Enhancing Sexual And Reproductive Health and Well being of Young People - 2020

Publication date: 2020

Enhancing Sexual and Reproductive Health and Well Being of Young People Building Common Ground between the United Nations and Faith-Based Development Partners Enhancing Sexual and Reproductive Health and Well-Being of Young People: Building Common Ground between the United Nations and Faith-Based Development Partners Section 1 – Overview[1] RELIGION, SPIRITUALITY AND YOUNG PEOPLE The religions of the world have a rich his-tory of engagement with adolescents and youth. Religious leaders and faith based organisations take responsibility, alongside parents and the state, for nurturing children, by equipping them with values and skills re- quired to grow into adulthood. The impera- tive to protect young people, but also to take seriously their own experiences and perspec- tives, are foundational principles contained within in most religions. Religious youth are not always given adequate voice within their traditions, but they remain a significant and permanent fixture in all faith communities, who continue to challenge and refresh all faith traditions. Given the holistic nature of much work carried out by faith based organizations, they often provide multiple entry points, for engag- ing with adolescents and youth. Most FBOs have some form of youth group, youth wor- ship, youth formation or youth leadership scheme. In addition religious organisations run schools, health centres, vocational train- ing schemes, as well as other outreach programmes for orphans and vulnerable youth, such as migrants and refugees. These services are ‘ready made’ platforms for en- gagement, which are currently being underutilized by the UN. Local FBOs and reli- gious leaders are rooted in local communities and frequently their networks are able to stretch far beyond the reach of the UN or the state. This means their service provision and wider presence and engagement with local communities is rich in social capital. Religion exerts signif icant influence over young people’s lives, but the reality is the impact of this engagement not always benign. FBOs have a mixed track record; sometimes promoting empowerment and fostering protection; and at other times sup- pressing young people’s rights and hamper- ing their wellbeing. Some FBOs encourage vio- lence and intolerance in young people and fail to protect vulnerable youth from violence and abuse or to hold those responsible to account. Other more subtle forms of op- pression are exerted when FBOs deny young people access to information and fail in their [1] This paper is authored by Helen Stawski, Senior Advisor on Development at the Office of the Archbishop of Canter- bury, Lambeth Palace, London. The research for this paper was undertaken during Ms. Stawski’s Secondment with UNFPA’s Technical Division in New York, and her research with members of the UN Inter-Agency Task Force on Engaging FBOs for Sustainable Development, from May to June, 2012. All the opinions expressed in this paper belong to the author alone, and are not representatives of any Institution, Office, Board Staff members, or Governments. 11111 duty to educate girls and boys so they can grow into their potential. Much has been written by religious schol- ars on the spirituality of young people, how- ever relatively little consideration has been given to how the psychological aspect of spiritual growth might impact on the behav- ior of adolescents and youth. Although the UN recognizes the religious dimension of children and youth in the Convention of the Rights of the Child[i], often this is limited to protecting an individual’s freedom to en- gage in religious activities and consigned to the private sphere. A deeper apprecia- tion that personal faith is both a public and a private matter is needed, to understand how young people’s spiritual values, iden- tity and participation impacts on their ca- pacity to make informed choices in a l l spheres of l i fe . This must be balanced against an acknowledgement that religious values are not the sole or defining factor of any individual or community, but instead are mediated through cu l ture , gender , ethnicity, age and socio-economic status. A more nuanced and contextual approach is re- quired from religious organisations and the UN to understand how religion influences and is influenced by multiple factors. Adolescence is a time of great change and growth, when young people are nego- tiating a range of influences, including reli- gious ones. Strategies, including work on sexual and reproductive health, which seek to support the wellbeing and dignity of ado- lescents and youth, need to give greater consideration to internal and external driv- ers of wellbeing generated by religion, spiri- tuality and the work of FBOs. This paper will seek to unpack some of these dimensions and suggest ways forward for more fruitful collaboration between FBOs the UN and faith based organizations on the sexual and reproductive health of adolescents and youth. UN WORK WITH FAITH BASED ORGANIZATIONS (FBOS) In recent years there has been a greater re-alization of the role played by faith based organizations in delivering a range of services to local communities[iii]. At the same time the BOX 1 – DBOX 1 – DBOX 1 – DBOX 1 – DBOX 1 – DE F I N I T I O N SE F I N I T I O N SE F I N I T I O N SE F I N I T I O N SE F I N I T I O N S O FO FO FO FO F F F F F FA I T HA I T HA I T HA I T HA I T H B B B B BA S E DA S E DA S E DA S E DA S E D O O O O OR G A N I S A T I O N SR G A N I S A T I O N SR G A N I S A T I O N SR G A N I S A T I O N SR G A N I S A T I O N S ( ( ( ( (T A K E NT A K E NT A K E NT A K E NT A K E N F R O MF R O MF R O MF R O MF R O M UNICEF P UNICEF P UNICEF P UNICEF P UNICEF PA R T N E R I N GA R T N E R I N GA R T N E R I N GA R T N E R I N GA R T N E R I N G W I T HW I T HW I T HW I T HW I T H RRRRRELIGIOUSELIGIOUSELIGIOUSELIGIOUSELIGIOUS C C C C COMMUNITIESOMMUNITIESOMMUNITIESOMMUNITIESOMMUNITIES FORFORFORFORFOR C C C C CHILDRENHILDRENHILDRENHILDRENHILDREN)))))[[[[[ I II II II II I]]]]] THE TERM ‘RELIGIOUS COMMUNITIES’ BROADLY REFERS TO BOTH FEMALE AND MALE RELIGIOUS ACTORS AND TO SYSTEMS AND STRUCTURES THAT INSTITUTIONALIZE BELIEF SYSTEMS WITHIN RELIGIOUS TRADITIONS AT ALL LEVELS – FROM LOCAL TO GLOBAL. THESE INCLUDE:  LOCAL WORSHIP COMMUNITIES (E.G., CHURCHES, MOSQUES, SYNAGOGUES, TEMPLES, ETC.)  DENOMINATIONAL LEADERSHIP (E.G., BISHOPS, CLERICS, AYATOLLAHS, LAMAS, ETC.)  SCHOLARS, THEOLOGIANS AND RELIGIOUS EDUCATORS  MISSION WORKERS  YOUTH FAITH OR INTER-FAITH GROUPS  WOMEN OF FAITH NETWORKS  FAITH-BASED OR FAITH-INSPIRED ORGANIZATIONS  DENOMINATIONAL, ECUMENICAL AND INTRA-RELIGIOUS INSTITUTIONS, UMBRELLA ORGANIZATIONS AND NETWORKS  INTER-FAITH INSTITUTIONS THERE IS AN IMMENSE COMPLEXITY AND DIVERSITY AMONG RELIGIOUS COMMUNITIES WITH REGARD TO BOTH THEIR POSITION AND STATUS IN SOCIETY AND ORGANIZATIONALLY. “THESE ACTORS VARY IN SIZE, MISSION, ROLE, GEOGRAPHIC SCOPE AND TECHNICAL CAPACITY – SOME OPERATE ON SHOE-STRING BUDGETS, WHILE OTHERS ADMINISTER OVER ONE BILLION DOLLARS ANNUALLY… SOME ORGANIZATIONS ARE LOOSELY INSPIRED BY FAITH PRINCIPLES, WHILE OTHERS ARE FORMALLY LINKED TO RELIGIOUS INSTITUTIONS.” IT IS IMPORTANT THAT RELIGIOUS COMMUNITIES BE UNDERSTOOD ON THE BASIS OF THE WAYS IN WHICH THEY IDENTIFY THEMSELVES. 22222 voice of faith, within civil society, is being more purposefully articulated in global policy forums, such as the Commission for the Sta- tus of Women and the Commission on Sus- tainable Development. In many cases FBOs are welcome partners in the struggle for human rights, whether in support of MDGs, cutting debt, challenging multinationals work in ex- tractive industries or promoting peace. How- ever some FBOs are also taking increasingly oppositional stances, particularly in areas of gender and reproductive rights. This presents a complex picture of multiple faith institutions and voices which impact on the work of the UN at local, national and global levels. Many UN organizations are engaged in processes to better understand how to work with FBOs at the global and local level. The natural starting point for this work has been to collate and analyze the range of existing UN-FBOs partnerships at country level, and then to promote dialogue to unpack the mu- tual value of these partnerships. Several UN agencies have produced guidel ines for working with FBOs: these include ‘Guide- l ines for Work ing with FBOs’ UNFPA (2010); ‘Strategic Framework for Partnering with FBOs’, UNAIDS (2011); and ‘Partnering with Religious Communities for Children’ UNICEF (2012)[iv]. From the donor constitu- ency, the UK Department for International Development launched its own ‘Faith Partner- ship Principles’ in 2012[v]. There is also increasing academic inter- est in the contribution of FBOs in promoting sustainable development and providing hu- manitarian assistance. These include the DFID funded ‘Religions and Development Research Programme’[vii], ‘Religion, Peace and World Affairs’, at Georgetown University[viii], ‘Africa Religious Health Assets Programme’[ix], and the ‘Journal of Refugee Studies’ special addi- tion on religion[x]. Many FBOs are also engag- ing in critical reflection and quantitative analy- sis of their own work with academic institu- tions through collaborative platforms, such as the ‘Joint Learning Initiative on Local Faith Communities’[xi]. UN participation in these multidisciplinary platforms is fostering a deeper institutional appreciation, of both the quantitative contribution of FBO services but also the qualitative impact provided by the unique strengths of faith based provision and local presence. BOX 2 – UNFPA BOX 2 – UNFPA BOX 2 – UNFPA BOX 2 – UNFPA BOX 2 – UNFPA WORKWORKWORKWORKWORK WITHWITHWITHWITHWITH FBO FBO FBO FBO FBOSSSSS ASSUMPTIONS UNDERPINNING UNFPA’S WORK WITH FBOS  CULTURES ARE THE CONTEXT IN WHICH ALL DEVEL- OPMENT WORK TAKES PLACE AND WHERE ALL INTERNATIONAL HUMAN RIGHTS AGREEMENTS ARE IMPLEMENTED  FAITH AS PART OF CULTURE IS AN IMPORTANT DE- TERMINANT OF VALUE SYSTEMS, AT BOTH THE INDIVIDUAL AND COMMUNITY LEVELS  CULTURES ARE DYNAMIC, INTERACTIVE AND EVOLVING  FBOS, RELIGIOUS LEADERS AND RELIGIOUS INSTITUTIONS, AS THE GATEKEEPERS AND INTERPRETERS OF RELIGIOUS TEXT AND THUS IMPACTING CULTURE, ARE IMPORTANT PARTNERS IN THE PROCESS OF DEVELOPMENT, PARTICULARLY WHEN IT COMES TO INFLUENCING BEHAVIOUR, ATTITUDES AND PERCEPTIONS  FBOS AND RELIGIOUS GROUPS HAVE ENORMOUS OUT- REACH, BOTH ACTUAL AND POTENTIAL. THEY MANAGE THE OLDEST, MOST FAR-REACHING AND DIVERSE ARRAY OF SO- CIAL SERVICE DELIVERY MECHANISMS AS WELL AS DEVELOPING THE FIRST UN GUIDELINES FOR WORKING WITH FBOS IN 2010, UNFPA NOW SPEAR- HEADS AN UN INTERAGENCY TASK FORCE ON FBOS, AS WELL AS FACILITATING A NETWORK OF OVER 500 FBOS GLOBALLY. [VI] Section 2 – Sexual and Reproductive Health of Adolescents and Youth - the challenge and