Promoting the Right to Sexual and Reproductive Health and Gender Equity in Diverse Cultural and Religious Settings

Oslo

Honourable Participants,
Colleagues and friends,

It is wonderful to be here in Oslo with all of you and to see many faces that I know and new ones that I will meet. I would like to thank Norway for hosting the Nordic meeting on this very critical yet complex subject.
I would like to thank Secretary of State Gry Larsen for reminding us of the framework for our consultation and for positioning the right to sexual and reproductive health in our dialogue.

But as I look at the participants and recalling what she said about involving me, I am still struck by the absence of men from this consultation. We are mostly women here and we have to strive to ensure that issues of sexual and reproductive health and gender equality are development issues of concern to both men and women. We still have a way to go.

Today I will talk about expanding engagement and partnership at the community level in service delivery of sexual and reproductive health programmes by Faith-Based Organizations (FBOs). I will not address the issue of youth perspective because this would be another keynote address by itself. This issue requires more knowledge and understanding especially as the youth culture has two poles – religiosity and progressive activism and young people have a special culture of their own. I would suggest that young people from diverse institutions including FBOs should be the ones to address their own perspective on culture and religion.

Some of us might not appreciate partnership with Faith-based Organizations but in our world today, such partnerships are expanding rapidly. Change has to find roots in people’s minds, behaviour, and interaction through their own empowerment but also through engaging the institutions in which they believe, to which they are attached and which provide them with the services they need, often in the absence of public services. I will focus on FBOs because of their large and community-based presence and their impact on communities. There is also a perception that they are all against the right to sexual and reproductive health, while in reality they are not monolithic and they play different roles and have diverse positions on culturally and religiously sensitive issues such as sexual and reproductive health.

In UNFPA, we have learned that the international debate on reproductive health and rights and gender equality was, and still remains, rarely technical; it was and remains about beliefs and values. Therefore, we must understand both culture and religion as they affect human experiences and lives, and support communities to bring about positive change from within.

Each one of us is a product of our own context; it is our individual identities and we often act and react based on how our context labels and stereotypes communities and people. When I started speaking about culture and religion, my background, as a Muslim woman from Saudi Arabia, worried supporters of ICPD, because they thought I would roll back the gains of ICPD on the right to sexual and reproductive health. But I persisted because the ICPD Programme of Action has stipulated that we work towards a broad-based alliance in order to sustain the implementation of women’s right to sexual and reproductive health. It recognized the existence of cultural values and religious beliefs that are not against human rights, as stated in its chapter on Principles.

This alliance accepts the diversity of our institutions but promotes working together for a holistic approach to implementation. The Programme of Action promotes every value and belief that endorses human rights. This is the main principle behind the use of cultural sensitivity to promote human rights. We know the WHAT and the WHY, but we must learn the HOW.

Why Now

One might ask, why now?

It is a recurring news item that the achievements of some countries of Central America is being over-turned as parliaments are pressured to go back on laws on sexual and reproductive health, especially sexuality education for in-school children and young people and abortion where it is legal under certain conditions. Progress achieved so far has been fragile because it is not well-grounded in broad community alliance.

We need to be pragmatic on two fronts: first to protect the gains that countries have achieved and, second, to ensure sustainability of ongoing progress and to expand it further. As international development actors, we can support the engagement of communities to demand change and to protect this change.

The challenge we are facing now, and I heard recently from ministers of health of a number of countries that I just visited, is how to make the link between macro policies at the national level and the services that save life that must be positioned at the community level and that in many of the poorest countries are mostly provided by Faith-Based Organizations. In other words, our challenge is to take the words of policies and agreements on health system strengthening and make them operational realities where it matters most at the primary health level that is community-based – where people in general and women in particular live and die. And investing in finding common ground to ensure the right to sexual and reproductive health is a more powerful approach than confrontation because it takes into consideration that we are dealing with people’s most private of human feelings and beliefs. I say this knowing too well that we, as international development actors, and FBOs are not the same and that FBOs are not a homogenous group. We can find common ground for joint work and mutual support, and MDG5, including its target on universal access to reproductive health, is the right entry point for engagement. Therefore, investing in finding common ground to ensure the right to sexual and reproductive health is a powerful, cost-effective and sustainable approach.

Furthermore, I say this because we are faced with a rising radicalized religiosity that regards itself as a rebellion against this imbalanced world, a rebellion against humiliation and powerlessness, as the great theological scholar Karen Armstrong says.

I believe that to counter voices against human rights, which threaten the right to sexual and reproductive health and the rights of women, we need to expand partnerships, including with progressive faith-based organizations.

