Health, including sexual and reproductive Health (SRH), has different cultural perceptions and various determinants. Some crucial determinants of SRH include information, education, lifestyle, religion, region, law, gender roles, economy and political will. These factors are not only separately related to SRH but mutually influence each other.
A research on reproductive behaviour in Muslim countries by Dr.Mehtab Karim of AKU in 1997 has indicated that while there exists a considerable number of studies comparing the reproductive behaviour of Muslim and non-Muslim women, few comparative studies attempt to explain the differential patterns of behaviour among the geographically widely spread Muslim population.
The vital new issues underscored by International Conference on Population and Development (ICPD) encompassed gender equity, violence against women, trafficking of women, female genital mutilation, child marriage, male roles and responsibilities, unsafe abortion, infertility, STDs/HIV/AIDS, safe(r) motherhood and antenatal care.
What are the reproductive health (RH) issues in Muslim countries? In theory, the RH issues in Muslim countries should be the same as in the rest of the world. Further, being the signatory to the ideals of Cairo, the Muslim countries like all other signatories should be following the same solutions and strategies towards the RH issues as prescribed by the ICPD. Broadly speaking, this is not entirely incorrect.
Global issues of gender- based violence, economic and social empowerment for women; RH rights etc. are also visible and prevalent in the Muslim societies. However, since the causes and consequences of such issues vary, Muslim societies, which in turn are not a homogeneous entity, have a separate set of RH issues.
Islam is perceived as a religion hostile towards women. Gender is still believed as a western idea by majority of Muslim groups. The visible manifestations of religious commitments by the Muslims arouse exceptionally strong feelings and intense attitude by the West and have become a hot debate even within Muslims. For example veiling of Muslim women is equated with oppression and subordination. Bearded Muslim men are perceived as fanatics, fundamentalists, and oppressors and malevolent.
Abortion is severely restricted in nearly all-Muslim countries. Sterilisation (a permanent family planning method) is illegal in some countries and remains the subject of on going debate in many Muslim communities.
Not all-Muslim countries are faced with similar RH issues. For instance, dowry-related violence is a typical South Asian example of gender discrimination and violence against women. This is not seen in the Arab world where males are supposed to bear all expenses of the marriage. Similarly, female genital mutilation, as a form of violence against women, is an RH issue concern, mostly in the African Muslim countries and some parts of Indonesia and Malaysia.
Further, there are country-specific areas of concern. For instance, in some parts of the Sindh province of Pakistan, Marriage with Quran is practised to protect the family property, thus, denying the rights of inheritance, marriage and happiness to the girl.
Islam grants a central position to family and family life. In spite of emphasis on globalisation as a way of life within the Muslim societies, marriage is still intact as an institution with family as the fundamental unit of the society. Roald (2002) has observed that the maintenance of family's spiritual status seems to be regarded as recognition of the role of women in Muslim society.
If it is assumed that there are certain Muslim World -specific RH issues, there arise a series of logical questions: Who suffers most because of these issues? Who should be targeted while designing solutions? Are there any interventions to deal with the issues?
As already stated, ICPD identified and emphasised new population groups. Men and adolescents have emerged as the most important target groups and potentially most profitable investment points for RH interventions. However, since ICPD, a lot of clatter and clamour is being raised about the terminology of male role in RH in general and family planning (FP) in particular. Is it involvement, participation, responsibility, partnership or anything else?
Men, who are called social gatekeepers, bear an additional responsibility of influencing RH behaviour and decisions in general. In their many roles, men can control access to health policy, information services, finances, transport, communication and public opinion.
Although statistics and qualitative studies mostly reflect a bleak picture of the Muslim world, there are examples of efforts and contributions with gender focus and sensitivity, which raise and sustain hope and optimism. Most of these actions and activities belong to some form of communication, which indeed is one of the most effective tools for dealing with a variety of RH issues.
Some country/regional examples in this connection are cited below:
Bangladesh:
Where religion refuses to stand in the way, The Family Planning Association of Bangladesh (FPAB) has discretely mobilised religious support as part of promotional activities to involve men. Persistent efforts have resulted in creating a sympathetic atmosphere for FP. Imams preaching in favour of FP from the mosques are generating immense positive impact.
The Islamic Republic of Iran:
The Islamic Republic of Iran drew International attention in the 1990s for having implemented one of the world's most successful policies to stabilise population growth. Iran's constitution is based on Islamic law (sharia) and government policies and actions are guided by Islamic principles. Iran has often tampered sharia with a pragmatic approach to modern social demands including the RH needs of its people. This assessment of Iran's response to ICPD mandate on youth, sexual and RH needs is based heavily on official documents and educational materials-reflecting Iran's intentions towards its young people.