imperative of working with faith based organizations (FBOs) SHARED GOALS FOR ADOLESCENTS AND YOUTH Agood starting point for considering in-creased collaboration around sexual and reproductive health is to acknowledge com- mon foundations and shared goals of the UN and FBOs with regards to adolescents and youth. Both FBOs and the UN want to create an environment where young people can be nurtured and grow into their potential. This goal is enshrined in article 4 of the Conven- tion of the Rights of the Child[xii], and ex- pressed in the 2012 UNFPA Adolescent and Youth Strategy as ‘Charting a course by which young people’s safe and secure passage to adulthood is ensured’[xiii]. It is also at the heart 33333 of the focus on the family advocated by most religions. Values related to the wellbeing of children are also contained in sacred texts of the world religions. UNICEF provides a good overview of religious writings related to reach- ing the marginalized, non violence, education and gender equality in their FBO partnership document ‘Partnering with Religious Commu- nities for Children’[xiv]. A closer consideration of the Convention of the Rights of the Child reveals many shared values with FBOs; learning about one’s cul- ture (29), receiving education and informa- tion (17), engaging in play and cultural ac- tivities (31), expressing oneself (15), and learning respect for others (15). Local faith communities are part of the framework for transmitting cultural values and behavioral norms. Many also engage in socio-political discourse as part of civil society. UNFPA rec- ognizes that sexual and reproductive health choices do not exist in isolation from social, political and economic wellbeing[xv]. FBOs have multiple platforms for engaging youth, including youth groups, schools, vocational training programmes, health facilities and other outreach initiatives that are embedded in local communities. They also engage par- ents, supporting rights related to the role of parents in nurturing (5), guiding (14) and protecting (19) their children. These plat- forms for engagement will be considered in more detail in the next chapter. In addition all major religions have at their core a message of peace and reconciliation, although this is not always respected. Religious teachings therefore contain within them the resources and the platforms to support these rights, and are often at the forefront of doing so. There are also shared concerns for the ‘most marginalized’ youth in society. UN agen- cies often create a separate category for the most at risk children, to ensure they are not unintentionally denied their rights. UNFPA recognizes that programmes to reach marginalized groups can be highly labor intensive[xvi], however FBOs are often the most well placed to reach the most disenfranchised and vulnerable youth who are excluded from mainstream state care, through their presence in conflict zones, areas of extreme poverty, and their mandate to care for the sick. This work seeks to provide services but also pro- tect children from sexual exploitation and other forms of violence, as enshrined in CRC and CEDAW[xvii]. ICPD + 5 outlines adolescents specific rights and needs in relation to sexual and re- productive health services. It calls for SRH services that are appropriate, user friendly and accessible for young people. Faith groups are increasingly recognizing the need for access BBBBBOXOXOXOXOX 3 – I 3 – I 3 – I 3 – I 3 – INTERFAITHNTERFAITHNTERFAITHNTERFAITHNTERFAITH D D D D DECLARATIONECLARATIONECLARATIONECLARATIONECLARATION TOTOTOTOTO I I I I IMPROVEMPROVEMPROVEMPROVEMPROVE F F F F FAMILYAMILYAMILYAMILYAMILY H H H H HEALTHEALTHEALTHEALTHEALTH ANDANDANDANDAND W W W W WELLELLELLELLELL-B-B-B-B-BEINGEINGEINGEINGEING GLOBAL INTERFAITH CONFERENCE IN NAIROBI 29 JUNE 2011[XIX] WE, LEADERS OF RELIGIOUS INSTITUTIONS AND FAITH BASED ORGANIZATIONS (FBO), BELIEVE THAT HEALTH IS A UNIVERSAL VALUE HELD BY ALL FAITHS AND A UNIVERSAL RIGHT FOR HUMAN BEINGS. OUR FAITH TRADITIONS, SPIRITUAL VALUES AND COMMITMENT TO SOCIAL JUSTICE LEAD US TO BELIEVE PASSIONATELY THAT FAMILIES SHOULD NOT SUFFER NEEDLESSLY BECAUSE THEY LACK ACCESS TO HEALTH SERVICES. WE ACKNOWLEDGE THE EVIDENCE THAT THE HEALTH BENEFITS OF ACCESS TO EDUCATION AND SERVICES, AND THEREBY AVERTING UNINTENDED PREGNANCIES, CAN BE SUBSTANTIAL. EACH YEAR LACK OF FAMILY PLANNING SERVICES AND EDUCATION IN DEVELOP- ING COUNTRIES RESULTS IN AN ESTIMATED 600,000 NEWBORN DEATHS; 150,000 MATERNAL DEATHS FROM ABORTION AND OTHER PREGNANCY-RELATED CAUSES; AND AT LEAST 340,000 CHILDREN LOSE THEIR MOTHER. WE RECOGNIZE THE IMPORTANCE OF ACCESS TO INFORMATION ABOUT AND SERVICES TO ENABLE FAMILIES TO PLAN THE TIMING AND SPACING OF THEIR PREGNANCIES CONSISTENT WITH THEIR FAITH FOR FAMILY WELL-BEING, FOR ACHIEVEMENT OF COUNTRY HEALTH TARGETS AND TO SUPPORT ACHIEVEMENT OF THE MILLENNIUM DEVELOPMENT GOALS (MDGS) BY 2015. WE RESPECT THE CHOICE OF FAMILIES BASED ON THEIR OWN FAITH AND NEEDS AND KNOW THAT STRONGER, HEALTHIER AND THRIVING FAMILIES AND COMMUNITIES RESULT WHEN COUPLES JOINTLY PLAN THEIR FAMILIES. IN THIS DECLARATION, WE COMMIT TO LEVERAGING OUR NETWORKS TO SUPPORT FAMILY HEALTH BY PROVIDING EDUCATION AND SERVICES THAT ENABLE FAMILIES TO PLAN THE TIMING AND SPACING OF THEIR PREGNANCIES CONSISTENT WITH THEIR FAITH. WE CALL ON OTHERS TO SUPPORT THIS INITIATIVE TO INFLUENCE GOVERNMENT AND DONOR POLICIES AND FUNDING. 44444 to information to make responsible and in- formed decisions (see BOX 3). Many faith groups share he priorities for counseling young people, as outlined in ICPD + 5; gen- der relations and equality, violence, respon- sible sexual behavior and family planning, family life, preventing the spread of HIV and other sexually transmitted diseases[xviii]. POINTS OF CONTENTION Despite the shared foundations betweenthe UN and FBOs to promote the growth and wellbeing of adolescents and youth, and a deepening engagement between the UN and FBOs on a range of issues, the promotion of sexual and reproductive health remains a highly problematic area for collaboration. Part of the unease surrounding SRH is fueled by disagreements over the legitimate limits of family planning, particularly concerning abor- tion, which many FBOs are philosophically opposed to. The reality is that there are a wide range of attitudes and approaches to an is- sues such as abortion amongst FBOs; some consider emergency contraception to the abortifacient, while others will accept mid term abortions if the mother’s life is in dan- ger. Many of those who disagree with abor- tion, still believe it should not be criminalized. Some FBOs reject packages of SRH services which include the distribution of condoms and sexual advice to unmarried youth. Some FBOs go further and reject the promotion of condoms in any circumstance. The UN and other inter- national partners should seek to better under- stand the nuanced positions of particular faith groups in specific contexts, and how these have been negotiated and developed from within. Many FBOs have been able to foster behavior change in support of increased SRH services, by building consensus around the language of family wellbeing, and grounding this objective in religious values. Areas of disagreement between the UN and FBOs on SRH for adolescents and youth must be seen in the context of a multiplicity of worldviews concerning both sexual activ- ity and the concept of youth. The period of time in an individual’s life classified as ado- lescence is a concept that originated in Eu- rope and North America around 60 years ago[xx]. It carries with it normative assump- tions concerning autonomy, family and indi- vidual identity formation, which are often ill- fitting to societal value systems in other parts of the world. The age bracket of ‘youth’ is culturally dependent, as is evidenced by the varying age limits for marriage, military ser- vice, employment and sexual activity. Many societies do not consider someone an autono- mous adult until they are married. More subtle value judgments also pertain to youth within communities and households concerning their ability and right to make decisions about vari- ous aspects of their lives. Parents will often retain an element of control over choices around dress, education, employment, social- izing and sexual relationships. In such con- texts insisting on the confidentiality of services for adolescents[xxi] will be received as deeply counter cultural, and resisted. Finding a way to work with parents and their value systems around the issue of youth autonomy is crucial to effect sustainable be- havior change. Indeed ICPD+5 states actions should be implemented with ‘full respect for the various religious and ethical values and cultural backgrounds of its people, and in con- formity with universally recognized interna- tional human rights’[xxii]. Parents in all societ- ies make decisions for their children in early childhood, indeed the CRC recognizes this as a parental duty, when children have not yet ac- quired the cognitive skills to make their own decisions[xxiii]. The UN recognizes the ‘evolving capacities’[xxiv] of young people, as the underly- ing concept which acknowledges and promotes the journey of growth during adolescence, into a fully autonomous individual. How exactly these capacities are understood and assessed within local contexts is the key issue. The UN uses multiple definitions for its work with adolescents and youth: under-18 years are defined as children; adolescents as 10 – 19 years; and youth as 15 – 24 years. The UN is operating in the context of a multiplic- ity of cultural value judgments regarding au- tonomy, societal roles and sexual behavior of adolescents and youth, many of which are not gender neutral. This is often at odds with a normative human rights framework, particu- larly in the areas of gender equality. Theo- ries of change recognize that no situation is static, rather that a dynamic negotiation of change is always present, although the direc- tion of travel is never certain. The intertwin- ing of religion and culture means FBOs are 55555 naturally part of the dialogue regarding au- tonomy, societal roles and sexual behavior of adolescents and youth. These differences have been exacerbated by the increasing politicization of sexual and reproductive rights in global standard setting fora. At the last Conference on Population and Development, certain member states contin- ued to oppose comprehensive SRH services, which include access to abortion and condoms[xxv]. There is particularly strong re- sistance from some FBOs and members states to provision of SRH for unmarried adolescents and youth. Such coalitions are attempting to reverse some of the gains made for maternal and child health. These highly politicized and public con- frontations with FBOs on SRH issues have fos- tered a sense that partnership in this area is unachievable because of polarized