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Culture is and always has been central to development. As a natural and fundamental dimension of people's lives, culture must be integrated into development policy and programming. This report shows how this process works in practice.

The starting point of the report is the universal validity of the international human rights framework. The focus is therefore on discussing and showcasing how culturally sensitive approaches are critical for the realization of human rights in general and women's rights in particular.

The report gives an overview of the conceptual frameworks as well as the practice of development, looking at the everyday events that make up people's experience of development. Culturally sensitive approaches call for cultural fluency – familiarity with how cultures work, and how to work with them. The report presents some of the challenges and dilemmas of culturally sensitive strategies and suggests how partnerships can address them.

Culture – inherited patterns of shared meanings and common understandings – influences how people manage their lives, and provides the lens through which they interpret their society. Cultures affect how people think and act; but they do not produce uniformity of thought or behaviour.
Cultures must be seen in their wider context: They influence and are influenced by external circumstances and change in response. They are not static; people are continuously involved in reshaping them, although some aspects of culture continue to influence choices and lifestyles for very long periods.

Cultural customs, norms, behaviours and attitudes are as varied as they are elusive and dynamic. It is risky to generalize, and it is particularly dangerous to judge one culture by the norms and values of another. Such over-simplification can lead to the assumption that every member of a culture thinks the same way. This is not only a mistaken perception but ignores one of the drivers of cultural change, which is multiple expressions of internal resistance, out of which transitions emerge. The movement towards gender equality is a good example of this process at work.

Appeals for cultural sensitivity and engagement are sometimes wrongly interpreted as acceptance of harmful traditional practices, or a way of making excuses for non-compliance with universal human rights. This is far from the case – such relativism provides no basis for action and produces only stalemate and frustration. Values and practices that infringe upon human rights can be found in all cultures. Culturally sensitive approaches determine what makes sense to people and work with that knowledge. Embracing cultural realities can reveal the most effective ways to challenge harmful cultural practices and strengthen positive ones.

    Culturally sensitive approaches:

  • go beyond "what" to "how" and "why" things are the way they are;
  • seek the local knowledge and relationships that can provide the basis for dialogue and positive change;
  • avoid generalizations and acknowledge differences in values and objectives, even within the same culture;
  • encourage humility among those who work with communities; and
  • ensure that deep understanding of human realities, including culture, rather than theories or assumptions, become the basis for policy.

Culturally sensitive approaches are both logical and practical, recognizing that cultural development is as much a right as economic or social development. Creative solutions abound within cultures, and culturally sensitive approaches seek them out and work with them. Culturally sensitive approaches are crucial for understanding local contexts – involving legal, political, economic and social power relations – and their implications for development.

Human Rights
In addition to the Universal Declaration of Human Rights (1948), Member States of the United Nations have adopted a wide range of instruments elaborating on the principles of universality, indivisibility, interdependence, equality and non-discrimination. Once they enter into force, countries agree to be bound by their provisions; the fundamental provisions are binding on all nations. These instruments are joined by consensus documents such as the International Conference on Population and Development Programme of Action (1994) and the Platform for Action of the Fourth World Conference on Women (1995).


There has been considerable discussion over the universality of human rights, but the discussion has often overlooked the critical interrelationships between human rights and cultures. The human rights framework includes protections for the collective rights of groups as well as those of individuals; among these is the right to health, including reproductive health. The language of rights is the language of resistance to deprivation and oppression, which is common to all cultures: People have begun using the language of rights to make their own claims.

Universal rights are realized by specific people and groups in their own cultural contexts, and must be understood in that way. This realization is what culturally sensitive approaches aim to achieve.

    Culturally sensitive approaches recognize that:

  • people in different cultures understand rights in different ways;
  • people in the same culture also have different perspectives on and experiences of rights;
  • people advocate for rights in ways that suit their cultural contexts;
  • human rights can be ingrained through "cultural legitimacy"; and
  • facilitating cultural legitimacy requires cultural knowledge and engagement.

Culturally sensitive approaches can provide tools for understanding how human rights and cultures interact. People will respect human rights which they see as culturally legitimate, but ensuring legitimacy calls for important safeguards:

  • Avoid imposing particular interpretations of rights which undermine cultural ownership.
  • Do not avoid struggles over the meanings of rights but acknowledge them.
  • Contribute to policies by taking local norms and practices seriously into account.
  • Understand cultures at local, national and international levels, and the interrelationships among them.

Culturally sensitive approaches call for the inclusion of all societies and reaching into communities, including marginalized groups within communities. This is not a swift or predictable process. Human development with full realization of human rights depends on serious and respectful engagement with cultures.

