This is dangerous, this is where we must provide guidance.”

Mayling warns of an impending vicious cycle of poverty should the poor continue to give birth to more children than they can afford to properly raise and educate.

“It is usually the poor who have more children than the better off,” she says. “What is worrying now is that women with only a high school education are having too-many children. We need to get more girls educated. It’s not good if they have too many children. It’s going to be more and more expensive. If the children are poor, the chances are the next generation will be poor too.”

Push for industrialization

Johannes Warouw, an urban planning expert at the University of Indonesia, says that given the population growth, “each city must be able to withstand migration and natural [population] increase. The question is, how are they going to meet the people’s basic needs?”

Mayling says the solution to the problem is to ensure that Indonesia becomes more industrialized. She says the process of industrialization will in turn bring about economic growth.

“If you look at the world, those societies that are rich countries today — the US, Europe, Japan, South Korea — the rise of those rich countries comes from industrialization. That comes from innovation, it comes from research, it comes from scientists. We don’t have that. The system doesn’t support it,” she says.

While Mayling believes that investing in science and technology is key to growing the economy, she laments the fact that being a scientist does not seem to be an aspiration for many young Indonesians.

“It’s not that we have no smart people, just that the smart people go on to be bureaucrats, because that’s where the money is. Basically our system hasn’t moved in that direction yet. I’m hoping that our universities can groom more scientists. We can’t be a rich country if we don’t industrialize,” she says.

Silver lining

The experts agree that Indonesia is now standing at a crossroads, where the fate of its people will be determined by whether the development of the economy and infrastructure can keep pace with the growing population.

“More investment in public infrastructure is crucial,” says Gundy Cahyadi, an economist from DBS Bank Singapore, when asked about the determining factor for Indonesia’s future given its increase in population.

“[There’s a] need to overhaul Indonesia’s outdated infrastructure to improve the dynamism of the economy. The government should gradually shift its focus into spending more on capital expenditure,” he says.

Gundy is optimistic about Indonesia’s population trend.

“The demographics are in Indonesia’s benefits. A relatively young population means positive support for the workforce. If we manage to tie this in with rising productivity, then we have the crucial factors needed to sustain growth momentum in the longer run,” he says.

But whether Indonesia can strike the right balance will depend on a sea change in the mind-set on family planning.

By Josua Gantan
Source: http://www.thejakartaglobe.com

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UN report on adolescent pregnancy

Every day, 20,000 girls below age 18 give birth in developing countries. Nine in 10 of these births occur within marriage or a union. Girls under 15 account for 2 million of the annual total of 7.3 million new adolescent mothers; if current trends continue, the number of births to girls under 15 could rise to 3 million a year in 2030.

The State of World Population 2013, published by UNFPA, the United Nations Population Fund, highlights the main challenges of adolescent pregnancy and its serious impacts on girls’ education, health and long-term employment opportunities. The report also shows what can be done to curb this trend and protect girls’ human rights and well-being

http://www.unfpa.org/webdav/site/global/shared/swp2013/EN-SWOP2013-final.pdf

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The National Food Security Bill (2013) of India: Women and the poorest of the poor are the winners

Dr. Joe Thomas *

The National Food Security Bill, 2013 is a bill enacted by the Indian parliament to provide for subsidised  food  and nutritional security to the people,  in human life cycle approach, by ensuring access to adequate quaintly of quality food at affordable prices to people to live a life with dignity.

This Bill would provide subsidised food grain, through the national Public Distribution System (PDS) (‘Ration Shops’) to 75% of India’s estimated 833 million rural population and 50% of an estimated 377 million urban population and dubbed as one of the largest social security scheme in the world.

According to the World Bank reports India accounts for a third of the world’s poor. Malnutrition, particularly among children is more common in India than in Sub-Saharan Africa. According to UNICEF report one in every three malnourished children in the world lives in India. About, 46 per cent of all children below the age of three are too small for their age, 47 per cent are underweight and at least 16 per cent are wasted. Many of these children are severely malnourished

Some of the provisions of this bill has specific entitlements for women and poorest of the poor of the country. For children in the age group of 6 months to 6 years; an age-appropriate meal, free of charge, through the local anganwadi (pre-school),  for children aged 6-14 years, one free mid-day meal every day (except on school holidays) in all government and government-aided schools, up to Class VIII. For children below six months, “exclusive breastfeeding shall be promoted”. There is also provision for children who suffer from malnutrition; to provide meals free of charge “through the local anganwadi”.