positions on key issues. It is therefore relegated to the category of issues on which FBO’s and the UN must ‘agree to disagree’[xxvi]. Not only is this an unproductive position to take, in terms of expanding the reach of SRH services through the significant networks of FBO health provi- sion globally, it is also inaccurate. Any attempt to contain and homogenize a ‘faith position’ on SRH, fails to acknowledge the diverse range of views on SRH held amongst FBOs, many of whom are not opposed to provision of a comprehensive package of SRH services, including condoms. CULTURAL DETERMINANTS OF HEALTH Attempts to homogenize a definitive faithposition on SRH also neglects a deeper consideration of how religion is lived out and negotiated within the framework of culture. Religious beliefs form part of, but are not the only factor, in sustaining cultural value sys- tems, which relate to sexual activity outside marriage and the autonomy and societal roles of adolescents and youth. Local FBOs and re- ligious leaders are often seen as custodians and protectors of cultural norms. However is important to remember that religiously or cul- turally based values are not necessarily static, but evolve over time. Therefore FBOs and re- ligious leaders are uniquely positioned to be enablers or barriers to change. Developing tools to understanding how FBOs in particu- lar contexts can be integrated into ‘theories of change’ is the foundation of building sus- tainable partnerships for SRH. BOX 4 – UNFPA CBOX 4 – UNFPA CBOX 4 – UNFPA CBOX 4 – UNFPA CBOX 4 – UNFPA CULTURALULTURALULTURALULTURALULTURAL LENSLENSLENSLENSLENS[[[[[XXVIIXXVIIXXVIIXXVIIXXVII]]]]] 66666 Health is rarely experienced as purely medical phenomena; rather it is understood through cultural norms, which often include religious beliefs. In recognition of this interconnectivity between the physical body and interpretative capacity of the mind, UNFPA holds ‘health’, ‘wellbeing’ and ‘iden- tify’ together in one category in their Call to Action[xxviii]. Given the significant impact of cultural barriers to the advancement of SRH, greater engagement with FBOs on this issue is of paramount importance, despite the chal- lenges. There have been significant gains in maternal and child health since ICPD, but mil- lions of women still do not have access to SRH services[xxix] and services to adolescents and youth are still largely ignored[xxx]. In many countries only around 30% of sexually active 15-24 yrs olds use condoms and usage drops further for under-15yrs[xxxi]. It is interesting to note that even where the law provides for SRH access for adolescents and youth, cultural and religious values continue to block provision of services in government as well as FBO health services[xxxii]. There are many barriers to the advance- ment of SRH: legal, economic, political, social and cultural. States are key partners in ensur- ing appropriate legislation is in place and na- tional resources are mobilized to facilitate greater access to SRH services for adolescents and youth. UNFPA recognizes that communi- BOX 5 – CBOX 5 – CBOX 5 – CBOX 5 – CBOX 5 – CULTURALULTURALULTURALULTURALULTURAL BARRIERSBARRIERSBARRIERSBARRIERSBARRIERS TOTOTOTOTO SRH SRH SRH SRH SRH THE WHO STUDY ‘SOCIAL DETERMINANTS OF HEALTH’ RE- VEALED HOW CULTURAL BELIEFS INHIBIT THE EFFECTIVE PRO- VISION OF SRH SERVICES TO UNMARRIED YOUTH, EVEN WHEN THE LAW PROVIDES FOR THESE SERVICES. WHEN INTERVIEWED HEALTH WORKERS OPENLY ADMITTED TO REFUSING SERVICES TO UNMARRIED YOUTH, AS IT WAS ‘AGAINST THEIR CUL- TURE.’ [XXXIII] CULTURAL VALUES ALSO NEGATIVELY IMPACT ADOLESCENT’S USE OF SERVICES. THIS IS DUE TO A LACK OF CONFIDENCE IN THE CONFIDENTIALITY OF HEALTH WORKERS AND THE FEAR OF BEING STIGMATIZED IF CONFIDENTIALITY IS BREACHED. THIS IS ALSO INDICATIVE OF THE MORAL QUANDARY MANY YOUNG PEOPLE FEEL ABOUT ENGAGING IN PRE-MARTIAL SEX. A RE- LUCTANCE TO ACKNOWLEDGE AND ACCEPT RESPONSIBILITY FOR THEIR SEXUAL ACTIVITY DISCOURAGES THEM FROM ACCESS- ING SRH SERVICES. AS ONE YOUTH COMMENTED ‘I DON’T WANT TO CARRY CONDOMS AS I KNOW WHEN I AM DOING IS WRONG’. ties hold joint responsibility with governments for empowering and protecting young people[xxxiv]. FBOs and faith leaders are key stakeholders within communities, helping to shape how young people understand health and their health choices, and directly provid- ing health services. FBO partnerships, which address the social determinants of health, complement state level engagement, and should be seen as part of a comprehensive theory of change, for the advancement of SRH for adolescents and youth. Section 3 – The contribution of faith based organizations towards the sexual and reproductive health of adolescents & youth through health service provision The next two sections will consider two di-mensions of the work of faith based organization’s sexual and reproductive health services for adolescent and youth. Section 3 will look at the significant contribution to health service provision made by FBOs glo- bally, paying particular attention to the diverse and wide reaching nature of this provision. Chapter 4 will address the work of FBOs in nurturing the cognitive development of young people and promoting their resilience and ability to make autonomous decisions. This analysis will aim to elucidate how FBOs are addressing both the push and pull factors in the effective use of SRH services and rooting this in a wider context of happy and healthy transition into adulthood. HEALTH SERVICE PROVISION Faith based organizations continue to be oneof the largest providers of health services globally. FBOs are also often the only provid- ers to marginalized communities, whether in remote rural communities or densely popu- lated urban settlements. Health provision is often considered as integral to the religious mandate to engage in compassionate service to others. A recent study of the service pro- vider behavior of faith based health services concluded religious not-for-profit providers 77777 are intrinsically motivated to serve (poor) people, and that this ‘ethos of service’ was demonstrably stronger than in government run health facilities[xxxv]. This track-record is acknowledged in the vast anecdotal evidence, which suggests individuals turn to FBO run health services when they are unable to pay. A number of recent surveys by the World Health Organization and the World Bank, amongst others, have attempted to quantify this provision[xxxvi]. A mapping carried out by WHO in 2009, estimated that between 30- 70% of health care provision in Sub-Saharan Africa was faith based[xxxvii]. The breadth of these figures gives some indication of the chal- lenge of mapping FBO health provision, much of which remains small-scale, local and con- sequently under the radar of national data collection and strategic planning mechanisms. However the body of research into faith based health provision has been steadily growing over the last decade with notable expertise residing at the Berkley Centre for Religion, Peace and World Affairs, as Georgetown Uni- versity and in the International Religious Health Assets Programme, based at the Uni- versity of Cape Town. Despite the challenges of capturing the global contribution of FBOs in the health sec- tor, the reality is many states are still unable to achieve national coverage of comprehen- sive health services and FBOs are key actors in filling this gap. Sometimes this is through official partnership agreements and joint fund- ing arrangements with the state; sometimes it is managed and funded entirely privately. Churches in many African countries have part- nership agreements with their governments, whereby the state pays for and provides medi- cal staff plus some equipment and medicines, leaving management, upkeep of facilities and shortfalls in equipment and medicines to the churches. Ghana and Zambia, amongst oth- ers, have formed Christian Health Associa- tions to streamline and strengthen the capac- ity of these partnerships and to share best practice and national resources. Faith based health provision can be sustainably financed through fees, whether for profit or not, or can be based on a charity model and receive ex- ternal funding through international faith net- works. Institutions can be managed by indig- enous or international staff, and contain vary- ing levels of local ownership. SEXUAL AND REPRODUCTIVE HEALTH SERVICES Most FBO health services will offer someform of sexual and reproductive health advice as part of their maternal health pack- age of care. However the quality and accessi- bility of this provision varies greatly. There are a wide range of perspectives amongst faith based providers on what kinds of services and advice can be offered, and who should and should not have access to them. Most FBO health providers accept the need for some form of family planning to promote maternal health. The Anglican Communion was the first church to publically state their support for contraception in 1930[xxxviii]. Many accept the use of condoms, or other contraceptive meth- ods to achieve this, although many still do not. There is some evidence to show that faith lead- ers from across different faiths are strength- ening their commitment to maternal health. Statements such as the Interfaith Declaration to Improve Family Health and Well-being, ref- erenced earlier in this paper, are a positive step forward[xxxix]. Despite these gains unmarried adoles- cents and youth are often denied access to SRH services, because of religious value sys- tems that do not sanction sexual activity out- side of marriage. Many FBOs feel that provid- ing young people with the means to have ‘safe sex’ actually encourages them to engage in sex, which is counter to their beliefs. While there is no evidence to support this claim, this concern speaks to a more fundamental ap- proach of many FBOs, who are unwilling to offer health services outside of a moral frame- work. This poses challenges to a public health discourse, which is unwilling to engage in ethical discussions concerning sex between two consenting individuals. Although sex has a universal biological dimension, it is experi- enced and understood is different ways in dif- ferent cultural contexts. The normative frame- work of public health approaches is often lim- ited in its ability to effect positive behavior change, because it seeks to isolate sexual ac- tivity from its social context. Interestingly the WHO recognizes that ‘Health is a sate of com- plete physical, mental and social well-being and not merely the absence of disease or infirmity’[xl]. Health is therefore connected to one’s place in society. This can be a point of entry into dialogue with FBOs to foster a 88888 greater appreciation of cultural and transcen- dental value systems related to sexual ethics. It is important remember that there is no ‘official’ or ‘homogenous’ faith position on the provision of SRH