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Harnessing the Untapped Potential of Faith Groups to Improve Health Indicators_Victoria Graham_5.6.14
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Harnessing the Untapped Potential of Faith Groups to Improve Health Indicators_Victoria Graham_5.6.14

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  • This afternoon I am going to share with you what I have come to learn about working with faith entities.
    As public health professionals, we are always looking to improve health services and affect behavior change in the most challenging of environments - environments that lack transportation, technology, limited education systems, food insecurity, on and on. What emerges from those environments for us to build upon to improve the health of populations.
    Collectively, faith entities possess the most diverse and extensive social sector and operational networks in the world. They are not networks that need to be built, but they are networks that exits – right now.
    In fact, faith entities are well positioned to work in partnership to promote healthy reproductive behaviors and to deliver family planning information and services. They are even positioned to influence national policy and government spending.
    While there are strong supporters of family planning within the faith community, there are also differing perspectives on family planning across the spectrum of religious denominations, among religious leaders, and among their membership.
    You may know that in recent years, faith entities have demonstrated an increased support for family planning as an essential contribution to saving the lives of women and children.. Many of these groups have emerged as strong vocal advocates and have joined global efforts to advance family planning funding and programs.
    In general, faith entities can and do play important – and sometimes essential – roles in providing contraceptive services, raising awareness and advocating for family planning. And, we can work with them to do so much more.
  • When I use the term faith-entities I am not only referring to the faith-inspired NGO that we typically refer to as an Faith-based Organization.
    I am also referring to the
    centralized religious or denominational networks and infrastructures such as churches, mosques, synagogues;
    related social groups and services;
    media outlets; mission efforts;
    health systems, facilities, outreach and community-based services;
    educational systems including medical training and high education;
    influential religious leaders at all levels;
    interfaith coalitions.
    It is my hope that as you listen this morning you will come to the conclusion that faith entities are indeed good partners for family planning and not just family planning they can be strong partners to advance other health sectors as well.
  • All major religions – Buddism, Christianity, Hinduism, Islam, Judaism, emphasize the importance of addressing the needs of marginalized individuals and communities and are committed to serving the poor and disadvantaged
    In many of the countries we work, particularly in Africa, faith entities are among the most mature and sustainable social networks. In some countries, they are the ONLY widespread social networks making them very sustainable partners.
    Who over the years have developed a deep and trusted relationships with their communities.
    And, their leaders have the ability to influence thinking and foster dialogue on controversial issues such as family planning
    In fact, in terms of family planning, most faith entities involved in health believe that healthy timing and spacing of pregnancy is important to maternal and child health.
  • Religion is a powerful and positive force, particulaly for the disadvantaged and poorest populations.
    In fact, a survey conducted by the Gallup Poll in 2009 showed that ninety-two percent of those living in countries with a per capita income of $2,000 or lower say that religion is an important part of their daily lives.
    In fact, there appears to be an inverse relationship between income and the importance of faith and religion in daily life. So as per capita income increases the importance of faith and religion to the daily life of respondents diminished
    Where are those countries you ask?
  • Let’s take a look at the countries with the lowest GDP, which is directly proportional to the GDI, are those countries in gold to light yellow Yes, Africa and South Asia.
    It is not a surprise to anyone that Sub Saharan Africa and South Asia have the lowest annual income in the world. But it is important to remember that 92% of those living in these countries indicate that faith and religion are important to them?
    So, they may be reached through religious and faith channels.
  • In this same BBC survey, Religious leaders emerge as have a higher credibility and trust when compared to politicians.
    You might say that isn’t saying much.
    But, it does let us know that religious leaders are poised to contribute to national dialogue on controversial issues and call politicians accountable, and working with other church leaders in an inter-faith collaboration makes them stronger.
    Faith leaders also have the standing to influence practices and policies through extensive networks reaching deep into communities, and across countries and regions.
    We have found that these influential leaders can be called upon to champion family planning policies at all levels -- individual, community, national, and international. But there is always more that can be done.
  • A survey conducted by BBC asked individuals from around the world who had had the most influence on their decision-making over the past year. The majority indicated that family had the most influence. But friends and religious leaders were also reported.
    13% of those surveyed in Africa said religious leaders.
    Faith and religious beliefs influence the way people live their lives, marry, create families and communities, have children, and the choices they make.
    The helps to supported the idea that religious leaders have access to families, are able to address private issues such as
    timing and spacing births,
    delaying marriage, and
    domestic violence.
    This makes them an important channel for social and behavior change.
    CIS – Commonwealth of Independent States
  • Some of us assume that since we hear so much about the Catholic Church and their opposition to FP that the members must take the same position.