Egypt:
Female Genital Mutilation: The road to success in Egypt in the Cairo FPA was suddenly bombarded with questions about female circumcision in Egypt prompted by the writings of Egyptian doctors, particularly Dr.Nawal Sadawai, although the impression was that the practice was illegal. One of the major achievements was the full-scale access to the media particularly broadcasting and TV. Have we succeeded or not? "We believe we have succeeded in at least breaking the taboo, and to a limited extent, changing attitudes and behaviour at different focal points throughout Egypt, a trend that promises to spread by example and snowballing at least to the younger generations of mothers," says Aziza Hussein, an Egyptian native.
Pakistan:
The giant leap of PTV. Back from the Bangladesh Media Workshop on Communication Strategies in South Asia, Simi Raheal has this to say, "As I finished reading my paper, 'Gender & development Targeting the Electronic Media' there was silence. Looking up I saw the expression of the South Asian media and I knew that I had left a lasting impression. I had talked of Pakistan television...admittedly a country lagging far behind in private sector communication... and its joint leap in to the present, courtesy Khawateen Time. I knew I had received the acknowledgement that no other country in the region had a women specific window on state or private television. I came back to my country ten feet taller.
Gender Watch by SACHET - An innovative advocacy project from Pakistan
SACHET is a local CSO with the aim to promote human development in Pakistan with gender perspectives. The CSO's first project was a pioneering gender show on the national television titled Gender Watch which not only defined word gender in a Pakistani perspective by finding its alternative word sinf in Urdu but also broke silence on many fronts.
The 19-episode program dealt with a number of sensitive issues such as gender based violence, family planning, empowerment of women, AIDS etc. with enter-educate approach which earned the viewer-ship of adolescent and young people across the country.
Challenges ahead
Health, including sexual and reproductive Health (SRH) is not merely the absence of disease but a state of mental, physical, social, and spiritual well being. This implies that the natural determinants of this state are not only factors within the health system but also those that are related to the social, economic and political domains.
The issues of SRH cannot be resolved unless the contributing factors are identified. The ultimate objective of any public health intervention is to bring out a change.
However, since 11th Sep'01, the Muslim bloc has emerged as the focal point of this change. The new global scenario has added to the already existing enigma and created a new set of issues in addition to the old ones.
It is time to go beyond rhetoric and take pragmatic decisions on the most debatable, disputed and tabooed issues. The biggest challenges in general are:
A research on reproductive behaviour in Muslim countries by Dr.Mehtab Karim of AKU in 1997 has indicated that while there exists a considerable number of studies comparing the reproductive behaviour of Muslim and non-Muslim women, few comparative studies attempt to explain the differential patterns of behaviour among the geographically widely spread Muslim population.
The vital new issues underscored by International Conference on Population and Development (ICPD) encompassed gender equity, violence against women, trafficking of women, female genital mutilation, child marriage, male roles and responsibilities, unsafe abortion, infertility, STDs/HIV/AIDS, safe(r) motherhood and antenatal care.
What are the reproductive health (RH) issues in Muslim countries? In theory, the RH issues in Muslim countries should be the same as in the rest of the world. Further, being the signatory to the ideals of Cairo, the Muslim countries like all other signatories should be following the same solutions and strategies towards the RH issues as prescribed by the ICPD. Broadly speaking, this is not entirely incorrect.
Global issues of gender- based violence, economic and social empowerment for women; RH rights etc. are also visible and prevalent in the Muslim societies. However, since the causes and consequences of such issues vary, Muslim societies, which in turn are not a homogeneous entity, have a separate set of RH issues.
Islam is perceived as a religion hostile towards women. Gender is still believed as a western idea by majority of Muslim groups. The visible manifestations of religious commitments by the Muslims arouse exceptionally strong feelings and intense attitude by the West and have become a hot debate even within Muslims. For example veiling of Muslim women is equated with oppression and subordination. Bearded Muslim men are perceived as fanatics, fundamentalists, and oppressors and malevolent.
Abortion is severely restricted in nearly all-Muslim countries. Sterilisation (a permanent family planning method) is illegal in some countries and remains the subject of on going debate in many Muslim communities.
Not all-Muslim countries are faced with similar RH issues. For instance, dowry-related violence is a typical South Asian example of gender discrimination and violence against women. This is not seen in the Arab world where males are supposed to bear all expenses of the marriage. Similarly, female genital mutilation, as a form of violence against women, is an RH issue concern, mostly in the African Muslim countries and some parts of Indonesia and Malaysia.
Further, there are country-specific areas of concern. For instance, in some parts of the Sindh province of Pakistan, Marriage with Quran is practised to protect the family property, thus, denying the rights of inheritance, marriage and happiness to the girl.
Islam grants a central position to family and family life. In spite of emphasis on globalisation as a way of life within the Muslim societies, marriage is still intact as an institution with family as the fundamental unit of the society. Roald (2002) has observed that the maintenance of family's spiritual status seems to be regarded as recognition of the role of women in Muslim society.
