Faith in family planning

Indonesia’s family planning programme has been effective over the last four decades and is now being quoted as a ‘success story’ around the globe – especially in resource-constrained economies.

One key element of this programme involved developing a strategic partnership between the government and Muslim religious leaders (MRLs). The continuous engagement of Indonesia’s government with the prominent leaders of religious organisation has yielded several fatwas that have played an instrumental role making family planning initiatives acceptable on the community level.

Indonesia’s bold national family planning initiatives were launched in 1965 and have been pursued since for the past five decades. The initial impetus for implementing these strategies was the government’s concerns about the rapid population growth and its impact on the youth and the social consequences of the age profile.

The programme is noted both for its successful results – measured through the decline in the fertility rate and the wide acceptance of family planning among the population – and for the active and effective partnerships with religious institutions, especially Muslim organisations like the Nahdlatul Ulama (NU), the Muhammadiyah, and the Indonesian Ulema Council.

At least 75 percent of Indonesians identify with the NU or the Muhammadiyah. These groups have been highly influential partners for the family planning programme. Women’s religious organisations, which are generally part of larger organisations, played a role in securing and sustaining religious support for family planning.

Indonesia’s family planning programme has faced two important challenges over the years. First, it has struggled to sustain and advance national goals during a period when decentralisation transformed politics and institutions. Second, it has faced challenges in defining and implementing the respective roles of public and private actors in family planning. Both concerns are currently the topics of an active debate.

The National Family Planning Coordinating Board (BKKBN) was created in 1967 to provide leadership and oversight. From the outset, the government believed that it needed to include religious leaders in the process. President Suharto contacted one of the leading religious figures, Dr Idham Chalid, who led a 1967 workshop that sought the views of religious representatives on family planning.

Government officials and religious leaders in Indonesia – including representatives from the Muslim, Christian and Hindu communities – were brought on various panels to discuss family planning. They came up with a pamphlet titled the ‘Views of Religions on Family Planning’. Haryono Suyono, the deputy head of the BKKBN, recorded the views of religious leaders on family planning with the objective of minimising the risk of offending their sentiments when the programme was launched.

Both the NU and the Muhammadiyah framed their support for family planning to ensure the general well-being of families. Their primary concern was that the mother should be healthy and that the size of a family should not significantly hamper the quality of children’s lives. Arguments about the overall population size were avoided.

Without the support of Muslim religious leaders, the family planning programme in Indonesia would not have successfully contributed to the decline in the fertility rate from 5.6 at the beginning of the programme to 2.3 at present.

Indonesia is one of the priority countries under FP2020 – a global movement that aims to give 120 million women and girls access to life-saving contraceptives by 2020. This initiative builds on the UN Secretary-General’s Global Strategy for Women’s and Children’s Health. The strategy was launched in 2010 and focuses on the provision of contraceptive information, services and supplies without coercion or discrimination.

Through the successful engagement with Indonesian MRLs, the BKKBN and UNFPA have jointly designed a SSC training course for other countries. UNFPA Indonesia’s technical assistance to the State Secretariat and the intensive week-long training course at BKKBN’s Center for International Training and Collaboration have been designed to share the Indonesian experience in partnering with Islamic and other faith-based organisations and religious leaders to encourage family planning initiatives and service provisions.

These initiatives highlight Islamic values and teachings that relate to family planning and reproductive health and provide a common ground for a collaboration between the government and religious leaders.

Since 2013, five successful training sessions have been conducted with participants from 15 countries. These sessions have provided participants with information and capacity-building to develop strategic partnerships with Islamic-based organisations and Muslim leaders who support family planning. They have also provided Indonesia with an opportunity to share the lessons it has learnt and communicate best practices.

The objective of the training course is to enhance knowledge about the Indonesian government’s strategic partnership with MRLS in FP. Participants can, in turn, apply these in designing suitable strategies for their respective countries.

In 1947, at the time of Independence, Pakistan’s population was 31 million. The fertility rate was 7.5 per women and the population growth rate was 4.5 percent per year. In the 1990s,the fertility and population growth rates were reduced to 5.1 and 2.9, respectively. But this reduction is negligible. By 2035, Pakistan’s population is projected at 260 million (as per UNFPA, Pakistan).

Pakistan faces a daunting challenge. According to initial estimates, it is currently the world’s sixth largest country in terms of population and is likely to become the third largest contributor to world population growth. According to UN projections, Pakistan’s population will grow to over 380 million by the year 2050, surpassing Indonesia, Brazil, Russia and the US to become the world’s third most populous country after India and China. With one of highest population growth rate for any Asian country, Pakistan will certainly experience a dramatic decline in the per capita availability of arable land, water and forest resources. The rapid population growth – which stands at three percent per year – is already eroding economic gains. The question that now arises is: what went wrong and why?

Notwithstanding the difficulties in confronting family planning programmes, there is evidence of a change in behaviour among Pakistani society. A World Bank study conducted in 2014 revealed that men are showing an increased interest in family planning services and contraception. However, they are unable to avail them primarily due to the poor economic climate and its implication for large families.

In 2015, a landmark meeting was organised with the collaboration of UNFPA the Population Council. During this meeting, the ulema from across the country endorsed a declaration to allow the use of all reversible family planning methods that can help women plan the timing and spacing of their pregnancies in a bid to avoid maternal deaths and improve the overall health of families.

They unanimously offered their support in promoting birth-spacing services and thereby creating a healthy and prosperous society. The religious leaders and heads of religious institutions also affirmed that Islam declares the preservation and maintenance of human life as an inalienable right of all individuals and families. They said the religion supports all measures, means and approaches that are in conformity to Islamic teachings to ensure this basic right.

Just like Indonesia, Iran and Bangladesh, Pakistan should also involve the religious community and consider them stakeholders in achieving the sustainable development goals.

Pakistan should also combat the organisational and management issues that have plagued its family planning programmes to achieve coverage and effectiveness. The approach to delivering family planning services should also be altered to improve the overall status of women.

The most important steps that have been suggested include expanding family planning concept beyond FP so they can also tackle concerns on reproductive health services. Other recommendations include generating a positive attitude among public officials, organising effective media campaigns through celebrity endorsements, improving the existing service quality and providing vasectomies and other reproductive services.

Giving priority to the education of women, encouraging religious leaders to endorse the programmes and emphasising the role of donor agencies to continue with their responsibility are some other steps that will eventually support a struggling economy and a young nation.

Email: mqesar@gmail.com

Twitter: @mqesar

The writer is a freelance journalistand is associated with the healthand development sector.