Faith groups do more to promote "healthy timing and spacing of pregnancies"

The Reverend Cannon Kabana and his wife Damalie Kabanda talk to their congregation about the benefits of family planning at St. Mark's Church in Uganda. More religious institutions are promoting the "healthy timing and spacing of pregnancies to their members. Photo: Mona Bormet, Christian Connections for International Health.

This was originally published on Oct. 31, 2018 on Global Health TV.

The role of religious organizations in promoting and advocating for voluntary modern methods of family planning – once met with skepticism or derision — is gradually gaining more acceptance both in the religious and secular worlds. However, the faith-based community still does not get significant funding for family planning (or global development more broadly) despite a growing consensus that faith-based organizations (FBOs) are vital and trusted development partners at the community level. 

“When family planning is positioned primarily as a major public health contributor to improved maternal, child, and family health, the trend has clearly been for growing support for family planning in most religious communities,” said Ray Martin, who was executive director of Christian Connections for International Health(CCIH), a membership network of faith and secular organizations that promote global health and wholeness from a Christian perspective (full disclosure: I am a board member of CCIH). “When family planning was seen as a tool for old-style versions of population control, it was harder to marshal Christian support.” 

It is difficult to gauge the trend in FBO involvement in family planning, said Doug Fountain, interim executive director of CCIH. The Christian church does not speak with one voice on family planning, according to Fountain. Some actively promote it, and some don’t. 

“I’m struck that there are Christians who believe ‘we don’t need family planning; God will give us the number of children we should have’” said Fountain. “It’s the same line of thinking as ‘we can ignore medical care, God will give us the health we need.’  I would not agree with that personally and I don’t think that voice is increasing.”

I have the impression that more FBOs are promoting and advocating for family planning. But sometimes they don’t call it “family planning,” because of the political baggage attached to that term but call it “healthy timing and spacing of pregnancies.”

CCIH defines healthy timing and spacing of pregnancies this way: “Enabling couples to determine the number and timing of pregnancies, including the voluntary use of methods for preventing pregnancy — not including abortion — harmonious with their values and religious beliefs.”

CCIH has even identified scriptural support for family planning— Biblical support on the healthy timing and spacing of pregnancies.

But are such faith-based health programs effective? This study published by the American Public Health Association that found that “faith-based programs can improve health outcomes.”

But the study also found something often mentioned about faith-based health programs, even by advocates for greater FBO work in global health: Faith-based programs need to be more rigorously evaluated and the results of these evaluations disseminated more widely. 

A 2018 study by the Nigerian Urban Reproductive Health Initiative found that “exposure to family planning messages from religious leaders was significantly associated with higher modern contraceptive use” and that “interventions that engage clerics of different faiths as change agents for shaping norms and informing behaviors about family planning and contraceptive use are crucial for increasing contraceptive uptake in Nigeria.”

Even Duncan Green, the strategic adviser for Oxfam GB and a lifelong atheist, seems to be warming to FBOs, especially those that work at the grassroots. In a blog entitled “Are grassroots faith organizations better at advocacy/making change happen?” he quoted a Tearfund study that said “church and community mobilization advocacy has proven that churches are regarded with a high level of trust. They are trusted by their congregations, by the communities in which they are located and by local government.” Green called this “powerful and convincing stuff.”

The faith community advocating for family planning is also playing a more prominent role on the international stage. In 2016, 85 representatives of the faith community from 26 countries held a faith pre-summit at the International Conference on Family Planning in Indonesia. They represented Buddhist, Christian, Confucian, Hindu, Jewish and Muslim faiths.

They issued a statement which was read in the conference’s closing ceremony in which they re-affirmed their commitment “to continuing to inform and educate our communities on family planning, especially youth and faith leaders, as is consistent with our faith values as it protects the lives and health of mothers and children and families.”

And the faith community plans a strong presence at the 2018 International Conference on Family Planning in Kigali, Rwanda next month, with interfaith prayer, a faith celebration, nine sessions and many poster presentations. 

But the amounts going to FBOs for family planning have been modest, said Ray Martin, who was executive director of CCIH from 2000 to 2014.

“One of my criticisms of the major donors is that even though they have been discovering that FBOs can make a contribution to progress in achieving ambitious global objectives, e.g. in the Sustainability Development Goals, they are still stuck in a mode of tokenism, not appreciating the sheer magnitude of the importance of religion in the lesser developed countries, and the huge impact that FBOs could have in family planning and other development areas,” said Martin.

Martin said three other factors create impediments to greater support for FBOs in family planning: 1) Some fundamentalist Christian groups continue to conflate family planning with abortion, even though they are completely different issues; 2) Continued Catholic opposition to modern contraception; and 3) The timidity of some FBOs who see the maternal and child health value of family planning but prefer to “play it safe” because of perceived uncertainty about support in some quarters.

Last year, there was a lively debate within the Christian community on whether evangelical Christians should support family planning. The Christian Journal for Global Health published an article which strongly questioned the Christian morality of such support.

Dr. Henry Mosley, professor emeritus in the Department of Population, Family and Reproductive Health at Johns Hopkins Bloomberg School of Public Health, responded with a strong defense of such support. 

Christian public health professionals should show the love of Jesus by modeling His life of service and healing, writes Moseley. “This can be done these days with many powerful, lifesaving technologies, not the least of which is contraception, since this is such a fundamental public health intervention that can have a powerful influence on the health and welfare of couples and their children as well as on the roles and status of women.”

The Islamic world has seen an increase in family planning in the majority of countries, according to Ahmed Ragab, professor of reproductive health at the International Islamic Center for Population Studies and Research at Al-Azhar University in Cairo, Egypt.

“However, there are still pockets of individuals opposing family planning and advocating against it as a conspiracy against Muslims, like Nigeria,” said Ragab.

Ragab said only a few Islamic FBOs are working in family planning and those that are – such as the Islamic Center for Population Studies at Al-Azhar University in Egypt and Muhammadiyah and Nahdat El-Ulama in Indonesia — are increasing their support.