services to unmarried youth, but rather multiple interpretations of religious texts, transmitted through different cultural frameworks, drawing a range of different practical conclusions. It is also important to remember denial of services to young people is not limited to faith based health provision, as evidenced by the WHO report[xlii]. There are many FBOs who do provide condoms and sexual advice to unmarried young people. Sometimes this is officially sanctioned and at times practically minded health workers offer services under the radar, against the wishes of their leaders. Rarely is this work publically championed by faith leaders, in part because of the reticence to talk about sexual health in general, but also because of the risk of back- lash from communities. This quiet approach is indicative of FBOs general preference for engaging in practical support, rather than advocacy. Much of this work remains small scale and unreported, or hidden within wider maternal health programmes. This poses chal- lenges and opportunities for those seeking to BOX 6 – CBOX 6 – CBOX 6 – CBOX 6 – CBOX 6 – CASEASEASEASEASE STUDYSTUDYSTUDYSTUDYSTUDY – G – G – G – G – GHANAHANAHANAHANAHANA C C C C CHRISTIANHRISTIANHRISTIANHRISTIANHRISTIAN H H H H HEALTHEALTHEALTHEALTHEALTH A A A A ASSOCIATIONSSOCIATIONSSOCIATIONSSOCIATIONSSOCIATION THIS CASE STUDY LOOKS AT HOW SRH SERVICES FOR ADOLESCENTS AND YOUTH CAN BE INTEGRATED INTO EXISTING FBO HEALTH PROVISION. THE GHANA CHRISTIAN HEALTH ASSOCIATION (CHAG), FOUNDED IN 1967, IS AN UMBRELLA ASSOCIATION OF ALL CHURCHES, WHO OPERATE HOSPITALS, PRIMARY HEALTH CARE CENTERS AND TRAINING CENTERS. THEY ARE THE SECOND BIGGEST PROVIDER AFTER THE MINISTRY OF HEALTH, COVERING AN ESTIMATED 35-40% OF THE POPULATION, MAINLY IN RURAL AND UNDERSERVED AREAS. IN 2002 THE AFRICAN YOUTH ALLIANCE/PATHFINDER EMBARKED ON A PARTNERSHIP WITH CHAG CALLED ‘WINDOW OF HOPE’ TO INTEGRATE YOUTH FRIENDLY SERVICES, INTO SOME OF THEIR EXISTING HEALTH FACILITIES. THIS PROJECT WAS PART FUNDED BY UNFPA. THE PACKAGE OF SERVICES INCLUDED THE PROVISION OF A RANGE OF CONTRACEPTIVES, DRUGS, CONFIDENTIAL ADVICE AND COUNSELING TO ALL YOUTH, INCLUDING YOUNG ADOLESCENTS, PLUS OUTREACH SERVICES, AND THE INCLUSION OF YOUTH ON FACILITY MANAGEMENT COMMITTEES. DESPITE SOME LOCAL CONTROVERSY SURROUNDING THIS WORK, AS WELL AS NATIONAL LEVEL RESISTANCE FROM SEVERAL MEM- BERS OF CHAG, THE PROJECT WAS IMPLEMENTED IN 10 HEALTH FACILITIES. DETAILS OF THE NEGOTIATING PROCESS WITH CHAG, REVEAL THE VALUE OF EXTENSIVE DIALOGUE AND COMPROMISE, TO ESTABLISH MUTUAL TRUST AND TO UNDERSTAND THE THEOLOGICAL AND CULTURAL RATIONAL BEHIND RESISTANCE TO THE PROGRAMME. IT NECESSITATED FLEXIBLE DEADLINES THAT GAVE SPACE FOR INTERNAL AGENTS OF CHANGE TO GUIDE THE PROCESS, AND NEGOTIATED AN ACCEPTANCE THAT NOT ALL MEMBERS WOULD PARTICIPATE. THIS WAS UNDERPINNED BY A DEEP COMMITMENT FROM THE LEADERSHIP ON BOTH SIDES TO STICK WITH THE PROCESS. THE RESULTS WERE EXTREMELY POSITIVE. THE QUALITY OF YOUTH SERVICES WAS SHOWN TO HAVE DOUBLED AFTER A YEAR, AND PARTICIPATING MEMBERS MADE PLANS AND COMMITMENTS TO FURTHER INTEGRATE YOUTH FRIENDLY SER- VICES INTO THE REST OF THEIR FACILITIES. CHAG’S REACH OF PROVISION AND THEIR PRESENCE IN LOCAL COMMUNITIES MEANS THEIR OWNERSHIP OF THE PROJECT HAS BUILT FOUNDATIONS FOR LASTING CHANGE IN SRH SERVICES. FULL CASE STUDY – SEE PATHFINDERS INTERNATIONAL ‘BUILDING PARTNERSHIP WITH FAITH-BASED ORGANISATION: INTEGRAT- ING YOUTH FRIENDLY SERVICES INTO THE HEALTH DELIVERY SYSTEM OF THE GHANA CHRISTIAN HEALTH ASSOCIATION OF GHANA’ (PATHFINDER INTERNATIONAL USA)[XLI] establish an evidence base for this work. It is interesting to note that a mapping of UNFPA FBO partnerships in 2008 revealed 14 exist- ing partnerships to promote the sexual and reproductive health of adolescents and youth. In seeking to better understand the con- tribution of FBOs to health service provision is it unhelpful to make generic statements about FBO health provision, but rather to ex- amine the specific objectives of different FBO providers, as well as the national legislative frameworks, and local contexts within which they operate. It is also important to appreciate the evolution of FBO health provision in the last fifty years, in the context of a transition out of colonial government in many parts of the world and the global professionalization of development. FBO approaches to health provision have not been static; they have adapted and increasingly integrated public health values. It is important to identify, re- spect and work with, not against, internal le- vers of change, and allow adequate time and flexibility to support this process. This is al- ways a process of negotiation, which has been most sustainable when in dialogue with reli- gious values on health. There are many ex- amples from the HIV sector demonstrating 99999 how religious texts have been used to engage in discussions about sex and sexuality[xliii]. A closer analysis of the multiple variables of FBO health provision will enable a more accurate discernment of the value and opportunities for partnering with FBOs for SRH. Section 4 – FBOs accompaniment of young people through adolescence as a protective factor for sexual and reproductive health Research into the sexual and reproductivebehavior of adolescents and youth shows that there are many protective and risk fac- tors located within culture, family and com- munity, which are necessary components of sustainable behavior change[xliv]. Although the significance of antecedents varies by coun- try, many relate to cultural norms concerning sexual behavior and relationships, psychologi- cal resilience, and the presence of supportive networks and alternatives to unhealthy behav- ior. Many FBOs have a track record of engage- ment in these areas, through their presence and influence in local communities. The com- munity level engagement of local FBOs and faith leaders can be seen as complementary to the protective factors offered by UNFPA in the form of commodities and information ser- vices. This section will consider how the values and platforms for youth engagement provided by FBOs are part of a comprehensive response to sexual and reproductive health goals. MULTIPLE PLATFORMS FOR ENGAGING YOUTH FBO work on SRH should not be consideredin isolation, but rather within the context of the holistic engagement of local faith communities with adolescents and youth, through a range of activities and services, which include education, health, civic edu- cation, leadership training, fellowship, sport and art. UNPFA identifies social assets such as peer-based social support networks, cul- turally creative activities and recreation, as a key strategy for building the resilience of adolescents and youth[xlv]. FBOs accompany young people through adolescence, interced- ing with advice and guidance at critical junc- tures in their development, such as providing marriage preparation classes. The reality is in areas of the world where UNFPA works many young people marry while they are still adolescents; this is a constructive entry point for partnership with FBOs. FBOs also partici- pate in adolescents other rites of passage, which provide windows of opportunities to engage young people. Their links to religious institutions and teachings means these ready-made platforms for engaging youth are trusted and sanctioned by parents, and are thus able to reach more extensively into communities. They are rich in social capital as they are part of the glue that holds society together, by bonding, bridging and linking individuals together[xlvi]. Faith based youth groups are usually con- sidered by parents to be ‘safe’ spaces for young people to learn to express them- selves. This is in part because they are con- sidered as places that will actively discour- BOX 7 - CBOX 7 - CBOX 7 - CBOX 7 - CBOX 7 - CASEASEASEASEASE STUDYSTUDYSTUDYSTUDYSTUDY – U – U – U – U – USINGSINGSINGSINGSING CHURCHCHURCHCHURCHCHURCHCHURCH NETWORKSNETWORKSNETWORKSNETWORKSNETWORKS FORFORFORFORFOR PEERPEERPEERPEERPEER EDUCATIONEDUCATIONEDUCATIONEDUCATIONEDUCATION ONONONONON SRH SRH SRH SRH SRH THE ANGLICAN CHURCH OF WESTERN CAPE IN SOUTH AF- RICA, IMPLEMENTED A YOUTH PEER EDUCATION PROGRAMME ‘AGENTS OF CHANGE’ AIMED AT CHANGING RISKY SEXUAL BEHAVIOR AMONG YOUTH (AGED 12 – 19 YEARS), WHICH ALSO INCLUDED WORKSHOPS WITH PARENTS. THE APPROACH TAKEN WAS AN ‘ABSTINENCE PLUS’ MODEL THAT EMPHASIZED DELAYING SEXUAL DEBUT, BUT ALSO PROVIDED YOUNG PEOPLE WITH INFORMATION ON HOW TO UTILIZE AND ACCESS CONDOMS AND OTHER ADVICE AND COMMODITIES. THIS AP- PROACH WAS IN LINE WITH THE CHURCH’S EMPHASIS ON AB- STINENCE, BUT ALSO CREATED OPPORTUNITIES TO EDUCATE PARENTS ON THE IMPORTANCE OF PROVIDING INFORMATION TO KEEP YOUNG PEOPLE HEALTHY AND SAFE. AN INDEPENDENT CONTROL TEST SHOWED THE PROGRAMME SUCCEEDED IN INCREASING BOTH THE PERCENTAGE OF THOSE DELAYING SEXUAL DEBUT AND, FOR THOSE WHO WERE SEXU- ALLY ACTIVE, INCREASING THE RATE OF CONDOM USE. THE CHURCH UTILIZED ITS EXISTING COMMUNITY AND YOUTH NET- WORKS TO ROLL-OUT THE INITIATIVE. THIS WAS IDENTIFIED AS A KEY FACTOR IN THE EFFECTIVENESS OF THE PROGRAMME.[XLVII] A SIGNIFICANT PROPORTION OF YOUTH GROUPS IN SUB-SA- HARAN AFRICA ARE AFFILIATED TO A RELIGIOUS ORGANIZA- TION. FEW ARE CURRENTLY CONNECTED TO SRH PROGRAMMES, BUT REMAIN A VAST UNTAPPED RESOURCE FOR ENGAGING ADOLESCENTS AND YOUTH. 