Yemen: Opening Minds to Reproductive Health

Ongoing engagement with the influential Ministry of Awqaf and Religious Guidance is contributing to broader perspectives on reproductive health and the status of women in this complex Islamic society.

Half of Yemen's children are undernourished, and maternal mortality, at 488 deaths per 100,000 live births, is one of the highest in the world. Yet efforts to improve the health status of the Yemeni people are constrained by economic factors and rapid population growth. With an average of 7 children per woman, Yemen has the highest fertility rate in Western Asia. According to the World Bank, most Yemenis lack access to health facilities. But changing mindsets about the often-misunderstood topics of reproductive health and rights and family planning is as important as providing services to deal with these issues.

UNFPA is working on both fronts, in support of the national population programme and in close cooperation with the country's Ministry of Awqaf and Religious Guidance.

A major accomplishment for the country, in 1992, was the establishment of a National Population Council, which developed a Population Strategy and Plan of Action. The involvement of the Council along with Muslim clergy and other religious leaders lent a great deal of legitimacy to the population programme, and it gained the support of the highest levels of government.

Helping to build the capacity of national institutions has been the focus of UNFPA assistance for many years. This has resulted in a close partnership with the Ministry of Awqaf and Religious Guidance and has included efforts to build the skills of its staff, along with religious leaders, in implementing the Plan of Action. This was carried out through advocacy materials, training of religious leaders and health service providers, and specially produced television and radio programmes. Support was also provided for study tours for ministry staff and parliamentarians, some of whom are tribal and religious leaders, to Egypt and the Islamic Republic of Iran. The aim was to increase their exposure to successful family planning efforts in other Islamic countries and to foster exchange among Muslim leaders and scholars.

WHAT WORKS

• Dialogue with influential religious leaders should be carried out on an ongoing basis, rather than as a one-time pre-programming activity. This helps to build commitment and ensure common understanding of issues including reproductive health, family planning, adolescent reproductive health and HIV/AIDS.

• Supporting individuals in civil society and academia who are knowledgeable about Islamic positions relating to population, poverty and reproductive health can be an effective way to reach policy makers.

• Identifying those power structures that perpetuate the status quo and those that support change can be used to strategic advantage. Support for change can be built up through sociocultural research, including gender analysis.

• Behaviour change can be slow in some societies. Incremental changes are possible, however, and may be more enduring in the long run.

The Ministry of Awqaf and Religious Guidance, with technical support from UNFPA, is currently helping to raise public awareness of reproductive health, including family planning, and the harmful effects of certain traditional practices such as forced early marriage and female genital cutting. The ministry has been influential in moving this agenda forward and, for the first time, has officially recommended that marriage be delayed until the age of 20.

A Source Book on Reproductive Health, produced jointly by the Ministry of Health and the Ministry of Awqaf and Religious Guidance, guides muftis, imams and other religious leaders on handling sensitive topics among their followers. The Source Book relates family planning and reproductive health to the Koran and stresses the Prophet's teachings on the equality of women and men.

Other recent efforts include work on HIV/AIDS. The Yemeni Cabinet has endorsed a National Strategic Framework for the Control and Prevention of HIV/AIDS. The strategy was drawn up with the participation of the Ministry of Awqaf and Religious Guidance, which is now reaching out to parliamentarians, imams and other religious leaders to enlist their support. The strategy stresses the vulnerability of women and youth to HIV infection and promotes the consistent use of male and female condoms in the context of Islamic laws and teachings.