Finding common ground


Ballooning up: Thai teen students putting balloons under their shirts so they look pregnant during a sex education programme at Panyapiwat school in Bangkok. — AFP

Ballooning up: Thai teen students putting balloons under their shirts so they look pregnant during a sex education programme at Panyapiwat school in Bangkok. — AFP

SECULAR NGOs and faith-based organisations (FBOs) are often at loggerheads when it comes to family planning issues.

Some NGOs blame FBOs for hampering work that needs to be done to prevent unwanted pregnancies and protect young people from sexually transmitted diseases. And the FBOs in turn feel that secular organisations are not sensitive to community mores.

However, last month’s Inter­national Conference on Family Planning in Bali revealed that the efforts of both types of organisations seem to be consolidating in some ways.

During the event, more than 40 global health and development organisations endorsed a global consensus statement for expanding contraceptive choice for adolescents and youths to include long-acting reversible contraceptives such as contraceptive implants and intrauterine contraceptive devices.

The wider choice is to be given to those sexually active from their first menstrual occurrence to age 24, regardless of marital status and parity.

Globally, there are 1.8 billion adolescents and youths, and 16 million adolescents ages 15 to 19 give birth annually – and some of these births are not planned, says the statement.

The statement also says that these efforts will hopefully reduce cases of maternal and infant morbidity and mortality, rates of unsafe abortions, and incidences of HIV and other sexually transmitted infections, and improve nutritional status, keep girls in school, improve economic opportunities, and contribute towards achieving the universal Sustainable Development Goals (SDGs) that have been adopted by all countries.

CEO of global advocacy organisation Women Deliver Katja Iversen says giving youths the opportunities and access so they can make those choices and reach their full potential is key for all.

Governments that have laws preventing sex before marriage are not in touch with reality, she said in a press conference at the event.

From the public health perspective, International Federation of Gynaecology and Obstetrics president Prof C.N. Purandare says govern­ments should make contraceptive available to all.

“We have women who come for an abortion and they don’t get the right advice, and they get pregnant again. We need to tell them the contraceptives available,” he says.

Youthful opinions

At the conference, young leaders gathered alongside policy makers, advocates and scientists to express their views and discuss their role in the family planning movement.

On religious barriers, Argentina young leader Paula Melisa Trad Malmod claims that sexual reproductive health information ­disseminated in schools in Argentina – a country that is mostly Roman Catholic – is sometimes not scientifically correct, such as condoms not being useful in preventing HIV/AIDS.

The country’s leadership is also not keen to discuss family planning at Congress, she said in a press conference the country’s youths held in Bali.

“Poverty in Latin America also makes women more vulnerable towards unwanted pregnancies and sexually transmitted diseases,” she says.

South Africa young leader Nomtika Mjwana says that people tend to place the responsibility on women to be a virgin but do not hold men to the same standard.

“When we address family planning, we need to start with male responsibility,” she says.

International Youth Alliance for Family Planning representative Ramya Jawahar feels that even those as young as 13 who want contraceptives should be allowed access unless statutory rape laws limit the age of consent.

Asked how she reconciles this with the fact that FBOs and many parents are not likely to agree to this, Ramya says adults need to talk to the young about sex and allow them to make conscious, good decisions about their body, and this includes respectful sexual intercourse and understanding the consequences of having it as a child.

In Pakistan, the patriarchal mindset and the use of religion in the favour of men pose barriers to family planning, says Pakistan young leader Ayesha Memon.

“Men dominate society and women have no say about when they will get married or have children. With men’s preference for male children, women may give birth to seven or eight girls before getting a boy and the girls will be left unattended,” she says.

Ayesha also touches on child brides, saying, “Ironically, parents do not allow their daughters to talk about sex or safe sex but are all right with making their 10-year-old daughter marry a stranger.”

Understand faith-based groups

President and CEO of inter­national reproductive health organisation Pathfinder Purnima Mane says that there is a tendency to think of FBOs as adversarial to sexual reproductive health when, in fact, the trend is changing.

“In the many countries where we have done work on family planning, we have found that you can work with faith-based communities as long as you first understand their principles.

“And then you are able to have confident conversations with them on why sexual and reproductive health is of interest to their community,” she said at another press conference during the Bali event.

Mane says that all FBOs would like their communities to survive and thrive but there are certain elements that are not acceptable to the societies they serve.

For instance, she says that some communities do not prevent the distribution of condoms although community members themselves may not distribute them.

Mane says that it is important to try and work with FBOs because the message on sexual reproductive health is more effective ­coming from a locally embedded organisation than from an outsider going in and trying to convince the community.

USAID (the US Agency for International Development that manages American foreign assistance) assistant administrator for global health Dr Ariel Pablos-Mendez says many faith-based organisations have no issue working with USAID, as they have found that delay in birth saves lives.

Also, he says the decline in infant mortality in the last 50 years has brought about an increase in the demand for family planning.

Senegal’s Health and Social Action Minister Dr Awa Marie Coll Seck says the success of family planning in many countries made up of faith adherents will depend on how governments work with them.

“And also, we cannot ask them to do something that they cannot do,” she says.

For instance, in Senegal, 92% of the population are Muslims, 5% are Roman Catholics and the rest, animists.

“The Catholics say they don’t want contraceptives but they say they will not interfere with what the government is doing.

“It helps that they don’t continue to criticise us,” she says, adding that her government also has a community of imams who support family planning work and counter those who criticise it.

She says governments must have the political will to provide contraceptive use to all besides teaching sexual health subjects in schools and training health workers to do counselling and not judge people.

Related stories:

Mutual respect needed

Need for comprehensive sexuality education