Cheikh Saliou MBACKE, Hassane SYLLA, Katherine Marshall
Ask health professionals how religious leaders view family planning and you may meet some skepticism. However, a program in Senegal has defied negative preconceptions and is an example of engaging religious leaders in health. A combination of leadership that brings different religious communities together, robust theological and intellectual inputs, learning partnerships, alertness to differing perspectives, and patient determination show religious support as a necessary facet of national family health initiatives. Cadre des Religieux pour la Santé et le Développement (CRSD), a coalition of religious leadership, has emerged as an interreligious non-governmental actor, a vital partner, and an integral part of Senegal’s family planning and welfare programs.
How did this coalition emerge and why has it met so much success? CRSD is grounded in theology and thus religious networks and ideas. It builds on broad government commitment to work with “religious champions.” CRSD was willing to learn from international experience with positive religious engagement and integrate key aspects into their programs. The FP2030 coalition that envisaged roles for religious actors offered encouragement. Other elements played important parts: the partnership that took on the challenge in Senegal, between Cheikh Saliou Mbacke, who brought long interreligious experience, and the World Faiths Development Dialogue (WFDD), drew heavily on personal relationships and, frankly, leaps of faith. Creative financial support was critical: the Hewlett Foundation, deeply committed to the region wide Ouagadougou Partnership supporting family planning, financed a modest pilot effort. But there were no blueprints and plenty of skepticism at the start.
CRSD’s work to promote family planning began from a limited base. In 2014, few Senegalese religious actors, including CRSD members, knew much about family planning and other aspects of family health. A learning-in-action process thus dominated the first years. Work began with efforts to mobilize and inform diverse religious leaders. This involved “top down” (visits to Senegal’s leading religious authorities) and “bottom up” (reaching community members and the creation of an Islamic “argumentaire”) approaches. A visit of leading Senegalese religious actors to Morocco drew on relevant experience, as did discussions with numerous Senegalese activists and scholars. The program grew steadily with meetings and workshops across Senegal, together with cooperative ventures in other Sahel countries.
Despite marked progress in increasing modern contraceptive use and reducing infant and maternal mortality, Senegal still has far to go to achieve its targets. Quantifying the full impact of the religious contributions is nigh impossible, but qualitative and quantitative measures provide evidence that these contributions are and continue to be substantial. Recognition by health authorities of the impact of CRSD interventions underscores the importance of involving religious leaders in health programs.
What lessons can be drawn from this experience? Shared experience and strong commitment by the diverse leaders to work together have been fundamental in the effort’s success. A deliberately measured, step by step approach helped build trust among the actors.
Intensive dialogue among CRSD members has been an essential feature. At first, some members actively opposed family planning, argued from a religious angle. A fiercely debated religious analysis (resulting in the argumentaire) brought members together and provided a solid foundation for continuing discussions on contentious topics, like approaches to unmarried youth and how to address misinformation. The essential consensus that religion, particularly Islam, supports family planning among married couples through birth spacing remains a foundation for action.
An important, continuing challenge is youth. Family planning advocates tend to focus on young people, many not yet married. CRSD reflected internally before engaging directly with this challenge, taking a measured approach before acting. Reluctance to participate directly and publicly in debates about providing family planning services to youth was not because they were in denial. Rather, defining a religious approach to the question was imperative. After many reflections and extensive consultations, CRSD decided to develop a religious argument on promoting the health of adolescents and young people.
The fundamental challenge to achieving national and regional family planning objectives is not to change behavior, but to transform the social norms and implicit standards that can hinder progress. These standards must first be understood and respected, followed by collaboration. It is problematic to seek to change norms without the participation and agreement of communities. Through negotiation and dialogue with influential members of the community (religious leaders, customary chiefs, opinion leaders, etc.), meaningful change can find genuine agreement.
Terminology used in advocacy is critical. Messaging such as “Family planning, through birth spacing, can help reduce maternal and infant-child mortality,” and “Islam and Christianity regard human life as sacred,” can be persuasive in religious advocacy for family planning. Important ideas can be rejected when terms offend the sensibilities of the targeted communities. Religious actors, charged with advocacy, can use the appropriate language to discuss the benefits of behavior change.
Dialogue within religious circles needs to move beyond them, especially to political and administrative leaders. Dialogue and cooperation between decision-makers, science, and religious actors are essential. This requires awareness of the critical role religious beliefs and leadership plays in social transformations. Early in the COVID-19 pandemic, CRSD promoted vaccination and advocated action by religious authorities, shaping behavior and saving lives. People’s trust in their religious leaders played critical parts.
The CRSD experience offers important learning. Some lessons are straightforward: respect for the distinctive approaches of different communities, avoiding traps of stereotypes and preconceived ideas, and a combination of patience and forward momentum. Less obvious are the practical importance of heeding diverse religious views, the careful processes needed to translate a broad willingness by government officials to engage with religious figures into operational strategies, and the merits of linking top down and more bottom up approaches. Senegal’s learning process is far from complete but it underscores the importance of strategic religious engagement—strategic in tailoring approaches to local context, religious in recognizing why diverse religious ideas and people played essential roles, and engagement as a respectful and active commitment to working together.