Women's Empowerment and Gender Equality
At a variety of international meetings and conferences since 1975, governments, civil society and United Nations bodies have committed themselves to work with and for women, with specific goals and targets, most recently the Millennium Development Goals in 2000. Yet gender inequality remains widespread and deep-rooted in many cultures. Women and girls are three fifths of the world's one billion poorest people, women are two thirds of the 960 million adults in the world who cannot read, and girls are 70 per cent of the 130 million children who are out of school. Some social and cultural norms and traditions perpetuate gender-based violence, and women and men can both learn to turn a blind eye or accept it. Indeed, women may defend the structures that oppress them.

Power operates within cultures through coercion that may be visible, hidden in the structures of government and the law or ingrained in the perceptions people have of themselves. Power relations are therefore the glue which holds and moulds gender dynamics, and underpins both the rationale and the way cultures interact and manifest themselves. Practices such as child marriage (which is a leading cause of obstetric fistula and maternal death) and female genital mutilation or cutting (which has severe health consequences) continue in many countries despite laws against them. Women may join in perpetuating these practices, believing them to be a form of protection for their children and themselves.

Advances in gender equality have never come without cultural struggle. Women in Latin America, for example, have succeeded in making gender violence visible and in securing legislation against it, but enforcement remains a problem.

UNFPA's approach to programming for women's empowerment and gender equality integrates human rights, gender mainstreaming and cultural sensitivity, encouraging transformative cultural change from within. UNFPA collaborates not only with governments but with a variety of local organizations and individuals, many of whom it identifies as agents of change.

The "culture lens" is UNFPA's tool for contesting gender inequality and building alliances. It helps to develop the cultural fluency needed for negotiating, persuading and cultivating cultural acceptance and ownership.

Culturally sensitive approaches must respond to variations in needs, experiences and cultures; must understand how people negotiate their own contexts; and must learn from local resistance. Approaches must be reflective, critical and comprehensive.

Reproductive Health and Reproductive Rights

People and communities give a wide variety of meanings to reproductive health and reproductive rights, and understandings may vary even among individuals within a community. Cultural sensitivity is about realizing and understanding these varied meanings and being prepared for some unexpected realities; for example, some men may work for gender equality against their apparent self-interest, and some women may support practices that apparently harm them. Culturally sensitive approaches seek to understand and work with a community's views about what men and women contribute to procreation; for example, what it signifies when a woman or a couple does not reproduce, the effect of contraception on a woman's ability to conceive or on a man's view of what makes up his "manhood". Such understanding is essential for effective cooperation.

Cultural sensitivity helps to mitigate and overcome resistance to couples and individuals voluntarily planning the timing, spacing and size of their families. It prepares the way for empowering women, in particular with control over their own fertility. Culturally sensitive approaches are essential tools for development organizations concerned with promoting sexual and reproductive health.

Culturally sensitive approaches are also critical in mobilizing communities and building partnerships to work against certain harmful traditional practices, notably female genital mutilation or cutting (FGM/C). Most national governments, local communities and the international community at large firmly stand against FGM/C as a violation of human rights and a danger to physical and mental health. It is, however, a widespread and deeply-rooted tradition among some communities, sometimes backed by a totally spurious interpretation of religious teaching. It may be considered essential for full entry into adulthood and membership in the community; women without it may be considered ugly and unclean. Ending the practice involves taking all the different cultural meanings into account and finding meaningful alternatives, in close cooperation and discussion with the community.

[W]e are reviewing our experience to enable us to respond to the cultural challenge: to help countries, communities and individuals interpret universal principles, translate them into culturally sensitive terms and design programmes based on them, programmes that people can really feel are their own.
We can succeed in this if we keep close to our hearts the conviction that each human life is uniquely valuable, and that the right to development is the right for men and women to express the full measure of their humanity.
— Thoraya Ahmed Obaid, Executive Director, UNFPA

In recognizing and supporting local efforts, it is important to make alliances with opinion-makers and leaders as well as with those whose work in the field gives them significant outreach and influence. Some of the most dramatic changes occur when the guardians of cultural norms and practices, the "gatekeepers", are advocates for women's rights. In Cambodia, Buddhist nuns and monks are prominent in the struggle to combat HIV; in Zimbabwe, local leaders have taken up the challenge. Successful alliances seek broad partnerships in areas of human rights and gender equality, and set standards to apply in specific areas such as HIV prevention and AIDS treatment and care. Cultural sensitivity also necessitates taking into account the many other local efforts for change by organizations such as women's, youth and workers' groups and the ways they work with and reinforce each other.
Religion is central to many people's lives, and an important dimension of culture which influences the most intimate decisions and actions. Appeals to religion can be used to justify cultural practices such as killings in the name of "honour" or "crimes of passion", which are blatant human rights violations. Cultural sensitivity entails support for the many women – and some men – within the society who contest the practice.