Every pregnant and lactating mother is entitled to a free meal at the local anganwadi  (during pregnancy and six months after child birth) as well as maternity benefits of Rs 6,000, in instalments.

This bill has radically altered the definition of ‘head of the house hold’ with long term implications for social reform and women’s empowerment.  A ‘head of the household’ will be the eldest woman, who is not less than eighteen years of age, in every eligible household, for the purpose of issue of ‘ration cards’. Where a household at any time, does not have a women or a women of eighteen years of age or above, but has a female member below the age of eighteen years, then the eldest male member of the house hold shall be the head of the household till the female member attaining the age of eighteen, shall receive the ‘ration card’

Through this scheme, the ‘Priority households’ are entitled to 5 kgs of food grains per person per month, and ‘Antyodaya’ (Antyodaya Ann Yojana was started in March, 2001, for the Below Poverty Line (BPL)  households to 35 kgs per household per month. The prices for the food for the next three years are given in Schedule I : Rs 3/2/1 per kg for rice/wheat/millets.

The identification of eligible households is left to state governments, subject to the scheme’s guidelines for Antyodaya, and subject to guidelines to be “specified” by the state government for Priority households. The identification of eligible households is to be completed within 365 days. The lists of eligible households are to be placed in the public domain and “displayed prominently”.

The governance of this bill also has several pioneering efforts. The Bill provides for the creation of State Food Commissions. The main function of the State Commission is to monitor the implementation of the Act, give advice to the states governments and their agencies, and inquire into violations of entitlements. State Commissions also have to hear appeals against orders of the District Grievance Redressed Officer and prepare annual reports. The Bill provides for a two-tier grievance redresses structure, involving the District Grievance Redresses Officer (DGRO) and State Food Commission. In addition, state governments are expected to put in place an internal grievance redressal mechanism which may include call centres, help lines, etc.

Mandatory transparency provisions envisaged in this bill include;  (1) placing all PDS-related records in the public domain; (2) conducting periodic social audits of the PDS and other welfare schemes; (3) using information and communication technology “to ensure transparent recording of transactions at all levels”; and (4) setting up vigilance committees at all levels to supervise all schemes under the Act.

The Food Commissions have powers to impose penalties and the Commission can authorise “any of its members” to act as an adjudicating officer for this purpose. In case of “non-supply of the entitled quantities of food grains or meals to entitled persons”, such persons will be entitled to a food security allowance from the state government, as prescribed by the central government.

Under this bill, the main obligation of the Central Government is to provide food grains (or, failing that, funds) to state governments, at prices specified in Schedule I, of the bill, to implement the main entitlements. The Central Government has wide-ranging powers to make Rules “in consultation with the state government”. The main obligation of state governments is to implement the relevant schemes, in accordance with the Central Government guidelines. State governments also have wide-ranging powers to make Rules. They are free to extend benefits and entitlements beyond what is prescribed in the Bill, from their own resources. Local Authorities and ‘Panchayati Raj’ Institutions are empowered to proper implementation of the Bill in their respective areas, and may be given additional responsibilities by notification.

The Bill has four schedules (these can be amended “by notification”). Schedule I prescribes issue prices for the PDS. Schedule II prescribes “nutritional standards” for midday meals, take-home rations and related entitlements. Schedule III lists various “provisions for advancing food security”. Schedule IV specifies a minimum food grain allocation for each state; in the case of states that might lose otherwise under the Act, this essentially means a continuing of existing allocations.

The government says it will spend about US $4 billion a year on the programme. However, some analysts says, it could cost about $23 billion a year and take a third of annual grain production.

This effort should be considered as an investment to the India’s future infrastructure needs. People are the most important infrastructure of any country.

____________________________________________________________

* Dr. Thomas the Executive Director of Partners in Population and Development- An intergovernmental organization promoting South-South Cooperation in the area of population and development. This is his personal opinion.