1 01 01 01 01 0 age adolescents and youth from becoming sexually active. This is turn is the reason why the UN often feels it cannot partner with such organizations as this ‘discourag- ing’ is contrary to the promotion of an individual’s autonomy, and are therefore defined as disempowering environments. However ‘abstinence plus’ approaches rep- resent a third approach, which both re- spects the value system of FBOs, and pro- vides opportunities to educate parents and young people in fostering a range of pro- tective factors. Good parenting bolsters protective fac- tors and promotes the resilience of young people[xlviii]. The role of parents is enshrined in the Convention of the Rights of the Child, and yet many initiatives seem reticent to en- gage parents in discussions on SRH choices of their children. WHO identifies connec- tion, love, behavior control, respect for in- dividuality, modeling appropriate behavior, provision and protection as the key paren- tal roles played, which contribute to young people’s sexual and reproductive health[xlix]. The moral influence of FBOs means they are able to engage parents in dialogue on how to be more supportive of their children’s moral and emotional development. Parents are more likely to accept this advice when they feel more ownership and understand- ing of the rationale of the FBOs work with their children. Therefore it is most effective when it is grounded in religious language con- cerning the family. Again opportunity is not always utilized and too many FBOs accept and even support authoritarian modes of parenthood. However there are also many FBOs who offer training and support to par- ents to promote happy, non-violent fami- lies. For example local Anglican priests in South Sudan were trained to give parents non-violent techniques for dealing with dis- agreements. There is a tendency for SRH infinitives to focus on girls, as the more vulnerable group, who are susceptible to early pregnancy or coerced sexual encounters. However the empowerment of girls requires the full par- ticipation of boys in realizing this goal. FBOs have ready-made platforms for engaging boys and often have teachings and activi- ties aimed specifically at young men. This provides space for issues of masculinity to be discussed and for associated cultural norms around power, dominance and vio- lence to be challenged. When religious lead- ers cha l lenge negat ive cu l tura l norms around gender, they can be powerful role models for young men. FBOs certainly have a mixed record on gender. Often they use their social capital to reinforce gender inequal i t ies . However there are countless examples of how reli- gious texts are being used to fight gender based violence and to promote women’s empowerment. FBOs have within them the intellectual and cultural resources to provide a contextual vision for gender equality based on their religious texts. FBOs need to be understood and engaged as key stakeholders in local communities, who form part of the local enabling envi- ronment for young people’s health choices. Susta inable and authent ic behaviour change on sexual and reproductive health requires attention to the values underpin- ning interconnected relationships that bind local communit ies. Programmes wil l be more effective if they work with rather than push against these factors. Bypassing local faith based stakeholders, can prohibit ac- cess to collective community knowledge, which may actually negate and inhibit a community’s internal development process and ability to take collective action[lii]. En- gaging local FBOs in value based dialogue on SRH issues needs to be integrated into current theories of change. BOX 8 – FBOBOX 8 – FBOBOX 8 – FBOBOX 8 – FBOBOX 8 – FBOSSSSS WORKWORKWORKWORKWORK WITHWITHWITHWITHWITH MENMENMENMENMEN ANDANDANDANDAND BOYSBOYSBOYSBOYSBOYS TWO RECENT EXAMPLES OF HOW LANGUAGE AND STORIES FROM THE BIBLE HAVE BEEN USED TO TACKLE GENDER BASED VIOLENCE AND PROMOTED GENDER EQUALITY COME FROM THE WORLD COUNCIL OF CHURCHES. THE TAMAR CAMPAIGN USES THE STORY OF THE OLD TES- TAMENT CHARACTER, TAMAR, WHO WAS RAPED BY HER BROTHER-IN-LAW, TO CHALLENGE THE SILENCE AND STIGMA AROUND GBV, BY ILLUSTRATING THE FAILURE OF HER FAM- ILY AND SOCIETY TO PROTECT HER[L]. A WOMEN’S EMPOWERMENT TRAINING MANUAL FOR CHURCHES CALLED ‘CREATED IN GOD’S IMAGE -FROM HE- GEMONY TO PARTNERSHIP’ FOCUSES IN ENGAGING MEN AND BOYS TO PROMOTE POSITIVE MASCULINITIES THAT CAN RE- SIST CULTURAL NORMS TO DOMINANT WOMEN.[LI] 1 11 11 11 11 1 COGNITIVE DEVELOPMENT AND PSYCHOLOGICAL RESILIENCE A distinctive contribution of FBOs is theirability to engage with the spiritual di- mension of young people. For those who self- identify as religious or spiritual, their spiritual development is intertwined with their psycho- logical growth, and therefore has an impact on their ‘evolving capacities’. Global statistics on values continue to show that the majority of the people (82%) believe in some form of religion[liii]. Religions provide individuals with ‘meaning enhancing capabilities’, through transcendental teachings, moral beliefs and behavioral norms, which help young people to make sense of the world and the choices open to them[liv]. Religious beliefs represent important sources of hope, ideals, worldviews and role models that influence the course of identity development during adolescence[lv]. A WHO study (2001) showed that in the ma- jority of regions spiritual beliefs were a pro- tective factor in delaying sexual initiation[lvi]. Greater consideration of the impact of spiri- tual beliefs on cognitive development of young people will open new opportunities for working with FBOs to support their evolving capacities. Faith based youth groups often provide a range of creative and collaborative social ac- tivities for young people, under the guidance of trusted adults, which develop their capac- ity for critical thought, leadership, coopera- tion and mutual service. This contributes to the third pillar of UNFPA’s strategy, which seeks to empower young people, by building their personal competencies, enabling them to contribute positively to local and global society, and providing them with information and confidence to take responsibility for their sexual and reproductive health[lvii]. Faith based youth groups often operate in the context of an under-resourced school system, which is unable to offer spaces for interactive development; although where FBOs are involved in education, many have made provision, additional to the national cur- riculum, through special clubs to foster ‘safe- guarding’ and learning around topics rang- ing from sexual health, peace-building and the environment[lx]. In many cases these platforms support human rights of young people by cre- ating environments where they can grow into BOX 9- CBOX 9- CBOX 9- CBOX 9- CBOX 9- CA S EA S EA S EA S EA S E S T U D YS T U D YS T U D YS T U D YS T U D Y -Z -Z -Z -Z -ZI M B A B W EI M B A B W EI M B A B W EI M B A B W EI M B A B W E C C C C CH R I S T I A NH R I S T I A NH R I S T I A NH R I S T I A NH R I S T I A N SSSSSTUDENTTUDENTTUDENTTUDENTTUDENT M M M M MOVEMENTOVEMENTOVEMENTOVEMENTOVEMENT THE ZIMBABWE STUDENT CHRISTIAN MOVEMENT BRINGS ADOLESCENTS AND YOUTH FROM ACROSS ALL CHURCHES IN ZIMBABWE TO RAISE AWARENESS AND PROMOTE DIALOGUE ON ISSUES OF CONCERN TO YOUNG PEOPLE. THROUGH MEET- INGS, RETREATS, SEMINARS AND NEW MEDIA ZSCM EM- POWERS YOUNG PEOPLE THINK ABOUT SOCIAL NORMS IN THE CONTEXT OF THEIR FAITH AND TO SPEAK UP AND SPEAK OUT. IN THE ZIMBABWEAN CONTEXT WHERE MANY CIVIL SOCIETY GROUPS HAVE BEEN SILENCED, THEY CONTINUE TO SPEAK UP ON GOOD GOVERNANCE AND NON VIOLENCE. ZSCM ALSO HAS A PROGRAMME ON HIV AND SRH[LVIII]. THE ZCSF IS ALSO PART OF THE WORLDWIDE STUDENT CHRISTIAN FEDERATION, OF OVER TWO MILLION YOUNG PEOPLE ACROSS THE WORLD. CREATED IN 1895, THE WSCM PROVIDES SPACE FOR CROSS-CULTURAL DIALOGUE ON ISSUES RANGING FROM HUMAN SEXUALITY TO PEACE- BUILDING.[LIX] their potential[lxi]. This contributes to foster- ing the capacity of adolescents and youth to make responsible decisions on sexual and re- productive health choices. The reality is that religious texts and be- liefs are open to a range of interpretations, and are transmitted through a multiplicity of cultural frameworks. Consequently the values young people receive from religious leaders and communities have the potential to either help or hinder their ability to make healthy, autonomous decisions. A central secular cri- tique of FBOs is that they generally inhibit rather than promote the ability of youth to develop the capacity to make choices through conservative approaches to sexual activity, and deny the reality of the pressures on young people’s lives. While there is some truth in this there are also many ways in which FBOs pro- mote cognitive growth and responsible deci- sion making that has been largely overlooked. It is important to avoid generalizations about what messages FBOs are transmitting, and in- stead to develop tools to discern the range of nuanced messages contained within a particu- lar interpretation and application of spiritual teaching in a specific context. When messages are empowering they foster the internal resilience of young people. Internal emotional resilience can be consid- ered a protective factor against unhealthy sexual behavior; for example by giving an in- 1 21 21 21 21 2 dividual the confidence to say no to sex, or to insist on the use of a condom. FBOs can as- sist UNFPA in its goal to ‘empower progres- sively the self-management of their sexual and reproductive health’ [lxii], by building the emo- tional resilience of young people, in part through religious and cultural values. In this way young people might not only know their rights but have the internal resilience to de- mand them. When boys are engaged in the conversa- tion, religious values can also be used to chal- lenge destructive forms of masculinity, which rely on violence and sexual dominance[lxiii]. Mes- sages of peace and non-violence can have a sig- nificant impact in post conflict settings, where societal checks and balances that protect young people from early pregnancy and gen- der based violence have broken down. Most faith based youth groups provide a mixture of messages, based on traditional interpreta- tions of holy texts, combined with local expe- riences and institutional memory, and the vi- sion of the youth leaders themselves. Effec- tive partnerships with faith based youth groups will allow positive messages to be re- inforced, while creating space for negative messages to be reviewed and challenged. Promoting resilience and mutual respect must be central to any approach to SRH. This is particularly important in contexts of con- flict, displacement and poverty, when an individual’s vulnerability increases. WHO re- search shows that when an individual is treated less equitably they are more likely to take sexual risks[lxiv]. Therefore when FBOs foster self esteem and mutual respect amongst young people they are fostering protective factors for sexual and reproductive health. A review of studies into the sources of resilience of young people in South Africa showed that religious leaders and personal faith were fun- damental to the processes and outcomes of resilience[lxv]. BOX 10 - EBOX 10 - EBOX 10 - EBOX 10 - EBOX 10 - EXAMPLESXAMPLESXAMPLESXAMPLESXAMPLES OFOFOFOFOF E E E E EMPOWERINGMPOWERINGMPOWERINGMPOWERINGMPOWERING ANDANDANDANDAND D D D D DISEMPOWERINGISEMPOWERINGISEMPOWERINGISEMPOWERINGISEMPOWERING MESSAGESMESSAGESMESSAGESMESSAGESMESSAGES PROMOTEDPROMOTEDPROMOTEDPROMOTEDPROMOTED BYBYBYBYBY FBO FBO FBO FBO FBOSSSSS EEEEEM P O W E R I N GM P O W E R I N GM P O W E R I N GM P O W E R I N GM P O W E R I N G M E S S A G E SM E S S A G E SM E S S A G E SM E S S A G E SM E S S A G E S A N DA N DA N DA N DA N D B E H A V I O U RB E H A V I O U RB E H A V I O U RB E H A V I O U RB E H A V I O U R F R O MF R O MF R O MF R O MF R O M RELIGIOUSRELIGIOUSRELIGIOUSRELIGIOUSRELIGIOUS YOUTHYOUTHYOUTHYOUTHYOUTH GROUPSGROUPSGROUPSGROUPSGROUPS DDDDDISEMPOWERINGISEMPOWERINGISEMPOWERINGISEMPOWERINGISEMPOWERING MESSAGESMESSAGESMESSAGESMESSAGESMESSAGES ANDANDANDANDAND BEHAVIOURBEHAVIOURBEHAVIOURBEHAVIOURBEHAVIOUR FROMFROMFROMFROMFROM RELIGIOUSRELIGIOUSRELIGIOUSRELIGIOUSRELIGIOUS YOUTHYOUTHYOUTHYOUTHYOUTH GROUPSGROUPSGROUPSGROUPSGROUPS FOSTERING SELF ESTEEM AND MUTUAL RESPECT –THE SACRED- NESS AND VALUE OF EVERY INDIVIDUAL PERPETUATING INTERNAL INEQUALITIES AND