Culturally sensitive approaches are essential for reaching the Millennium Development Goals, which includes a target, under Goal 5, to reduce the maternal mortality ratio by 75 per cent. The numbers of women dying as a consequence of pregnancy and childbirth are essentially unchanged since the 1980s, at about 536,000. Many times that number, between 10 and 15 million, suffer injury or illness. Lower maternal mortality, and avoiding injuries such as obstetric fistula, depends on better care in pregnancy and childbirth, emergency services in cases of complications and access to family planning. Cultural sensitivity is essential for success in these critical initiatives.

Engaging men in the design, implementation and delivery of programmes, for instance, is a means as well as the result of culturally sensitive approaches, and is a requirement of any development process intended to change behaviours and attitudes. Gender inequality and negative male attitudes are generally seen as a challenge to reproductive health and rights. Closer attention to men's experiences of gender and its inequalities is one of the building blocks of culturally sensitive approaches.
Cultural constructions of masculinity and sexuality can increase risk-taking and reduce the likelihood of men seeking help. Men tend to engage in sex at a younger age and have more partners than women; this may be connected with society's expectations of what makes a "real" man, and encourages risky sexual behaviour. Some men may be less concerned about their health than their masculinity. Cultural constructions increase stress and pressure on some men to prove themselves by exerting "male" authority, to the extent of forcing themselves on unwilling women. Their behaviour damages not only women's health but their social personalities – raped women have been forced to marry their rapists, or even accused of adultery.

Men may view seeking help or even information as a sign of weakness. They are much less likely than women to submit to voluntary counselling and testing for HIV. Male ignorance and anxiety puts both women and men at risk, but men may not see their behaviour as risky. Social and economic factors are also important: In communities where poverty, drugs and guns are common, HIV and AIDS take their place alongside other risks.

Culturally sensitive approaches go beyond standard explanations of male behaviour to investigate the relationship among social, political and legal contexts and resulting cultural norms, and the conditions under which men and women resist them. Building on this knowledge with local initiatives enables targeted and measured development support.

Poverty, Inequality and Population

Universal access to education and health care helps all. Universal access to education and health care helps all.
© UNICEF/HQ06-1355/Claudio Versiani

The International Conference on Population and Development (ICPD) Programme of Action is the basis for achieving population objectives, on which development depends. ICPD goals, now incorporated in the Millennium Development Goals (MDGs), include universal access to reproductive health care, universal education, the empowerment of women and gender equality. Marginalized communities benefit least from development policies, and are more likely to be poor. Their education and health care are not as good and their lives are shorter than those of the better-off. Poorer women in particular are bound by harmful aspects of tradition and culture, with higher risks of maternal death, illness and injury.

Unequal "development" increases the extent and the depth of poverty. Low levels of health and education make it more difficult to translate any additional income into improved well-being, preventing people from setting or reaching personal goals. Gender relations and physical capacities also have an impact in determining access to opportunities and resources and the ability to enjoy human rights. Analysing people's choices in their local conditions and contexts is therefore a precondition for better policies.

Population issues come down to decisions people make in specific cultural contexts, for example, about family planning, education, health care and migration. Compared with the rural past, development has redefined the value of children. Smaller families and more investment per child have become the norm, and cultures have adapted accordingly, aided by better reproductive health and other services. Poor people may still want larger families, because their circumstances have changed less. Many have yet to see how smaller families and better health and education can benefit them.

Some poorer women do want fewer children, but cultural constraints hold them back. Taking that into account, family planning programmes can succeed even where there has been little economic development, as in Bangladesh. On the other hand, some poor women use contraception because they cannot afford children, rather than to protect their own reproductive health.

The key to reproductive health is making motherhood safer via (1) access to family planning to reduce unin¬tended pregnancies and to space intended pregnancies; (2) skilled care for all pregnancies and births; (3) timely obstetric care for complications during childbirth; and (4) skilled care for women and babies after delivery.