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Capturing the Demographic Dividend in Pakistan

Edited by Zeba A. Sathar, Rabbi Royan,  and John Bongaarts

A pdf version of the book is available at the  following url
http://www.popcouncil.org/publications/books/2013_PakistanDividend.asp

According to Prof. David Bloom, this book brings together many ideas that have been discussed for some time in Pakistan and around the world. The compelling path forward it lays out, which entails extensive development of education and major efforts in the reproductive health arena, offers an inviting and highly achievable means for shaping and harnessing Pakistan’s growing population in a way that promotes inclusive economic development. As such, this book can be considered part of a blueprint for development in Pakistan.

This book is a joint attempt by the Population Council, and the United Nations Population Fund and is worth reading as well as being a tremendous addition to the list of reference books.  Its author Dr Zeba Sathar has injected life in it through hard work, comprehensive research, and commitment to the cause, to let the readers know that there is strong linkages between population growth and social sector problems like health, education, labour force, employment etc.  This book is a valuable contribution to create awareness that unchecked population growth might prove a disaster for Pakistan.  In a couple of decades, the population of Pakistan will rise to 300 million. With progress in social sectors, and employment opportunities growing at a slower pace than anticipated the country will be under enormous  demographic pressure.

CONTENTS

Foreword (PDF; 1.8MB)

David E. Bloom

Chapter 1: Overview: The Population of Pakistan Today
Rabbi Royan, Zeba A. Sathar

Chapter 2: Population Trends in Pakistan (PDF: 4.0MB)
John Bongaarts, Zeba A. Sathar, Arshad Mahmood

Chapter 3: Education and Population: Closely Linked Trajectories for Pakistan (PDF: 5.0MB)
Asir Wazir, Anne Goujon, Wolfgang Lutz

Chapter 4: Why Has Pakistan Not Reaped Its Demographic Dividend? (PDF: 3.9MB)
Rashid Amjad

Chapter 5: Population and Poverty Dynamics in Rural Pakistan: Evidence from the Longitudinal Household Survey (PDF: 2.2MB)
G.M. Arif

Chapter 6: Meeting the Challenge of Demographic Change through Equitable Development (PDF: 2.3MB)
Akmal Hussain

Chapter 7: What Hampers Population Policy in Pakistan? The Crossroads of Women’s Empowerment and Development Agendas (PDF: 1.8MB)
Saba Gul Khattak

Chapter 8: Policies for Capturing the Demographic Dividend in Pakistan (PDF: 2.2MB)
John Bongaarts, Ali Mohammad Mir, Arshad Mahmood

Chapter 9: Conclusions (PDF: 1.5MB)
Zeba Sathar, Rabbi Royan

References (PDF: 1.6MB)

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PPD Policy Brief on ‘Adolescent Pregnancy: Status, Socio-Economic Cost, Policy and Program Options for 25 Member Countries of PPD’

 

Background

‘Adolescent pregnancy’ is the theme for the World Population Day this year.  Partners in Population and Development (PPD) is taking this opportunity to highlight the status of adolescent pregnancy in its member countries and discuss relevant policy and program options for them.

PPD is a southern-led, southern-run Inter-governmental organization of 25 developing countries across Africa, Asia, the Middle-east and Latin America, promoting South-South Cooperation in Reproductive Health, Population and Development (http://www.partners-popdev.org/).

The adolescents aged 10-19 years stood about 1.2 billion in 2011 constituting 18% of the total world population. About 90% of the adolescents live in developing countries and nearly 62% in 25 PPD member countries.  In the member countries of PPD, the proportion of adolescents ranged from highest 25% in Ethiopia, Yemen and Zimbabwe to lowest 15% in China and Thailand in 2011 (Table 1).

Early Marriage and Adolescent Pregnancy

While adolescent marriage is a human rights abuse, it also presents a formidable threat to adolescent girls’ lives, health and future prospects. According to WHO and UNFPA reports, 2012, over 30% of adolescent girls in developing countries were married before 18 years of age and about 14% before the age of 15 years. The prevalence of adolescent marriage before 18 years among women aged 20-24 years ranged widely among the member countries of PPD, with the highest 66% in Bangladesh and the lowest 6% in South Africa (Table 1).

