Religious Leaders and Family Planning: A Match Made in Heaven?

Just a few years away from 2020, Zambia still has a significant journey ahead to reach the targets and commitments we made at the 2012 Summit on Family Planning in London. Zambia’s current fertility rate of 5.6 births per woman is among the highest in sub-Saharan Africa. Consequently, although maternal mortality and infant mortality rates have had a downward trend in the past few years, they still remain relatively high. Contraception use in the country remains low at 49 percent with high unmet need, especially among adolescents and women in rural areas. Sixty percent of the population in Zambia lives below the poverty line.

In light of such statistics, Zambia committed to scaling up the utilization of family planning through strategies such as doubling the budget allocated to family planning, improving the method mix of family planning commodities, and engaging religious leaders in “new dialogue” on family planning. Although the country has made progress in increasing the contraception prevalence rate, both demand and supply side barriers still exist. One major challenge in the utilization of family planning, especially in rural communities, are the myths and misconception surrounding family planning, including beliefs that family planning is not biblical or that it causes sterility.

Why religious leaders?

In many developing countries, religion is an integral part of society and religious leaders are important, well-respected community gatekeepers. In Zambia for instance, there are more churches than there health facilities. Over 98% of the population reported belonging to the Christian faith with the majority (80%) being Protestants and 20% being Catholics. Religious activities are the most common method of civil engagement reported by young people in Zambia. Faith based organizations (FBOs) are key in the delivery of social amenities such as health and education and as such are critical stakeholders in development.

FBOs have within them structures that can be used to disseminate information and promote healthy lifestyles. These include mission-supported health facilities, marriage counseling, and fellowship meetings for youth, men, and women. FBOs and religious leaders are uniquely positioned to be leveraged in improving the well-being of the population they serve. Through correct interpretation of doctrine and information sharing, FBOs and their religious leaders potentially hold the key to demystifying family planning and thus generating demand and reducing the unmet need.

The Churches Health Association of Zambia (CHAZ) oversees over 16 FBOs that run health facilities or provide health services in the country. CHAZ has been the government’s key partner in addressing major health issues such as HIV and TB through the provision of medical supplies, technical support, and supervision and grants. CHAZ has also been instrumental in spearheading the engagement of religious leaders in family planning dialogue. So far, CHAZ has convened two meetings with religious leaders from affiliated churches to begin the new dialogue as stated in Zambia’s FP2020 commitments.

At the most recent meeting held in May 2017, CHAZ again brought together religious leaders and other stakeholders to assess the progress being made and review what more could be done by religious leaders in scaling up family planning utilization in Zambia. Some key factors central to successfully engaging religious leaders emerged:

Definition is key.

Religious leaders at the meeting unanimously agreed that they were not against family planning as perceived by many. The term family planning encompasses a wide range of activities, most of which leaders agreed are in line with biblical principles. With a clear understanding of what family planning is, it would be easier to garner the support of religious leaders. Mrs. Karen Sichinga, the Executive Director of CHAZ, defined family planning as: “Enabling couples to determine the number and timing of pregnancies, including the voluntary use of methods to prevent pregnancy, not including abortion, harmonious with biblical beliefs and doctrine.”

Another religious leader added that the family planning has biblical foundations. He explained that the God expects his creation to plan just like he did when he created the world. He further stated that it would be irresponsible for a married couple not plan for the children they would bring into the world and cause them suffering because they can not adequately provide for their needs. Religious leaders therefore have a huge task of communicating to their denominations the biblical definition of family planning and adequately guiding members to make informed decision and dispel myths.

Belief sensitivity matters.

The religious leaders stressed the need for belief sensitivity if their engagement in family planning is to be meaningful. They also expressed that there is a need to support the church and whatever method of family planning it chooses to promote. For instance, although the Catholic Church has for a long time been labelled to be against family planning, the church does actually promote the use of the natural family planning method. Natural family planning, also known as the Standard Days Method (SDM), is a WHO recognized and scientifically proven family planning method. SDM is usually not provided in health facilities, resulting in missed opportunities for the many Catholic women who might favor this method.

The church’s biblical stance on abortion and use of family planning among the unmarried are also points of departure for the church and other secular promoters of family planning. The religious leaders insisted that even as they engage in promoting family planning, they should be allowed to do so within the premise of their doctrine. According to the Bible, sex is only allowed for married couples. Consequently, the church maintains it has no place in the promotion of family planning to the unmarried. One religious leader commented: “The youth should not be engaging in sexual activities in the first place… The only method of family planning which we support for the unmarried is abstinence. We also provide age appropriate information about sexuality and fertility management to equip the youth with information. For young people going through marriage counseling, we leverage that opportunity and talk about family planning in greater detail since they are about to go into marriage.”

Evidence shows that as many as 16,000 school-age girls in Zambia fell pregnant in 2014 alone. This means that 16,000 girls were also exposed to infections such as HIV and the cervical cancer-causing human papilloma virus. The girls who are falling pregnant are part of the many churches and congregations across the Zambia. Religious leaders, like other civil society organizations, should share in the responsibility of bringing this number down and should find ways of improving the effectiveness of the chosen method of family planning that they are promoting. In addition, other non-religious stakeholders in family planning should embrace the idea of compromise and respect of beliefs as engaging churches on a limited basis is better than no engagement at all.

Building trust is critical.

In order to maintain unity of purpose among all the religious leaders affiliated with CHAZ, there is an urgent need to address the concerns raised by some religious leaders. One religious leader charged that the current dialogue with religious leaders being coordinated by CHAZ was cosmetic and instead called for frank closed-door talk with the government and CHAZ on the church’s position and involvement in issues of sexual and reproductive health in the country. The leader noted that the content of family planning as it was being presented at the meeting in front of the media was very different from what is presented elsewhere, and these differences were threatening the very values that the church stood on.

It is certain that CHAZ has taken a step in the right direction in engaging religious leaders in demand generation for family planning. It remains to be seen how this engagement can be coordinated and managed to result in improved outcomes for family planning.

Mulenga Mukanu was a 2016–2017 Global Health Corps fellow in Zambia.