THE IMPACT OF RELIGIOUS LEADERS’ ADVOCACY INTERVENTION IN GUINEA

1. THE IMPACT OF RELIGIOUS LEADERS’ ADVOCACY INTERVENTION IN GUINEA MICHAEL BLAKE AND STELLA BABALOLA Johns Hopkins University Center for Communication Programs, Baltimore, Maryland Paper presented at the 2001 APHA Annual Conference, October 21-25, 2001, Atlanta, GA

3. Background • Guinea’s population is predominantly Muslim • Religious leaders are very important community gate keepers and sources of information, particularly in rural areas • Few religious leaders know modern methods of FP, many associate FP with sterilization

4. Background • Many leaders believe modern methods are forbidden by Islamic texts • Guinea has a group of Islamic scholars willing to increase awareness of Islam and reproductive health (Oulemas de Guinee); some work done with them in HIV/AIDS prevention (by PSI)

5. Advocacy Part of Men’s Multimedia Campaign • Work with religious leaders was an integral component of the men’s campaign, which was designed and implemented as part of the USAID-funded PRISM RH project in two regions of Guinea: Haute Guinee and Guinee Forestiere. The PRISM project is being implemented by MSH and JHUCCP.

6. Advocacy Goal • To foster an enabling environment and increased social support for family planning and other health center services.

7. Target Audience • Religious leaders from towns that have a health center in PRISM project zone (Faranah, Nzerekore, and Kankan regions).

9. Objectives of RL Intervention • Before the end of the campaign, 75% of religious leaders will know at least 3 modern methods of FP • Before the end of the campaign, 50% of religious leaders will hold at least 2 sermons on FP per month

10. FORMATIVE RESEARCH • Pre-intervention FGDs and in-depth interviews among local religious leaders revealed: • Widespread recognition among the religious leaders that closely spaced births are contrary to the teachings of Islam; • FP is acceptable for the purpose of child spacing but not for limiting the number of children;

11. FORMATIVE RESEARCH • The only situation that could justify the use of FP for limiting the number of births is when the health of the mother is in jeopardy; • A lot of misinformation about modern FP methods; • Modern family planning methods associated with debauchery and perceived to be contrary to the teachings of Islam;

12. Advocacy Strategies • Collaborate with a highly visible and respected religious organization (Oulemas de Guinee) • Increase visibility of local leaders • Focus on family health

13. Key Family Planning Messages • Islam supports the use of modern family planning methods among married couples • Modern methods of FP are readily available in local health centers • Modern FP methods are safe and very effective

14. Project Activities: Workshop • 15 district workshops: • Participants included 3 religious leaders from each health center catchment area. • Over 450 leaders attended. • The three-day workshops featured local, regional and national facilitators.

15. Project Activities: Workshop • The workshop focused on: • Islam and Child Health, • Islam and Maternal Health, • Islam and Couple Health, and • Islam and Family Planning

16. Activities: Video • Video (local language): • Made up of four segments reflecting themes of workshop; • used to stimulate discussion and give national/regional leader’s viewpoints; • in addition to workshop airing, also used during community mobilization events

17. Activities: Print materials • 1 poster : featuring passage from Al-Baqara • 2 brochures describing, Islam and Family Planning: What I should know

18. Activities: Radio • Radio drama: Imam featured in 3 of 26 episodes • Radio programs, including roundtable discussions and interviews with local religious leaders, all in local languages

19. IMPACT EVALUATION

20. METHODOLOGY • Impact evaluation is based on panel data derived from pre and post-intervention surveys among religious leaders. The same religious leaders were interviewed before the intervention and at the end of the intervention, four months later.

21. Awareness About Family Planning Methods

22. % who were aware of specific FP methods, baseline, follow-up n=98

23. % who were aware of specific FP methods, baseline, follow-up - cont. n=98

24. Mean number of modern methods known: baseline, follow-up n=98

25. Perceptions about family planning and Islam

26. % who know verses of Koran or Hadith that favor use of FP n=98

27. % who believe that Islam allows use of FP methods for child spacing n=98

28. % who believe that Islam allows use of FP methods for limiting births n=98

29. % who believe that specific FP methods are forbidden by Islam n=98

30. % who believe that specific FP methods are forbidden by Islam - cont. n=98

31. Mean # of methods considered “mubah” or “haram”: baseline, follow-up n=98

32. Attitudes Toward Family Planning

33. % who believe that having many children is a sign of wealth: baseline, follow-up n=98

34. % who believe that the value of a woman depends on the number of sons she has. n=98

35. % who believe that FP could encourage adultery: baseline, follow-up. n=98

36. Discussion of FP with Spouse

37. % who have ever discussed FP with their wives: baseline, follow-up n=98

38. % who discussed FP with their wives during last 3 months. n=98

39. Perceived Social Support for Family Planning

40. % who believe that their wives approve of family planning n=98

41. % who believe that most of their friends approve of FP n=98

42. % who believe that most religious leaders approve of FP n=98

43. % who believe that most of the women in their community approve of FP n=98

44. % who believe that most of the men in their community approve of FP n=98

45. Advocacy for Modern Methods

46. % who have ever encouraged someoneto use a modern FP method n=98

47. % who have ever preached in favor of modern FP methods : baseline, follow-up n=98

48. % who preached at least 2 sermons a month promoting family planning during last 3 months n=98

49. Use of Modern Contraceptive Methods

50. % currently using a modern contraceptive method, baseline, follow-up n=98