Marginalize or Mainstream Voices, Well-Grounded or a Passing Fad?

And my thinking on engaging communities is not new. My voice was part of marginalized calls to engage religious leaders and faith-based organizations in development. Among the early such initiatives was The World Faiths Development Dialogue, which was set up in 1998 by James Wolfensohn, President of the World Bank, and Lord Carey of Clifton, then Archbishop of Canterbury, to help promote a dialogue on poverty and development, both among the different faith traditions and between them and development agencies, such as the World Bank. As one of the follow-up actions, the Development Dialogue on Values and Ethics Unit at The World Bank convened a major meeting of faith and development leaders in July 2009 with a focus on issues related to service delivery by faith-based organizations.

Today you hear about many more initiatives to link ethics, values, and faith to international development. The most recent, September 2009, is an initiative by The Tony Blair Faith Foundation, the UK Department for International Development, Islamic Relief, World Vision, and Oxfam. Together they are hosting six seminars around the theme of “New Perspectives on Faith and Development”, one of which will focus on FBOs as health and education service providers. This partnership is aware that “the role of faith in the context of development is complex – it is often hugely positive, but it can also be deeply problematic”.

I believe that these initiatives are responding to a rapidly changing environment stressing community engagement and ownership by the people.

It is the HOW and not the WHY and the WHAT

We at UNFPA recognize the need to work through positive values that exist in all countries and in all cultures to realize further progress. We have learned through country experiences that culture matters. And, therefore, we are committed to deliberately, systematically and strategically institutionalizing a culturally sensitive approach to development.

Our work on culture is based on eight principles and we include religion within culture:

• Principle 1 is that cultures are the realities within the contexts in which development takes place and that people seek religious leaders and institutions for guidance, comfort and support.
• Principle 2 is that people are the products of their culture and also its creators. As such, they are not simply passive receivers but active agents who can reshape cultural values, norms and expressions.
• Principle 3 is that cultures are neither static nor monolithic. Every culture is characterized by diversity, contestability and private and public space for mediation and negotiation and diverse interpretations. This also includes interpretations of religious texts that are made by “men” and I mean “men” and that can be changed by the engagement of both men and women of faith.
• Principle 4 is that cultures have a strong impact on the social sectors and on social relations, but especially on gender power relations.
• Principle 5 is that it is through change from within societies/communities that cultural norms, traditions and expressions are changed.
• Principle 6 is respect for cultural independence and cultural diversity with the acknowledgement that change can be mediated in favour of human rights and gender equality.
• Principle 7 is that cultures and religions share common denominators with universal standards, such as human equality, compassion and tolerance and that their manifestation and/or interpretations can be a force to promote or obstruct human rights.
• Principle 8 is that human rights can be recognized and internalized through a culturally sensitive approach that gives social basis and support to the legal approach and that builds on positive cultural values and religious interpretations that strengthen human rights principles.

Success, we have learned, requires patience, willingness to listen carefully, respect for cultural diversity, and learning to find different ways to express culturally-loaded issues. The point is that we cannot achieve human rights for people; achieving human rights is the responsibility of the people themselves, but we can support their efforts in this process.

To have an appropriate intervention, we know the “WHY” and the “WHAT” and, thus, we need to know the context for the “HOW”.

MDG5 as an Entry Point

We, at UNFPA, took time to establish regional and global networks of faith-based organizations that provide services to communities. We needed to learn and understand.

In the global consultation of Faith-Based Organizations for Population and Development that took place in Istanbul, Türkiye in October 2008, FBOs from all regions, representing seven religions, showcased their work on maternal health, violence against women and the prevention of HIV and committed to work together, respecting each other’s ‘theological” space. Their request for capacity building took us by surprise because it was direct and simple.

They asked for three areas for capacity development: first, support to develop their knowledge base about medical and other substantive information related to maternal health and HIV so that they could counsel their constituency with accuracy and clarity; second to develop messages that they could use in communicating with their constituency; and third, to develop their capacity to interact with one another across religions.

And, in response, we at UNFPA are seeking support to fulfil their request. We followed this Istanbul meeting with a consultation in August 2009 for large global faith-based organizations that concluded by committing themselves to work with UNFPA on two priorities: improving maternal health and ending violence against women.

I would like to share three quick examples from Bangladesh, Egypt, and Malawi because they show the value of community participation and feedback.

In Bangladesh, the rates of child and maternal mortality were cut by half in the past decade. And much of this progress is attributed to community engagement and mobilization, including the participation of religious leaders.