If it is assumed that there are certain Muslim World -specific RH issues, there arise a series of logical questions: Who suffers most because of these issues? Who should be targeted while designing solutions? Are there any interventions to deal with the issues?
As already stated, ICPD identified and emphasised new population groups. Men and adolescents have emerged as the most important target groups and potentially most profitable investment points for RH interventions. However, since ICPD, a lot of clatter and clamour is being raised about the terminology of male role in RH in general and family planning (FP) in particular. Is it involvement, participation, responsibility, partnership or anything else?
Men, who are called social gatekeepers, bear an additional responsibility of influencing RH behaviour and decisions in general. In their many roles, men can control access to health policy, information services, finances, transport, communication and public opinion.
Although statistics and qualitative studies mostly reflect a bleak picture of the Muslim world, there are examples of efforts and contributions with gender focus and sensitivity, which raise and sustain hope and optimism. Most of these actions and activities belong to some form of communication, which indeed is one of the most effective tools for dealing with a variety of RH issues.
Some country/regional examples in this connection are cited below:
Bangladesh:
Where religion refuses to stand in the way, The Family Planning Association of Bangladesh (FPAB) has discretely mobilised religious support as part of promotional activities to involve men. Persistent efforts have resulted in creating a sympathetic atmosphere for FP. Imams preaching in favour of FP from the mosques are generating immense positive impact.
The Islamic Republic of Iran:
The Islamic Republic of Iran drew International attention in the 1990s for having implemented one of the world's most successful policies to stabilise population growth. Iran's constitution is based on Islamic law (sharia) and government policies and actions are guided by Islamic principles. Iran has often tampered sharia with a pragmatic approach to modern social demands including the RH needs of its people. This assessment of Iran's response to ICPD mandate on youth, sexual and RH needs is based heavily on official documents and educational materials-reflecting Iran's intentions towards its young people.
Egypt:
Female Genital Mutilation: The road to success in Egypt in the Cairo FPA was suddenly bombarded with questions about female circumcision in Egypt prompted by the writings of Egyptian doctors, particularly Dr.Nawal Sadawai, although the impression was that the practice was illegal. One of the major achievements was the full-scale access to the media particularly broadcasting and TV. Have we succeeded or not? "We believe we have succeeded in at least breaking the taboo, and to a limited extent, changing attitudes and behaviour at different focal points throughout Egypt, a trend that promises to spread by example and snowballing at least to the younger generations of mothers," says Aziza Hussein, an Egyptian native.
Pakistan:
The giant leap of PTV. Back from the Bangladesh Media Workshop on Communication Strategies in South Asia, Simi Raheal has this to say, "As I finished reading my paper, 'Gender & development Targeting the Electronic Media' there was silence. Looking up I saw the expression of the South Asian media and I knew that I had left a lasting impression. I had talked of Pakistan television...admittedly a country lagging far behind in private sector communication... and its joint leap in to the present, courtesy Khawateen Time. I knew I had received the acknowledgement that no other country in the region had a women specific window on state or private television. I came back to my country ten feet taller.
Gender Watch by SACHET - An innovative advocacy project from Pakistan
SACHET is a local CSO with the aim to promote human development in Pakistan with gender perspectives. The CSO's first project was a pioneering gender show on the national television titled Gender Watch which not only defined word gender in a Pakistani perspective by finding its alternative word sinf in Urdu but also broke silence on many fronts.
The 19-episode program dealt with a number of sensitive issues such as gender based violence, family planning, empowerment of women, AIDS etc. with enter-educate approach which earned the viewer-ship of adolescent and young people across the country.
Challenges ahead
Health, including sexual and reproductive Health (SRH) is not merely the absence of disease but a state of mental, physical, social, and spiritual well being. This implies that the natural determinants of this state are not only factors within the health system but also those that are related to the social, economic and political domains.
The issues of SRH cannot be resolved unless the contributing factors are identified. The ultimate objective of any public health intervention is to bring out a change.
However, since 11th Sep'01, the Muslim bloc has emerged as the focal point of this change. The new global scenario has added to the already existing enigma and created a new set of issues in addition to the old ones.
It is time to go beyond rhetoric and take pragmatic decisions on the most debatable, disputed and tabooed issues. The biggest challenges in general are:
- Are we ready to give up our mutual differences and unite to respond to prejudiced responses, attitudes and deliberate ignorance within and outside the Muslim world?
- Is our media ready to go beyond commercialism and transform itself into a tool for genderising development?
- Are we ready to ask the donors not to intermingle our culture and religion and take either of these as anti-development entities?
- Are those who are in the corridors of power and politics ready to take immediate steps to change not only the condition but position of oppressed men, women and children in their respective societies?