NEGATIVE STE- REOTYPES OF OUTSIDERS CHALLENGING VIOLENT AND SEXUALLY DOMINANT FORMS OF MASCULINITY – FINDING EQUAL IDENTITY IN GOD’S LOVE GENDER BIAS – PROMOTING FEMALE SUBMISSIVENESS AND MALE DOMINANCE PROMOTING SELF EXPRESSION AND COGNITIVE GROWTH INHIBITING SELF EXPRESSION AND ACQUISITION OF KNOWLEDGE MAKING THE CONNECTION BETWEEN SEXUAL INTIMACY, LOVE, RESPONSIBILITY, MUTUAL RESPECT AND COMMITMENT STIGMATIZING SEXUALITY - NEGATIVE TEACHING ABOUT THE BODY- A BELIEF THAT ALL SEXUAL SATISFACTION IS WRONG TALKING ABOUT DIFFERENT TYPES OF LOVE AND IDENTIFYING WHICH ONES SHOULD NOT BE EXPRESSED THROUGH SEXUAL INTI- MACY (FOR EXAMPLE FROM PARENTS, GUARDIANS AND OTHERS IN AUTHORITY) OR OUTSIDE OF COMMITTED RELATIONSHIPS IGNORING ABUSE, OR ENCOURAGING FORGIVENESS WITHOUT JUSTICE AND ACCOUNTABILITY FOR PERPETRATORS FOSTERING THE CONFIDENCE TO RESIST PRESSURE TO HAVE SEX OR TO NEGOTIATE THE USE OF CONTRACEPTION IGNORING THE REALITIES OF PRE-MARITAL SEX, EXTRA-MARI- TAL ACTIVITY AND GENDER BASED VIOLENCE HELPING PARENTS AND CHILDREN TO COMMUNICATE WITH EACH OTHER IN NON VIOLENT WAYS AUTHORITARIAN APPROACHES TO INTERGENERATIONAL IN- TERACTION AND MARGINALIZATION OF YOUTH COMPASSION, FORGIVENESS, RECONCILIATION AND REHABILI- TATION PUNITIVE AND EXCLUSIONARY APPROACHES TO DEVIANCY MUTUAL RESPECT, COMMUNITY SUPPORT AND INCLUSION FOR ALL – INCLUDING LISTENING TO MARGINALIZED GROUPS REACTIONARY POSITIONING WITHIN LOCAL COMMUNITIES 1 31 31 31 31 3 PROTECTIVE ENVIRONMENTS AND SUPPORTIVE NETWORKS Sexual behavior is influenced not only byvalues but by socio-economic realities faced by adolescents and youth. UNFPA rec- ognizes safe and fair employment as a key enabling factor for the wellbeing of adoles- cents and youth[lxvi]. For many vulnerable young people finding alternatives to risky sexual behavior requires both economic al- ternatives to seeking protection through sexual activity and protection from predatory adults. FBOs are often involved in life skills and vocational training for youth. Many also offer safe spaces, such as youth hostels and day centers, where young people are given the space to make autonomous decisions, freed from some of the socio-economic or cultural pressures exerted upon them. Given the revelations of abuse in FBO-run institutions, no one can be complacent in as- suming all initiatives are safe and empower- ing spaces for young people. Many FBOs are now engaging in processes to educate staff on these issues and install child protection policies[lxvii]. More understanding and commit- ment needs to be fostered within FBOs on the importance of ‘safeguarding’. The UN and other NGO partners can support and encour- age FBOs to do achieve this by insisting on safeguarding as principle of partnership, but also by providing capacity building for FBOs to help them build appropriate mechanisms to protect young people. The social capital of FBOs can be also be used in negative ways to exc lude and stigmatize[lxviii]. FBOs are often criticized for their religious condemnation and ostracism of young people when they deviate from proscribed sexual behavioral norms. Reli- gious texts are often used to justify judg- mental positions; however an interesting development is how many FBOs are using those same texts to demonstrate how the suffering of one is the collective responsi- bility of all. This moves communities from the condemnation of the individual to a need for repentance and action from the commu- nity as a whole to provide more comprehen- sive forms of support and protection. The strength of this approach comes from the uti- lization of spiritual values and language in holding local communities’ to account as ‘duty bearers’. HIV & AIDS responses by the UN and other agencies over the last twenty years have demonstrated the importance of engaging with faith communities, whether they are perceived as a barrier or an ally in deliver- ing effective programmes. Very early in the HIV pandemic it was recognised that local faith communities and FBOs, with their un- paralleled reach, were at the forefront in providing care and support for those sick with AIDS-related illness and for orphans and other vulnerable children in affected communities. However, at the same time, faith teachings, in stressing abstinence and faith- fulness, were often seen to stigmatise those living with HIV, blaming them for their in- fection. Such stigma and discrimination were identified as key barriers to promot- ing testing and treatment while also inhib- iting prevention efforts. While some FBOs promoted comprehensive prevention ap- proaches stressing their duty to protect life, others found it difficult to discuss sex and safer practices, particularly condom use, in a faith context. AIDS programmes therefore started to work with the faith communities, both to build on the positive aspects of their responses and to transform the negative di- mensions. In many contexts FBOs now play a significant role in challenging HIV-related stigma and discrimination, not least through BOX 11 – UBOX 11 – UBOX 11 – UBOX 11 – UBOX 11 – USINGSINGSINGSINGSING SPIRITUALSPIRITUALSPIRITUALSPIRITUALSPIRITUAL TEXTSTEXTSTEXTSTEXTSTEXTS TOTOTOTOTO PROMOTEPROMOTEPROMOTEPROMOTEPROMOTE PROTECTIVEPROTECTIVEPROTECTIVEPROTECTIVEPROTECTIVE COMMUNITYCOMMUNITYCOMMUNITYCOMMUNITYCOMMUNITY NETWORKSNETWORKSNETWORKSNETWORKSNETWORKS UNICEF WORKED WITH BUDDHIST SCHOLARS IN THAILAND TO UNPACK THE HOLY TEACHING OF THE FIVE NOBEL TRUTHS. IN THE PAST LOCAL BUDDHIST INTERPRETATIONS OF THE CONCEPT OF ‘SUFFERING’ POINTED TO UNCRITICAL ACCEPTANCE, WHICH MINIMIZED LOCAL PROTECTIVE FACTORS FOR YOUTH AND RESULTED IN A COLLECTIVE FAILURE TO PROTECT THE VULNERABLE. A REFOCUSING ON THE CONCEPT OF THE FIVE NOBEL TRUTHS, WHICH UNDERSTANDS SUFFERING TO BE COMMUNAL AND THE CAUSE TO BE IGNORANCE, FACILITATED BEHAVIOR CHANGE OF FBOS AND FAITH LEADERS, WHO BEGAN TO INVEST IN ESTABLISHING PROTECTIVE FRAMEWORKS FOR ADOLESCENTS AND YOUTH.[LXIX] 1 41 41 41 41 4 BOX 12 – TRANSFORMING STIGMA AROUND HIV ONE INITIATIVE HAS ENGAGED WITH CHRISTIAN CHURCHES AND THEIR LEADERS IN NIGERIA, TRANSFORMING THEIR ATTITUDES TO COMPREHENSIVE HIV PREVENTION. KEY ELEMENTS OF THE INITIATIVE INCLUDED ADDRESSING TRADITIONAL PERSPECTIVES ABOUT DISEASE, GENDER AND OTHER ISSUES, RECOGNISING OTHER CULTURAL WORLDVIEWS OPERATING ALONGSIDE RELIGIOUS TEACHINGS. A MORE COMPREHENSIVE PREVENTION FRAMEWORK (SAVE), PROMOTING A FULL RANGE OF SAFER PRACTICES (ABC, PMTCT, ACCESS TO TESTING AND TREATMENT, GENDER EMPOWERMENT, ETC) ENABLED THE FAITH LEADERS TO MOVE AWAY FROM CIRCULAR DEBATES ON ABSTINENCE AND FAITHFULNESS VERSUS CONDOMS. THE ACTIVE INVOLVEMENT OF PEOPLE LIVING WITH HIV, INCLUDING PASTORS, ALSO CHALLENGED ATTITUDES, ENABLING THE CHURCH LEADERS TO SEE HIV AS A PUBLIC ISSUE, MAKING MORAL DEMANDS ON THEM TO INFORM AND EQUIP THOSE VULNERABLE TO HIV WHILE TACKLING THE UNDERLYING CAUSES OF VULNERABILITY. THROUGH ALL THIS, CHURCHES WERE ABLE TO AFFIRM CHRISTIAN TEACHING ON VALU- ING LIFE AND ADDRESSING EXPLOITATION AND INJUSTICE, WHILE EXPLORING THEIR OWN FAITH TEACHINGS AND MOTIVATIONS AT A DEEPER LEVEL. ADAPTED FROM: TEARFUND (2008) TRANSFORMING APPROACHES TO HIV PREVENTION IN NIGERIA. TEARFUND UK. the network of religious leaders living or per- sonally affected by HIV (INERELA)[lxx]. COMPLEMENTARY PROTECTIVE FACTORS The UNFPA Framework for Adolescents andYouth advocates for an integrated ap- proach that situates the sexual and reproduc- tive health choices of young people, within the context of other areas of their life, such as education, citizenship and livelihoods[lxxi]. These choices also need to be considered in the context of their identity and participation in religious groups. Autonomous decisions are not made in a vacuum; rather individual agency requires the negotiation of a range of influences and arguments. Studies into behaviour change demonstrate the degree to which the values of local communities have significant influence on the sexual and repro- ductive health decisions and outcomes of ado- lescents and youth[lxxii]. One study into the impact of religiosity on sexual behavior shows the religious focus on abstinence does have a positive impact on prolonging sexual debut[lxxiii]. However a focus on abstinence without additional information denies young people access to other protective factors. Abstinence plus programmes provide oppor- tunities to access a range of complementary protective factors for adolescents’ sexual and reproductive health. A significant proportion of youth groups in sub-Saharan Africa are affiliated to a reli- gious organization. Their links to religious institutions and teachings mean these ready- made platforms for engaging youth are trusted and sanctioned by parents, and are thus able to reach more extensively into communities. Religious youth groups are usually considered by parents to be ‘safe’ spaces for young people to learn to express themselves. This is in part because they are considered as places that will actively discour- age adolescents and youth from becoming sexually active. This in turn is the reason why the UN often feels it cannot partner with such organizations as this ‘discouraging’ is contrary to the promotion of an individual’s autonomy, and are therefore defined as disempowering environments. However the picture is more complex than this. In reality while some FBOs are fully en- gaged in sexual and reproductive health of young people, others remain reluctant to of- fer a ‘comprehensive’ package of SRH services that include the provision of condoms and sexual health advice to unmarried people. However there are many ways in which FBOs are fostering of a range of other protective factors pertaining to the sexual and reproduc- tive health of adolescents and youth. Much of this work is complementary to the protec- tive factors advanced by public health mod- els, as it addresses the social determinants of health. FBOs are rich in social capital and have access to local networks and opinion form- ers, not available to the UN and other non in- digenous organizations. Embedded in local communities, they are able to promote last- ing behavior change in the lives of young people and in the contexts within which they experience growth and change. 