In Egypt, the country is on track to reducing maternal mortality, because it has invested since the 1990s in taking a holistic approach, by improving hospitals, training health personnel, and improving community awareness about the dangers of delivery and the need to seek care in health facilities. It also included both Muslim and Christian leaders speaking to their constituencies on this critical intervention.

In Malawi, which has one of the highest maternal mortality rates in Africa, death rates have declined in two districts with community mobilization and improved facilities. In these communities, ownership of the UNFPA Safe Motherhood program was placed in the hands of the communities and there is now a deliberate effort to scale up similar programs in more districts throughout Malawi.

I would also like to share news from Christian Connections for International Health, which is a network of 150 Christian organizations and secular affiliates. They have expanded their family planning advocacy, and they are working to connect their member organizations with UNFPA in their countries to strengthen advocacy, capacity building and reproductive health services.

We are also working with others to prevent HIV infection and raise awareness about HIV and AIDS. At the recent 9th International Congress on AIDS in Asia/Pacific held in Bali, Indonesia, there was an Interfaith Pre-conference which recognized the urgency of confronting gender-based violence in an increasingly feminized pandemic. It was emphasized that faith-based responses are most effective when interfacing with the most marginalized groups. This includes networks and organizations of people living with HIV, including sex workers, men who have sex with men and injecting drug users.

We also see progress being made to end female genital mutilation and cutting. After many years of work and some false starts and setbacks, we can now point to impressive success in reducing the acceptability and incidence of female genital mutilation/cutting in several countries.

In Burkina Faso, Ethiopia, Egypt, Kenya, Mali, and Senegal, we know what needs to be done and we learned how to do it. And this knowledge can help reduce the risk of FGM faced by three million girls and women every year.

We have learned that public discussion led by respected community and religious leaders and supported through intensive media campaigns can help communities to openly question and confront this traditional practice. We have learned that efforts must focus on reducing social support for the practice itself rather than abandonment by practitioners. Approaches that focus only on seeking to “convert” the cutters through education and providing alternative revenue, or the passage of laws to criminalize the practice, are not sufficient because they do not address the underlying social norms that support the practice.

And we have learned that in areas where FGM was justified on the basis of Islam, a community-based intervention working with Islamic leaders and scholars has made the difference. The engagement of credible religious leaders as advocates for total abandonment of the practice is a critical and absolutely necessary part of the campaign.

Learning from community experience and being informed by social science and human rights perspectives, UNFPA and UNICEF, supported by Norway and other donors, are implementing a programme to accelerate the abandonment of FGM/C in 17 countries. By 2012, working closely with governments, NGOs, religious leaders and community groups, we hope to bring about a 40% reduction of the practice in targeted communities and to have at least one country declared free of FGM/C.

Women of Faith – Where are They in This Debate?

A group of activists that we look forward to engage on issues of sexual and reproductive health are networks of women of faith.

As UNFPA, we participated in launching and supporting a new network that brings together three partners: the Women, Faith and Development Alliance. The Washington National Cathedral’s Center for Global Justice and Reconciliation launched this initiative in April 2008 to promote gender equality and women’s empowerment, a priority in the Cathedral’s efforts to create justice and to “heal a broken world.”

Conclusion

It was gratifying to hear former US President Jimmy Carter speak on behalf of the Elders, a group started by Nelson Mandela, calling on all leaders to challenge and change the harmful teachings and practices that justify discrimination against women. The Elders ask that leaders of all religions have the courage to acknowledge and emphasize the positive messages of dignity and equality that all world's major faiths share. Their main message is that the word of God does not justify cruelty to women.

I am passionate about this issue because I believe that religion is the final frontier in our work to promote human rights, including the rights of women and the right to sexual and reproductive health. I firmly believe that including faith-based organizations and progressive religious leaders in our circle of partners will generate greater progress, even in dealing with what is considered taboos such as sexual orientation, gender identity, abortion or sex work.

I wish to conclude by the words of Archbishop Desmond Tutu, who said: “We can no longer allow ourselves to be so deeply separated by our differences over issues like sexual behaviour and reproductive rights that we ignore our common call, commanded by every religion - to address the deep injustice of extreme poverty borne so heavily by women and girls.”

I also recall Archbishop Desmond Tutu talking in a conference in Dublin a few years ago, about the ABC formula to prevent HIV transmission. Referring to the C (condom), he said that we certainly depend on God, but “sometimes God needs a little help”.

My friends, during the past 15 years since ICPD, we have come a long way. But we still have a long way to go to realize this vision where every woman is treated with dignity and respect and the right to sexual and reproductive health is protected.

In our complex world, the task of our generation, whether we are religious or secular, is to build a global community where people of every persuasion can live together free of fear and want, in peace, justice and equality.

Thank you.