Morava is a participant in Global Citizen Year, an international bridge year program designed to unleash the potential of high school graduates as leaders and effective agents of change.
When I asked my host mother why she was going to the hospital one day, she replied simply, “Planning.” In Senegal, where contraceptive use rates are low and fertility rates high, a lack of family planning causes a range of serious problems, including higher-risk pregnancies, preterm births, and more deaths of mothers and infants. Growing numbers of people in Senegal, such as my host mother, favor family planning—but many remain resistant.
My apprenticeship at Association Rurale de Lutte Contre le SIDA (ARLS) in Senegal’s Thiès region prompted me to explore this issue. As an organization founded to fight AIDS and now working on a range of cross-sector women’s leadership issues, ARLS puts reproductive and maternal health high on its to-do list. ARLS staff members educate women on the importance of family planning in health centers and through personal village visits, but they told me that some of these women struggle to reconcile family planning with deeply revered Islamic traditions.
Senegal is a country where religion often trumps politics. As my language tutor explained: “If an imam and [Senegalese President] Macky Sall were in a room with only one chair, Macky Sall would have to sit on the floor.” With low levels of contraceptive use and Macky Sall on the floor, the options for intervention are limited, and the people best positioned to promote family planning may be Islamic leaders. But the relationship between family planning and the Quran’s teachings is a contentious topic among Senegal’s religious leaders. Many imams believe family planning is contrary to the Quran, parts of which prize fertility as an element of divine order.
The answer lies in championing religious leaders who do support family planning and its intentions, and in focusing on it as a health issue rather than a mechanism for limiting births. In this way, community members, local organizations, and government authorities could catalyze a change in attitude. To do so effectively, they must acknowledge and work within cultural norms. Religious leaders, the large majority of whom are men, are well-positioned to influence attitudes in part because patriarchal norms impose limitations on women throughout the country: A woman may not be making independent or even cooperative choices with her husband about conception and birthing. Therefore, those advocating for family planning would do well to appeal to both men and women.
In the past, Senegal has done exemplary work involving religious leaders in efforts to promote sexual health—particularly with HIV prevention. In the 1990’s, many imams participated in local outreach to educate citizens about prevention methods, and some even created a radio show about HIV/AIDS prevention and Islam. Compared with neighboring countries, HIV has relatively little presence in Senegal today, with a 0.5 percent prevalence rate among adults ages 15 to 49. (The adult prevalence rate is 1.8 percent in Gambia, 1.6 percent in Guinea, 3.7 percent in Guinea-Bissau). The organization with which I apprenticed, ARLS, follows the same strategy of involving religious leaders in promoting health awareness, but now with a focus on family planning endeavors. The local imam who works with ARLS, for example, has been involved at the organization’s various health posts for years. National organizations already collaborate with imams on health issues, but it is important that more local and regional organizations such as ARLS engage with rural imams.
Given the past success of religious involvement in HIV prevention, and changing attitudes toward family planning, religious leaders have an important role to play in improving Senegal’s sexual and reproductive health statistics. I am grateful for my bridge year in Senegal for giving these statistics faces, and bodies I’ve brushed up against in busy markets and the backs of buses. Even with this personal experience, I recognize that my perspective is limited and under-developed. But of this I am fairly certain: Progress on any issue is dependent on how closely we can examine and draw from the culture, values, and priorities of the people living the numbers.