1 51 51 51 51 5 Section 5 – Building effective partnerships between the UN and FBOs The final section of this paper seeks to buildon the arguments made for the existing and potential contribution of FBOs to the sexual and reproductive health of adolescents and youth, by making some practical sugges- tions for establishing partnerships between FBOs and the UN at the country level. These gains also need to be reflected within inter- national standard setting and strategic plan- ning fora if they are to foster lasting improve- ments across the sector. These suggestions draw extensively from existing UNFPA, UNICEF, UNAIDS and DFID guidelines for working with FBOs[lxxiv]. In doing so this paper affirms the direction of travel within the UN system towards more effective collabora- tion with FBOs. It also encourages UN staff to consult more widely within their own or- ganizations and within the wider donor com- munity, to access the expertise and institu- tional memory being internally generated on these issues. FUNDAMENTAL PRINCIPLES OF PARTNERSHIP – HOW TO ENGAGE Effective UN partnerships with FBOs forsexual and reproductive health must be un- derpinned by transparent and mutually re- spectful relationships. Many of the barriers to partnership are related to mutual mistrust between the UN and FBOs, born out of ig- norance and a tendency to stereotype indi- viduals and perceived agendas, which is compounded by a lack of shared language around sexual and reproductive health and well-being[lxxv]. Therefore it is important to provide space for dialogue with a range of faith based actors (see next section) in order to unpack and understand each other’s val- ues, language and actions. Dialogue with local partners is nothing new, but it is important that dialogue with lo- cal faith actors is characterized by transpar- ency and mutual respect[lxxvi]. This can be par- ticularly challenging when FBOs, hold dif- fering views from the UN on certain aspects of the human rights framework, such as re- productive rights. However the divergence around issues within the body of wider body human rights should not be a barrier to good partnership, given that there is strong con- vergence between the UN and most FBOs on the fundamentals of the Declaration of Hu- man Rights. Following good partnership prin- ciples will reaffirm this mutual commitment to human rights. Transparency means both the UN and FBOs are required to explain their values and language, rather than expecting one party jus- tify their position with regards to the other’s normative framework. This requires UN staff to be ready to unpack their values as en- shrined in the human rights framework, to explain in plain language why they hold to these values, and be honest about challenges of implementation. There is no neutral space and UN staff should be self-aware of their val- ues and knowledge base and develop skills to enter into dialogue with others values[lxxvii]. FBOs must be allowed to bring their own theological frameworks and language to the table. This will help them to communicate their values and to establish common ground around human rights, which have strong roots in religious concepts of justice and human dignity. There is often a reticence by the UN to engage directly with religious discourse, as they are a secular organization, but it is es- sential in order to foster greater understand- ing of the values and actions of FBOs. How- ever it is also incumbent on FBOs to make themselves understood in secular terms where possible, and to be transparent about inter- nal dialogue over interpretations. Local theo- logical debates concerning sexual health need to be better understood and integrated into theories of change. Both sides must listen to and engage with critiques from the other, re- sisting the temptation to retreat into en- trenched positions and jargon. Through this iterative process common ground can be iden- tified and trust can be built. Just as important is for FBOs and the UN to acknowledge and understand each others ‘footprint’, track-record or impact on local communities. Although the UN and FBOs are often working on similar projects, they are often quite disconnected at country level, with limited second hand knowledge about each other’s community health work. Increasing 1 61 61 61 61 6 knowledge of one another helps to create a ‘level playing field’[lxxviii] for partnership, where each party’s unique strengths and weaknesses are understood and incorporated into project design. As acknowledged by this paper there is currently limited data on the health and wider community development work of local FBOs. This is because much of it is small scale and is not captured in national mapping, and most is not funded by INGO or government donors and thus does not appear in their M&E data. It is important that the UN and other donors invest in more research in this area and in communicating research findings across UN agencies. Mapping can also be conducted at a local level by establishing ongoing rela- tionships with multi-faith networks of key stakeholders. This also helps to communicate the work of the UN to FBOs and other faith based stakeholders in civil society. LEVELS AND FORMS OF PARTNERSHIP – WHO TO ENGAGE UNFPA affirms the need to work withacross a diverse range of stakeholders, including religious leaders, to make a positive impact on young people’s lives[lxxix]. The pa- per has sought to build on that commitment to demonstrate that there are a wide range of faith based actors making an impact on the sexual and reproductive health of adolescents and youth. Faith leaders, local faith communi- ties, religious youth groups, faith based devel- opment organizations, and inter-faith networks are just some of the range of faith based actors[lxxx]. Understanding who to engage with on sexual and reproductive health is perhaps the most significant challenge for UN organiza- tions. Internal religious structures and inter-re- ligious networks are complex, dynamic and of- ten political, making them difficult for outsid- ers to understand and penetrate. However there are already good some examples of en- gagement between UNFPA and different types of faith based actors, which can be replicated. National rel igious leadersNational rel igious leadersNational rel igious leadersNational rel igious leadersNational rel igious leaders are often gatekeepers to a complex web of relationships and activities, as well as being institutional opinion formers, making them key partners. They often also have opportunities to influ- ence national policy makers. In Bangladesh and Philippines, UNFPA has successfully har- nessed the power of national faith leaders to lobby governments for a change in laws re- lated to sexual and reproductive health[lxxxi]. However it is crucial that the UN is able to reach beyond senior faith leaders to access those within faith communities who are work- ing closely with young people. Local faith leadersLocal faith leadersLocal faith leadersLocal faith leadersLocal faith leaders are embedded in local communities, accompanying people day to day throughout their lives, being present at births, marriages, deaths, to providing moral guidance and emotional support. This makes them key agents of change. In reality, although many local faith leaders see the ef- fects of bad SRH services throughout their communities and would like to help, they are often reluctant to talk about SRH issues be- cause cultural taboos and of a lack of infor- mation. There are a growing number of case studies showing the positive impact of em- powering local faith leaders with basic SRH information and awareness raising on related issues such as gender based violence and FGM/C. A number of training manuals for faith leaders have been developed; for example ‘Pastors Preach Population’ from UNFPA in Papa New Guinea. These need to be shared more widely within regions. Faith based youth groupsFaith based youth groupsFaith based youth groupsFaith based youth groupsFaith based youth groups are a vastly under-utilized ready made platforms for en- gaging and understanding youth. Youth groups can provide opportunities to dialogue with young people about how their faith im- pacts their sexual behavior and use of SRH services, and identify which values need to be encouraged and which challenged. They also provide spaces to cultivate and mark young people’s development, which can be incorpo- rated into strategies for promoting the evolv- ing capacities of youth. In Guyana, UNFPA was able to build on a project, which utilized community worship spaces to discuss issues of adolescent sexual and reproductive health, to establish a partnership with the Anglican National Youth Council[lxxxii]. Pursuing strate- gies to identify and engage local and national religious youth groups, will help to embed change within religious structures. It is equally important to dialogue with youth workers,youth workers,youth workers,youth workers,youth workers, as they are at the interface between imparting faith values and accompa- nying youth people through adolescence. Youth workers are also accountable to faith 1 71 71 71 71 7 leaders and parents and can offer insights into the mult ip le in f luences on young people’s behavior and help identify the most effective strategies for change. Strategies for engaging youth workers should appre- ciate that they have less opportunities for dialogue with external agencies, as com- pared to faith leaders, and need to be spe- cifically identified and targeted. Although the voice of women is signifi- cantly under-represented in re l ig ious leader’s forums, most religious traditions have vibrant women’s groups.women’s groups.women’s groups.women’s groups.women’s groups. In addition to religious activities, faith based women’s groups usually deal with the practical re- alities of women’s lives, of which sexual and reproductive health feature prominently. A good example of th is is the Angl ican Mother’s Union’s Literacy and Development and Family Life Programmes[lxxxiii]. In Cam- bodia, UFPA has already worked with Bud- dhist nuns to facilitate outreach to adoles- cent girls to education them on issues re- lated to sexual and reproductive health, such as traff icking, the commercial sex trade and HIV[lxxxiv]. Listening to the voices of religious women, young and old, will fos- ter a greater understanding what specific re- ligious values really say about gender and how women negotiate these values alongside practical realities. It is important to realize that religious leaders are not always theologians. Theolo-Theolo-Theolo-Theolo-Theolo- gians and theological educatorsgians and theological educatorsgians and theological educatorsgians and theological educatorsgians and theological educators in semi- naries and other religious training institutions help to shape values and practical interpreta- tions and should be considered key agents of change. They have the greatest access to religious texts and authority to interpret them. UNFPA has a lready worked with Egypt ’s Al-Azhar Univers i ty to engage youth and women religious leaders in ad- vocacy programs that advance the MDGs, including co-producing a manual on “Islam and Development’’ [lxxxv]. Work in FGM/C has shown that supporting the creation of safe spaces for internal discussion of reli- gious texts with respected theologians can enable a review of theoretical interpretations and practical application, which promote the wellbeing of young people. In 2008 and then again in 2011 the Grand Imam of Al Azhar University issued declarations stating that FGM/C is not part of Islam[lxxxvi]. Faith based schoolsFaith based schoolsFaith based schoolsFaith based schoolsFaith based schools are also ready made platforms for engaging youth. As is the case with health facilities, there are a range of arrangements with governments across dif- ferent contexts, ranging from fully privatized institutions to those that fully integrated into the national education system. Even in the lat- ter model local faith leaders continue to in- fluence the choice extra-circular activities, and can thus be enablers of blockers of changing attitudes in schools. UNPFA has suc- cessfully partnered with the Russian Ortho- BBBBBOXOXOXOXOX 13 – F 13 – F 13 – F 13 – F 13 – FEMALEEMALEEMALEEMALEEMALE G G G G GENITALENITALENITALENITALENITAL C C C C CUTTINGUTTINGUTTINGUTTINGUTTING ANDANDANDANDAND R R R R RELIGIOUSELIGIOUSELIGIOUSELIGIOUSELIGIOUS TEXTSTEXTSTEXTSTEXTSTEXTS::::: BELIEFS ABOUT FGC ARE AN INTEGRAL PART OF PEOPLE’S CULTURES. THEY HAVE A MEANING AND FULFIL A PURPOSE TO SOME COMMUNITIES, HOWEVER MUCH THEY ARE JUDGED AS HARMFUL AND A VIOLATION OF GIRLS’ AND WOMEN’S RIGHTS. THOSE WORKING ON ENDING FGC NEED TO UNDERSTAND THE DEEP FELT BELIEFS AND SHOW RESPECT FOR THE INTEGRITY OF THE CULTURE, BUILDING POSITIVE MOTIVATION FOR CHANGE WHILE MAINTAINING THE BENEFICIAL ASPECTS OF THEIR CULTURE. IN MANY CONTEXTS, COMMUNITIES STATE THAT THE PRACTICE IS DEMANDED BY THEIR FAITH. 