Early marriage can lead adolescent girls to complications related to pregnancy and childbirth, and expose them to sexually transmitted infections including HIV. In developing countries, complications of pregnancy and childbirth are the leading causes of death among adolescent aged 15-19 years and accounts for about 50,000 deaths each year. Adolescents who give birth carry a much higher risk of dying from maternal causes compared to women who are in their twenties and thirties. The risk increases exponentially as maternal age decreases, adolescents under 15 years carry five times more risk of dying during childbirth compared to women in their twenties.  The adverse effects of adolescent pregnancy also impact the health of their newborns. Still births and newborn deaths in the first week of birth are 50% higher among babies born to adolescent mothers than among babies born to mothers aged 20-29 years.

Adolescent Pregnancy in PPD Member Countries

Among the 25 member countries of PPD, pregnancy among adolescents aged 15-19 years was highest in Egypt (9.6%) and lowest in Tunisia (0.9%). Among the member countries of PPD in Asia-pacific region, the rate was highest in Bangladesh (6.1%) and lowest in Vietnam (1.6%). In Sub-Saharan Africa, Mali (5.4%), Uganda (5.7%) and Zimbabwe (5.5%) had similar high rates of adolescent pregnancy. The lowest rate of adolescent pregnancy was in South Africa (2.3%). In the MENA region, the highest prevalence of adolescent pregnancy was in Egypt (9.6%) and the lowest was in Tunisia (0.9%).  The prevalence of adolescent pregnancy was 4.3% in Colombia and 3.9% in Mexico.

According to WHO, 2012, about 16 million adolescents aged 15-19 years and 2 million adolescents under the age of 15 years give birth every year. About 95% of these births occur in developing countries. The prevalence of women aged 20-24 years who gave birth before 18 years, ranged widely in PPD member countries, from the highest 46% in Mali to the lowest 3% in Vietnam (Table 1). A considerable proportion of adolescent pregnancies are either unplanned or unwanted and 30% to 60% of these pregnancies among adolescents end in abortion.

According to the Guttmacher Institute and UNFPA, 2009, around 44% of married adolescents aged 15–19 years in the developing countries wanted to avoid pregnancy of which only 33% used a modern contraceptive method. The prevalence of contraceptive use (modern methods) ranged widely in 25 member countries of PPD. The prevalence was highest in Thailand (67%) followed by Colombia (55%), South Africa (48%), Indonesia (45%), Bangladesh (37.6%), Morocco (36%) and Zimbabwe (36%). The lowest prevalence was in Nigeria (2.4%).

Among adolescents who wanted to avoid pregnancy in PPD member countries, the prevalence of unmet need of contraceptive was highest in Ghana (62%) followed by Mali (35%), Ethiopia (33%), Senegal (31%), India (27%), Benin and South Africa (26%), Bangladesh and Pakistan (20%), Nigeria (19%), Zimbabwe (17%), Uganda (11%), Kenya (9%), Colombia (8%) and Morocco (1%).

PPD has been actively advocating for repositioning family planning in the international development agenda and working with its member countries to realize the commitments made by the governments at the London FP Summit 2012 to address the unmet need.

Currently, PPD is working with a research consortium of 6 partners (Population Council, ICDDR,B, London School of Hygiene and Tropical Medicine, Marie Stops International, African Population and Health Research Centre and PPD) on the STEP UP (Strengthening Evidence for Programming on Unintended Pregnancy) project to generate policy-relevant research to promote an evidence based approach for improving access to family planning and safe abortion. The evidence will inform programs to address the unmet need and unintended pregnancies of adolescents. As one of the partners of this international consortium, PPD is involved in increasing the research evidence uptake, capacity building as well as creating partnership and networking in five focus countries (Bangladesh, India, Kenya, Ghana and Senegal).

