Religious leaders spread word on birth spacing, HIV/AIDS

Imam Habib Thiam, second from right, explains to members of the religious community in Kaffrine, in central Senegal, that Islam supports women's health and a healthy family life. Photo by R. Nyberg, USAID

KAFFRINE, Senegal – Imam Habib Thiam looks up as the curtain parts at the door to his room. A friend, a fellow Muslim community leader from across town, shakes hands and tells him about a medical problem his wife had the night before, keeping them both up all night. Turning to his visitor, Thiam says women’s health has become more of an issue to him of late. And he’s decided to take life-saving messages to the mosque.

In fact, ever since his exposure last November to what Islam has to say about birth spacing and discussions of related health issues, he takes every occasion to talk about them: weddings, funerals, baptisms, prayers, religious holidays. At a USAID-sponsored meeting for religious leaders in this peanut-harvesting town of 31,000 people, Thiam heard shocking news: 15,000 Senegalese mothers may die between 2001 and 2007, many of them young girls who bleed to death giving birth.

“This is 10 times the number of people who drowned on the Joola ferry,” he recalls, his eyes widening. The ferry sank off the Atlantic coast between the capital Dakar and Ziguinchor in the Casamance region, south of The Gambia, in September 2002. It is arguably the greatest national tragedy in living memory. “I don’t even dare contemplate the magnitude of it.”

The day after the meeting, Imam Thiam preached at the mosque next to his home, bringing in a nurse from the health post to discuss the importance of birth spacing and maternal health issues. He said early marriage was “dangerous” for young girls and should be avoided. He told pregnant women to avoid heavy work and to visit health clinics before giving birth. And he informed them that there are good health and economic reasons for lengthening the period of time between pregnancies.

“One of the best channels to spread the messages is through the religious leaders,” he said. “We are a people of faith.” Indeed, over 90% of Senegalese are Muslim, and about 5% Christian.

USAID has invested about $120,000 in efforts to inform religious leaders of reproductive health issues and the risks of HIV/AIDS. This includes printing information kits in Arabic and the most widely spoken local language, Wolof, outlining what Islam says about birth spacing.

“Islam forces no one to have a dozen children,” said Bashir Niass, Arabic teacher at the Waldiodio Ndiaye High School in Kaolack and Regional Coordinator of the USAID-assisted Islam and Population Network for Kaolack. “Marriage in Islam is conditional. If you have the means, you can get married. At a minimum, you must have a small house and enough money to support your wife and your children,” he said.

“Islam does not reject birth spacing,” Niass, who accompanies the USAID team during presentations to religious communities, said. “Everyone knows that birth spacing is a necessity now.” And he frequently tells his students the same.

There is proof in the sacred writings of Islam as well. “The Koran tells us that between the moment of conception and the moment of weaning, 30 months should pass,” said Abdou Aziz Kébé, an Islamic scholar, university professor, and secretary general of the Islam and Population Network.

Kébé noted that there are misconceptions about contraceptives in Senegalese society that have limited their expansion. “It’s not the condom that is bad -- it is wrong to have sex outside marriage,” he said. Preliminary results from the USAID-supported demographic and health survey (DHS) in 2005 put national contraceptive prevalence rate at 10.3%, an increase over past years but still an indication of serious constraints in both the supply and demand for family planning services.

Last year, 30,908 community members participated in reproductive health dialogue sessions that focused on fidelity and women’s rights, and the number and spacing of children. USAID also supported 627 sessions on reproductive health issues using a life skills manual. These sessions were attended by nearly 6,000 youth, more than half of them women.

USAID worked with 3,500 religious youth leaders, 2,000 of them women, who participated in training sessions using a faith-based life skills manual, translated into Arabic, which addressed questions of religious faith and healthy behavior.

“The religious nature of our life skills training has greater impact,” said Louise-Anne Ciss, a Catholic member of the Coalition of Religious Youth Organizations against HIV/AIDS. “We have to communicate with religious youth on the basis of faith. During the training, some people didn’t believe HIV/AIDS existed. Now they do.”

With its approach, USAID is seeing that messages of reproductive health are reaching large numbers of ordinary people through their trusted religious leaders who are sought out daily for advice on life choices.