The more likely it is that a woman will give birth with a skilled attendant present, the better the outcome is likely to be. Poorer women and poorer countries with lower proportions of attended births have higher rates of maternal mortality and morbidity. A woman may choose a traditional rather than a skilled birth attendant because the former provides a range of services before and after delivery, and because she is more familiar with the woman and her culture. Providing skilled birth attendants who have a cultural connection with the women they serve, as well as effective emergency and obstetric care backup and referral, which are also culturally acceptable, is a challenge for reproductive health services.
Migration has been a mixed experience for all concerned. International migrants – some 191 million in 2005 – provide at least $251 billion annually in remittances home, with appreciable effects on household and national economies. Their contribution is cultural as well as economic; migrants pick up and transmit cultural messages in both host and sending communities, including attitudes to human rights and gender equality.

Host countries' migration policies often have to contend with misunderstanding, discrimination and hostility towards migrants; source countries deal with the loss of skilled, qualified workers as well as family and community members. Trafficking, the dark underside of migration, damages both communities and the individuals concerned. It is becoming more common as migration policies become more restrictive, exposing migrants to economic exploitation, physical abuse and violence. These conditions provide fertile ground for conflicting cultural discourses. These include the reinvention of tradition (some of which entail perpetuating harmful practices such as FGM/C) among some groups of migrants, who feel alienated by the physical distance from their cultures of origin, while also marginalized by their host cultures.

Internal migration produces a range of risks and opportunities, weighted towards risk for the poor in both native and migrant populations. Better urban services, including reproductive health, are offset by their cost and the migrants' lack of social networks. Many migrants go home to give birth, despite apparently poorer-quality care.

The cumulative impact of economic and social change is forcing cultures to change in response. But the process may not be swift, and successful adaptation depends on understanding what is happening. Cultural change can itself change the social, political and economic context that produced it, and traditions and systems of meaning can survive many changes.

War, Gender Equality and Women's Empowerment
Women become a target in war because of their perceived position as guardians of culture. Rape is an act of violence aimed not only at a woman but at the cultural compositionof her national or community identity. Communities may view raped women as tainted or worthless, and they may suffer further violence as a result. Few communities address gender-based violence openly, and women often do not talk about it.

Militarization of a culture works against women's empowerment and gender equality, partly through the increased incidence – and acceptability – of violence. Conflict imposes additional responsibilities and costs on women who may become heads of household in the absence of men. Men may feel themselves powerless and unable to fulfil their duty to protect their families. This can arouse male resentment and violence.

Women's human rights are an international security concern, accepted as such by the United Nation's Security Council resolution 1325 (2000), which also recognizes the need for cultural engagement to ensure that women are part of the peace process. Despite concerns about what is missing from UNSC 1325, it recognizes critical policy gaps and calls for change.

Cultural sensitivity is required by those engaged in development and humanitarian assistance when working with women who have coped with the stresses brought on by armed conflict. Culturally sensitive approaches target both the potential and actual deterioration in gender relations, and aim to protect whatever progress women have made towards gender equality, including women's reproductive health and rights. Culturally sensitive approaches are especially needed in the context of armed conflict, which challenges cultural expectations of masculinity such as men's responsibility for protecting their families.

Male frustration and impotence in the face of wartime hardships often turn against women, but the common perception of women as victims and men as aggressors does not describe the varied responsibilities that women take on in wartime as heads of household, breadwinners, caregivers and combatants. Policies and approaches must recognize this complexity. Failure to recognize people's resilience and resourcefulness and what has changed as a result of the conflict may exclude women and minorities, including people with disabilities, from involvement in setting post-conflict priorities and development strategies.

Culturally sensitive approaches are also needed for people coping with trauma, meeting refugees' needs for sexual and reproductive health care, building partnerships with local organizations and helping people retain or recover their sense of cultural identity amid the ravages of war.
Inclusive strategic partnerships are a cornerstone of culturally sensitive approaches. These are built on recognizing that creative interventions on and around human rights often necessitate meaningful participation from communities built on an appreciation of symbols, forms and powerful agents of communication.

    Conclusions
  • International development agencies ignore culture – or marginalize it – at their peril. Advancing human rights requires an appreciation of the complexity, fluidity and centrality of culture by intentionally identifying and partnering with local agents of change.
  • Approaches based on cultural knowledge provide viability to policymaking – and enable the "cultural politics" required for human rights.
  • Cultural fluency determines how systems of meanings, economic and political opposition, or supportive policies develop – and can be developed.
  • To develop cultural fluency, UNFPA proposes a "culture lens" as a programming tool.
  • Culturally sensitive approaches investigate how variables such as economic status, politics, law, class, age, gender, religion and ethnicity intersect and lead to divergent understandings and manifestations of power.
  • Culturally sensitive approaches call for different analytical and operational frameworks, and for introspection within the development community.

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