Socio- Economic Cost of Adolescent Pregnancy

While adolescent pregnancy and child birth presents serious threats to adolescent girls’ health and lives, it also results in substantial social and economic costs.  While there is information gap in developing countries, reviews in developed countries reported substantial social and economic costs linked to adolescent pregnancy and child birth. According to the Centre for Disease Control (CDC), 2008, in the United States, adolescent pregnancy and child birth accounted for nearly USD 11 billion each year.  An economic evaluation of a comprehensive adolescent pregnancy prevention program in the United Kingdom, 2011, reported that the cost savings from averted births were nearly USD 1,599 per adolescent per year.  Adolescent pregnancy and childbearing also have significant long term social consequences for the adolescents, their children, families and communities. Reviews showed that adolescent pregnancies led them to less educational attainment, poor health and poverty. Children born to adolescent mothers also experience poor health outcomes, low level of cognitive development, have behavioral problems and less educational attainment.

Policy and Program Options

PPD is urging the governments of its member countries to take immediate steps to end early marriage and adolescent pregnancy. It can be achieved through formulating policies and programs for empowering girls, changing social and cultural norms, undertaking legal reform and reinforcement, designing and implementing programs ensuring universal access to reproductive health.

Proven strategies include keeping adolescent girls in schools using economic incentives and livelihood programs, protect them from coerced sex, offering life skills, informing families and communities on adverse effects of adolescent pregnancy, and mobilize them to support girls to grow and develop into women before becoming mothers.

The programs need to include Sexual and Reproductive Health and Rights (SRHR) information, skills building and services for adolescents e.g. a) informing adolescents about their rights to have access to health care services b) providing accurate knowledge on sexual and reproductive health c) increasing the use of contraception by adolescents at risk of unintended pregnancy d) addressing unmet need for Family Planning e) increasing access to adolescent friendly services f) reducing unsafe abortion among adolescents and to ensure post abortion care g) increasing the use of skilled antenatal, childbirth and postnatal care h) increasing community awareness and participation i) addressing gender equity and equality j) promoting youth-adult partnerships, and k) ensuring male participation in all SRHR programs for adolescents.

PPD is also urging its member countries to share their lessons learned with each other from existing SRHR programs for adolescents to prevent early marriage, adolescent pregnancy, and improve over-all adolescent health. PPD is willing to facilitate the exchanges as a part of promoting South-South Cooperation among its member countries in Reproductive Health, Population and Development.

Table1_PB_100713

Sources:

http://www.unfpa.org/public/world-population-day/

http://www.unicef.org/sowc2013/files/SWCR2013_ENG_Lo_res_24_Apr_2013.pdf

http://www.who.int/maternal_child_adolescent/documents/countries/en/index.html

http://www.devinfo.info/mdg5b/

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960203-7/fulltext

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2960407-3/fulltext

http://www.bmj.com/content/339/bmj.b4254

http://www.indianpediatrics.net/feb2004/feb-137-145.htm

http://www.cdc.gov/teenpregnancy/aboutteenpreg.htm

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3020976/

http://www.who.int/gho/publications/world_health_statistics/EN_WHS2013_Full.pdf

http://www.unfpa.org/webdav/site/global/shared/documents/publications/2012/MarryingTooYoung.pdf

http://whqlibdoc.who.int/hq/2012/WHO_FWC_MCA_12_02.pdf

http://www.who.int/maternal_child_adolescent/documents/mpsnnotes_2_lr.pdf

http://www.unicef.org/media/files/PFC2012_A_report_card_on_adolescents.pdf

http://www.guttmacher.org/pubs/AddingItUp2009.pdf

http://www.icpdtaskforce.org/beyond-2014/policy-recommendations.html

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Trends of Human Development Index (HDI) in Partners in Population and Development (PPD) Member Countries, 1990-2012

The UNDP’s Human Development Report 2013: The Rise of the South: Human Progress in a Diverse World indicates Global South Shows Major Gains. But still Least Developed. South- South Collaboration for improving HDI needs to be explored.

Human Development Index (HDI) is a composite estimate of national development that includes indicators along three dimensions; life expectancy, educational attainment and command over the resources needed for a decent living.

The 2013 Report identifies four specific areas of focus for sustaining development momentum: enhancing equity, including on the gender dimension; enabling greater voice and participation of citizens, including youth; confronting environmental pressures; and managing demographic change.

In 2012, the global average of HDI value was 0.694. Among the developing regions, Europe and Central Asia had the highest HDI value (0.771) followed by Latin America and the Caribbean (0.741). The average HDI value was lowest for Sub-Saharan Africa (0.475) followed by South Asia (0.558).