    There is also some media attention given to conservative Christians who oppose family planning use.
    Here are the results of the National Survey of Family Growth survey conducted in 2006-2008 that really tell the story.
    In fact, we find the opposite.
    Catholic, Protestant, Evangelical, and individuals who do not identify association with a religious affiliation are the lowest users.
    We see quite the oppositie.
  • The Adventist Church in Malawi
    Over 1300 churches spread throughout three main administrative districts
    Central 250 churches; North 150 churches; South (950 churches)
    1.2 - 1.6 million attend Sabbath services each week
    Within the church they have Departments for Health and Family Ministries
    Two major hospitals in the South:
    Blantyre Adventist - 40 bed referral hospital in Blantyre (700,000 pp) serving entire Southern Region (6 million pp)
    Malamulo Hospital: rural hospital includes services such as community health
    AHS manages 17 clinics and dispensaries throughout the country,
    Adventist Health Centre in Lilongwe, serving the central region.
    ADRA in Three Regions of Malawi:
    HIV/AIDS and Food Security Program
    Broadcasts the most watched TV and radio program in the country titled “Why are we dying?”
    Collaborates closely with the Adventist Health System
    WASH projects
    This is one church in one small country. It is important to mention that some religious affiliation have educational systems associated with these organizations as well, including high education for medical training
  • I’ve talked quite a bit about the importance of working with faith entities and their inherent benefits.
    We also need to recognize that diversity among faith entities. There is not a one-size-fits-all. In fact, while there are similarities, there are also differences. Particularly when it comes to family planning.
    First is the language used around family planning. Some are uncomfortable with the term contraceptives. Many faith groups prefer to use the terminology healthy timing and spacing of pregnancy.
    I’ve observed that some faith groups oppose providing contraceptives to unmarried youths. While I acknowledge their beliefs opposing sex before marriage I challenge them to consider the outcome of not providing these individuals with contraceptives – an unplanned pregnancy.
    For many faith groups, it is important that family planning is understood to exclude abortion, for some faith groups this includes methods they believe to be abortifacient. It is important that everyone understand that family planning does not in anyway equate to abortion. In fact, the only relationship that family planning has to abortion is an inverse relationship – when FP use goes up abortions go down.
    Some religious entities are more influential than others in motivating members to fully practice their beliefs.
    For family planning this next one is the most important. Appropriate family planning methods. Some faith entities only support natural methods, some FE have classified IUDs and EC are abortificients, even though there is not solid evidence for this classification.
    What is important is that their beliefs are respected but at the same time is it important that women have access to the entire range of services.
    Finally, there is a difference in the level of interest that faith groups in family planning. We feel there remains some resistance among leadership that needs to be addressed.
  • Most of the CCIH members who responded to this question 60% are purchasing contraceptives and drugs locally.
    Approximately 50% are obtaining contraceptives from the MOH. With this small response that means about 10 organizations in selected countries are obtaining contraceptives from MOH. This is something that needs to be resolved.
    In the same survey 40% respondents indicated that lack of contraceptive supplies, lack of human resources, hampered their efforts to provide FP.
  • There are differing levels of interest among faith groups in participating in family planning programs. We aren’t sure what the drivers are for this decision. It may be lack of information, lack of tools and resources, or simply not knowing how to take on this challenge.
    But we can that say that of those groups interested many feel that FP should hot be a stand alone program but family planning program should be a part of a comprehensive package of health services.
    The bottom line is that not only are faith entities good partners for public health, and particularly family planning. They are also interested in working in this area.
  • A spirit of respect and trust must be established between all of the partners involved. There must be a willingness and openness to partner with individuals and groups you may not understand,, different beliefs and faith traditions., who may have a different agenda.
    It will be important to build on the comparative Advantage of Faith Entities. Learn about their strengths and potential for advancing family planning. Yes, they will be challenges and areas that need to be strengthened but keep the end in mind.
    Establish Partnerships: The value of robust partnerships with multiple donors and implementers to ensure support for a broad spectrum of program activities and faith entities.
    Integration: The importance of integrating family planning into existing activities and services with the objective of creating a package of health services that address the essential health needs of the individual and community. This is important to faith entities.
    Compliance with Federal Laws.  Compliance with federal laws and USAID regulations regarding religious organizations receiving USAID funding and also with all statutory and policy requirements pertaining to abortion and assistance for family planning.
  • So, here is your take home message:
    Faith entities are an under utilized social sector network for health promotion, supporting behavior change and bringing services to underserved populations.
    It is time we begin tapping into this resource.