Among the member countries of PPD in Asia-pacific region, in 2012; (Table 1. Trends of Human Development Index (HDI) in PPD Member Countries, 1990-2012)  the HDI value was highest for China (0.699) and lowest for Bangladesh and Pakistan (0.515). During the period from 1990 to 2000, the average annual HDI growth ranged from highest 1.98% in Viet Nam to lowest 0.89% in Pakistan. During 2000 to 2012, the average annual HDI growth ranged from 1.74% in Pakistan to 0.82% in Thailand.

Among the member countries of PPD in Sub-Saharan Africa, in 2012; the HDI value was highest for South Africa (0.629) and was lowest for Mali (0.344). During the period from 1990 to 2000, Mali and Uganda achieved over 2% average annual HDI growth (2.86% and 2.06%, respectively). During 2000 to 2012, Ethiopia achieved highest annual HDI growth (3.09%) followed by Mali (2.04%).

In the member countries of PPD in MENA region, the HDI value was highest for Tunisia (0.712) followed by Jordan (0.700), Egypt (0.662), Morocco (0.591) and Yemen (0.458) in 2012. During the period between 1990 to 2000; the average annual HDI growth ranged from 2.78% in Yemen to 0.95% in Jordan. During 2000-2012, the average annual growth was highest in Yemen (1.66%) and was lowest in Jordan (0.62%).

Compare to other regional member countries, Colombia and Mexico, the two member countries of PPD in LA and Caribbean had better HDI values (0.719 and 0.775, respectively) in 2012. The average annual HDI growth was 0.93% for Colombia and 1% for Mexico during the period from 1990 to 2000. During 2000-2012, the average annual HDI growths were 0.75% and 0.59%, respectively.

The Report also suggests that as global development challenges become more complex and transboundary in nature, coordinated action on the most pressing challenges of our era, whether they be poverty eradication, climate change, or peace and security, is essential. As countries are increasingly interconnected through trade, migration, and information and communications technologies, it is no surprise that policy decisions in one place have substantial impacts elsewhere. The crises of recent years—food, financial, climate— which have blighted the lives of so many point to this, and to the importance of working to reduce people’s vulnerability to shocks and disasters.

Health is increasingly becoming the core concern of development. The findings of the report is an indication that in the coming years, the practice of  health diplomacy may need to develop additional body of knowledge and become a mature discipline.

Table 1. Trends of Human Development Index (HDI) in PPD Member Countries, 1990-2012

 

HDI

1990

 

HDI

 2000

 

HDI

2012

 

Average annual HDI growth

1990-2000

%

Average annual HDI growth

2000-2012

%

HDI

Ranking of PPD MCs in 2012

Asia-Pacific
Bangladesh

0.361

0.433

0.515

1.83

1.46

146

China

0.495

0.590

0.699

1.78

1.42

101

India

0.410

0.463

0.554

1.23

1.50

136

Indonesia

0.479

0.540

0.629

1.21

1.28

121

Pakistan

0.383

0.419

0.515

0.89

1.74

146

Thailand

0.569

0.625

0.690

0.94

0.82

103

Viet Nam

0.439

0.534

0.617

1.98

1.22

127

Sub-Saharan Africa
Benin

0.314

0.380

0.436

1.95

1.14

166

Ethiopia

0.275

0.396

3.09

173

Gambia

0.323

0.360

0.439

1.09

1.65

165

Ghana

0.427

0.461

0.558

0.77

1.60

135

Kenya

0.463

0.447

0.519

-0.33

1.24

145

Mali

0.204

0.270

0.344

2.86

2.04

182

Nigeria

0.471

153

Senegal

0.368

0.405

0.470

0.97

1.25

154

South Africa

0.621

0.622

0.629

0.01

0.11

121

Uganda

0.306

0.375

0.456

2.06

1.65

161

Zimbabwe

0.427

0.376

0.397

-1.26

0.46

172

MENA
Egypt

0.502

0.593

0.662

1.68

0.92

112

Jordan

0.592

0.650

0.700

0.95

0.62

100

Morocco

0.440

0.512

0.591

1.54

1.20

130

Tunisia

0.553

0.642

0.712

1.51

0.86

94

Yemen

0.286

0.376

0.458

2.78

1.66

160

LA and Caribbean
Colombia

0.600

0.658

0.719

0.93

0.75

91

Mexico

0.654

0.745

0.775

1.00

0.59

61


Source:
Human Development Report 2013, The Rise of the South: Human Progress in a Diverse World, http://hdr.undp.org/en/media/HDR_2013_EN_complete.pdf