    Thank you
  • Transcript

    • 1. Harnessing the Untapped Potential of Faith Groups to Improve Health Indicators Victoria Graham, MBA USAID/GH/PRH/SDI May 6, 2014 CORE Group Meeting
    • 2. Faith entity defined • Faith-based Organizations • Centralized church networks and Infrastructure of religious denominations • Related social groups and services • Faith-related media outlets (web, radio, TV) • Faith-based health systems, facilities, and outreach and community-based services • Education systems including medical training and higher education • Influential denominational leaders • Interfaith coalitions
    • 3. Why work with faith entities? •Committed to serving the poor and disadvantaged •They have a long-term presence in their communities •They have deep and trusted relationships with their communities •Leaders are skilled and influential communicators able to shape cultural norms and promote healthy behaviors. thinking and foster dialogue •Leaders have access to the family and individuals . •Most faith organizations with health programming recognize that HTSP is important to maternal and child health
    • 4. Faith and religion are important to those living in poor countries Crabtree S, Pelham B. Religion Provides Emotional Boost to World’s Poor. Gallup World Web site. Why faith entities?
    • 5. Countries by GDP (nominal) per capita From Wikipedia, the free encyclopedia The poor valuing faith and religion as part of their daily life are found in Africa and South Asia Why faith entities?
    • 6. Religious leaders are more trusted than politicians globally Ferrett G. Africans Trust Religious Leaders. British Broadcasting Company Web site. Available http://news.bbc.co.uk/2/hi/Africa/4246754.stm. Dated 14 September 2005. Accessed March 24, 2014 Why faith entities?
    • 7. Other than friends and family, religious leaders influence personal decisions Ferrett G. Africans Trust Religious Leaders. British Broadcasting Company Web site. Available http://news.bbc.co.uk/2/hi/Africa/4246754.stm. Dated 14 September 2005. Accessed March 24, 2014 Why faith entities?
    • 8. Survey MethodologyContraceptive Method All women Catholic Protestant None Mainline Evangelical Highly Effective 69 68 73 74 62 Sterilization 33 32 34 41 26 Pill/other hormonal 31 31 35 28 30 Intrauterine device 5 5 4 4 6 Condom 14 15 13 10 17 Natural FP 1 2 1 1 1 Other 5 4 4 6 7 None 11 11 10 9 14 Current USA contraceptive use among women at risk of unintended pregnancy by religious affiliation (Natl Surv Fam Grwth 2006-08; n=7,356 women)
    • 9. Faith Entities are extensive social sector networks The Adventist Church in Malawi •Over 1300 churches within Central, North, and South Malawi •1.2 - 1.6 million attend Sabbath services each week •Departments for Health and Family Ministries The Adventist Health System in Malawi •Two major hospitals in the South – Blantyre and Malamulu •Sanitarium in Lilongwe serving the central region. •Adventist Health Services - 17 clinics throughout the country, ADRA works in all three regions of Malawi: •HIV/AIDS and Food Security Program •Broadcasts the most watched TV and radio program in the country titled “Why are we dying?” •Collaborates closely with the Adventist Health System •WASH projects Why faith entities?
    • 10. Diversity among faith entities • What is appropriate family planning language • Beliefs on age of marriage, use of contraception among unmarried • Beliefs regarding appropriateness of abortion • Ability to motivate members to practice beliefs • What methods are appropriate – All methods – All methods except what they believe are abortificients – Only natural methods
    • 11. CCIH survey respondents source of drugs and contraceptives - 20 respondents Huber D, Yang ER, Brown J, and Brown R. International Family Planning Christian Actions and Attitudes, August 2008.
    • 12. CCIH Survey Respondents interested in doing more in family planning - (57 Respondents) Huber D, Yang ER, Brown J, and Brown R. International Family Planning Christian Actions and Attitudes, August 2008.
    • 13. Guiding Principles • Spirit of Respect and Trust • Build on the comparative advantage of faith entities • Establish partnerships • Support integration of FP into other health services, especially maternal and child health • If working with USAID, Compliance with Federal Laws* USAID’s regulations regarding participation by religious organizations is found in the Federal Register (69 FR 61716) and is dated October 20, 2004. USAID restrictions regarding abortion and support for family planning service delivery can be found at http://www.usaid.gov/what-we-do/global-health/family-planning/usaids-family-planning-guiding-principles-and-us-0
    • 14. Faith entities are an under utilized social sector network for health promotion, supporting behavior change and bringing services to underserved populations Particularly healthy timing and spacing of pregnancy, domestic violence, and improving gender norms Let’s explore how to effectively utilize these social sector networks
    • 15. Thank You!

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