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Gaining Momentum: Women Empowerment and Health

IntWomensDay2013Luckily enough, women’s rights have improved a great extent deal over past centuries. Once, women were just expected to look after their household and rear children, but overtime women have become more involved in careers and excelled in those. Globally, countless women have achieved superior positions in politics, as great professors, writers, doctors and or even in just their respective workplaces.

However, it is not the case everywhere. In many countries, many nations still women are subjugated in various forms. It’s not that unusual anymore to flip pages of the newspaper to find cases of rapes, domestic violence, suicides due to eve teasing, sexual harassments and what not. Just within last year in Asia there have been major incidents such a girl being raped by a teacher in, several gang rapes, girls being harassed, beaten or even shot to death just for voicing their opinion; to name just a few. Similar stories occur all over the world, somewhere, everyday, only it does not get publicized. Although, the laws and government do put in a lot of effort to address these and other issues related to gender inequality, women continue to lag behind men in almost all aspects. Except for a calculable number of countries, children still take their father’s surnames, which is probably the he most common and simple example of the existing patriarchy. Men are still the head of the family, the higher income holder and thus with the strongest voice. Resultantly, women automatically become the weaker one in the family and eventually in the society also affecting maternal health in the process.

Not only just after marriages, discrimination of women due to this “insecured” society where it is unsafe for women to travel alone at night, leads to young girls are pushed into bearing the burden of marriage at a very early age, i.e. adolescent marriage. Young girls at the age of 10-19 gets separated from education are therefore unaware of their rights related to reproduction and sexuality which includes topics such as family planning, delayed childbearing, uses of contraception, treatment of fertility, interruption of unwanted pregnancies, breastfeeding etc. Consequently, she falls prey to complications in child-birth arises causing both the lives of the young mothers and infants to be threatened.  Thousands of women continue to lose their lives in pregnancy and childbirth; while many suffer pain, ill health and permanent disability as a result of pregnancy related problems.  Besides, an estimated 215 million of them lack access to modern contraception. Also up to 20 million unsafe abortions are performed on women, of whom 70,000 die every year. Not only just that, in case of planned pregnancies even, every single women carrying the children in their wombs deserve their husband’s attention, support, care and concern. After all, the father’s duty begins from the very second the baby is conceived. Just because the baby is inside the mother, it does not mean that he does not have any responsibility. In fact it is his duty to ensure his wife is taking nutritious meals, medications on time and routine check-ups to the doctor.  In addition, every man should also respect their wives decision in family making and has no authority to force them to take children unless she is willing to.

It is astounding; despite playing the versatile roles of a daughter, a wife, a mother, a home maker and also a sincere employee at work, women are discriminated. With the motto of not just counting people, rather making every people count The 1994 International Conference on Population and Development (ICPD) in Cairo was a milestone in the history of population and development, as well as in the history of women’s rights. With the aim of providing universal access to family planning and sexual and reproductive health services and reproductive rights, delivering gender equality, empowerment of women and equal access to education for girls, addressing the individual, social and economic impact of urbanization and migration and supporting sustainable development along with addressing environmental issues associated with population changes, a total of 179 countries have achieved remarkable success.

Nonetheless, to guarantee that no mother dies due to deficient of proper treatment, there is still a long way to go. Women need to be educated and made aware of their rights so that they can raise their voices when necessary, so that they do not lose their lives due to their husbands’ blatant ignorance or the obnoxious behavior by the men domineering in the society. Dear women, nobody will wrap your rights in a box and give it to you; you have to be bold and seek it for yourselves. Till the day you consider yourself a minority, you are going to be marginalized. Be bold, be brave and voice your rights. Gift a little independence to yourselves. PPD wishes you all a very happy and sovereign women’s day!

Rakshinda Huq, PPD

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