80% OF COMMUNITIES WHICH PRACTICE FGC ARE MUSLIM, YET 80% OF MUSLIMS IN THE WORLD DO NOT PERFORM FGC. SIMILARLY THE PRACTICE CONTINUES IN SOME CHRISTIAN COMMUNITIES. IN MANY INITIATIVES, RELIGIOUS LEADERS AND SCHOLARS HAVE BECOME KEY ADVOCATES, SINCE THERE IS NO REFERENCE TO FGC IN THE QUR’AN OR THE BIBLE. WHO IN THE EASTERN MEDITERRANEAN WORKED WITH ISLAMIC SCHOLARS WHO CLARIFIED THAT FGC IS NOT A RELIGIOUS OBLIGATION, BUT IS RATHER “A CUSTOM THAT CAUSES AN ABSOLUTE INJURY”[LXXXVII]. FOLLOWING THIS RULING, UN AND OTHER AGENCIES HAVE PROVIDED SPACES FOR RELIGIOUS SCHOLARS TO WORK WITH FAITH LEADERS TO ENSURE CLARITY ON THE RELEVANT RELIGIOUS TEXTS. WHEN CONVEYED BACK TO LOCAL COMMUNITIES, THIS MESSAGE HAS A POWERFUL IMPACT ON ATTITUDES AND BELIEFS, ENABLING PEOPLE TO SEE THAT THEIR RELIGIOUS DOES NOT ENDORSE THE MUTILATION OF INFANTS, GIRLS AND WOMEN. THIS IN TURNS HELPS TO CREATE A SAFE ENVIRONMENT FOR COMMUNITY DIALOGUE ON CULTURAL CHANGE. ADAPTED FROM UNICEF (2001) THINGS CHANGE: ENDING FEMALE GENITAL CUTTING – A RESOURCE BOOK FOR WORKING WITH YOUTH AND COMMUNITIES. SARA COMMUNICATION INITIATIVE. UNICEF ESARO. 1 81 81 81 81 8 dox Church to promote human rights and HIV prevention in its schools, including youth friendly serv ices and peer based learning[lxxxviii]. Strategies for schools should apprec iate that fa i th groups cons ider schools as part of their holistic community outreach, and integrate this into their en- gagement with faith. Interfaith networksInterfaith networksInterfaith networksInterfaith networksInterfaith networks are not normally programme implementers themselves, but rather coordinating or dialoguing platforms between groups of implementing bodies. This means each member is l ikely to have a slightly different approach and thus the net- work can provide a space for negotiating change. For the last ten years UNFPA has supported a network of diverse faith-based organizations in Ghana to bring reproduc- tive health education and services to local communities and to address the needs of young people. Implementation strategies differ between members of the network, depending on what each respective doc- trine allow; some organizations are provid- ing condoms, undertaking counselling, and referring clients to health centres. Others are assisting in income-generating activities. If problems arise that are specifically related to another religious tradition, the project co- ordinator or focal point consults with or re- fers them to another organization in the net- work. Each organization is a source of guid- ance and support for the others on culturally sensitive issues ranging from family life to the prevention of HIV/AIDS and teenage preg- nancy. In this way, diverse religious institu- tions have been brought together to interact, plan and discuss issues of mutual concern[lxxxix]. Establishing partnership with umbrella networks also provides cover for those testing internal change. Local faith based development or-Local faith based development or-Local faith based development or-Local faith based development or-Local faith based development or- ganizationsganizationsganizationsganizationsganizations are more likely to be partners of the UN and other INGOS as they are more at- tuned to the secular development frame- work. Where these organizations are also deeply embedded in local faith communi- ties they can also be interlocutors, helping the UN to understand the wider contribu- tion and footprint of particular faith groups and to translate religious concepts into hu- man rights language. In Brazil, UNFPA was able to sensitize local Catholic communities on sexual and reproductive health issues through a local Catholic FBO[xc]. However if they are authentic agents of change working within religious traditions, there is always the risk that faith leaders may resist the pace of change and attempt to limit or prohibit their activities. Where this occurs external agents should withdraw to allow space for internal dialogue and be ready to re-engage if as appropriate. IIIIInternational faith based organisationnternational faith based organisationnternational faith based organisationnternational faith based organisationnternational faith based organisationsssss have a role to play in mapping the impact and best practice of local faith actors listed above across regions and communicating this at a international policy and standard setting level. They also have a role in building the capacity of local faith actors in project cycle manage- ment. UNFPA is currently collaborating with over 15 IFBOs on the Joint Learning Initia- t ive into Faith and Local Communit ies , which is gathering evidence on the impact of local faith communities in achieving de- ve lopment and humanitar ian goals[xci]. Strengthening engagement with FBOs as a glo- bal level is also crucial in order to impact policy and encourage country level partner- ships by internationally sharing examples of good practice with FBOs. IFBOs can carry a positive voice from national FBOs on their commitment to and track record of support- ing the sexual and reproductive health of young people into global standard setting fora like ICPD and CSW. Faith based organisations are complex, dynamic and multidimensional, comprised of collections of individuals negotiating their faith values alongside a range of other values and practical realities. Each context is different, so it is important for UN staff to de- velop the local relationships and basic under- standing of religious structures that will ex- pose them to key agents of change within faith based organizations. It is also important not attempt to instrumentalize FBOs with regards to sexual and reproductive health messages, but rather to recognize the impact and legiti- macy of faith based actors and faith values within theories of behavior change and seek to engage and listen to them as equal part- ners. A deeper understanding of structures, values and track-record of provision of the range of FBOs will help UN staff to discern effective strategies for catalyzing change, and opportunities for transforming turning obstacles into advantages. 1 91 91 91 91 9 BOX 14 - SBOX 14 - SBOX 14 - SBOX 14 - SBOX 14 - STRENGTHENINGTRENGTHENINGTRENGTHENINGTRENGTHENINGTRENGTHENING SRH SRH SRH SRH SRH PROGRAMMESPROGRAMMESPROGRAMMESPROGRAMMESPROGRAMMES THROUGHTHROUGHTHROUGHTHROUGHTHROUGH COMPLEMENTARYCOMPLEMENTARYCOMPLEMENTARYCOMPLEMENTARYCOMPLEMENTARY PARTNERSHIPSPARTNERSHIPSPARTNERSHIPSPARTNERSHIPSPARTNERSHIPS WITHWITHWITHWITHWITH FBO FBO FBO FBO FBOSSSSS SSSSST R A T E G I E ST R A T E G I E ST R A T E G I E ST R A T E G I E ST R A T E G I E S MAPPING OF EXISTING FBOS PARTNERSHIPS ON SRH WITHIN UN AND SRH SECTOR NEW RESEARCH INTO RANGE OF ACTIVITIES WHERE FBOS IMPACT SRH ENGAGE A WIDER RANGE OF FBO STAKE- HOLDERS, INCLUDING YOUTH WORKERS, RE- LIGIOUS YOUTH, WOMEN’S GROUPS, ETC MUTUAL AND TRANSPARENT COUNTRY LEVEL DIALOGUE BETWEEN UN PROGRAMME STAFF AND FAITH LEADERS (THERE IS NO NEUTRAL SPACE) USE THE CULTURAL LENS AND OTHER UN GUIDELINES FOR ENGAGING WITH FBOS ALLOW SPACE AND TIME FOR JOINT PROGRAMME DESIGN – BE FLEXIBLE AND PRAGMATIC FAITH LITERACY (FAITHS NOT STATIC) UN LITERACY (HUMAN RIGHTS FRAME- WORK) ENGAGE IN JOINT ACTION LISTEN TO AND SUPPORT CHANGE AGENTS WHO HAVE RESPECT WITHIN THEIR FAITH COMMUNITIES SUPPORT PROCESSES TO ENGAGE WITH THEOLOGICAL TEXTS IN CONSIDERATION OF SEXUAL AND REPRODUCTIVE HEALTH ISSUES ENGAGE RELIGIOUS WOMEN AND YOUTH IN COLLABORATION WITH RELIGIOUS MEN PPPPPARTNERSHIPARTNERSHIPARTNERSHIPARTNERSHIPARTNERSHIP O O O O OUTCOMESUTCOMESUTCOMESUTCOMESUTCOMES FBO / UN JOINT PROGRAMMES FOR SEXUAL AND REPRODUCTIVE HEALTH OF ADOLESCENTS AND YOUTH FBO ACCEPTANCE OF UN PROGRAMMES ON SEXUAL AND REPRODUCTIVE HEALTH FOR ADOLESCENTS AND YOUTH (NOT AD- VOCATING AGAINST THEM) BEHAVIOR CHANGE AROUND NEGATIVE SEXUAL AND REPRODUCTIVE HEALTH PRACTICES AAAAANTECEDENTSNTECEDENTSNTECEDENTSNTECEDENTSNTECEDENTS OFOFOFOFOF CHANGECHANGECHANGECHANGECHANGE IDENTIFY GOOD PRACTICE INCREASE AWARENESS OF HOLISTIC ENGAGEMENT OF FBOS WITH YOUTH UNDERSTAND THE RANGE OF PROTEC- TIVE FACTORS PROVIDED BY FBOS, AS RELATED TO CULTURAL DETERMI- NANTS OF SRH FOSTER AUTHENTIC PARTNERSHIPS – NOT TRANSACTIONAL OR INSTRUMEN- TAL, BUT BASED ON TRUST AND COMPLEMENTARITY ESTABLISH SHARED GROUND AND GOALS DISPEL STEREOTYPES AND UNPACK PER- CEIVED AGENDAS SUPPORT INTERNAL LEVERS OF CHANGE INTEGRATE FBOS AND SPIRITUALITY INTO THEORIES OF CHANGE 2020202020 SUGGESTED WAYS FORWARD  Engage with faith leaders, theologians and faith networks at a national and local level in transparent and mutual dialogue (utilizing the UNFPA Cultural lens and other guidelines for working with FBOs) to build mutual literacy and establish common ground around sexual and reproductive health goals for adolescents and youth.  Conduct country level informal map- ping of FBOs work with adolescents and youth, including identifying key agents of change, through established UNFPA multi- faith networks, as well as local and interna- tional FBO interlocutors.  Utilize existing country level consulta- tions for the UNFPA Adolescent and Youth Platform for Action, to engage key faith based stakeholders from across the differ- ent sectors related to youth, such as health, education, livelihoods, and values develop- ment. Integrate their insights and assets into programme design.  Strengthen existing networks by pro- viding technical support and financial as- sistance to local youth-serving FBOs, such as religious youth groups, women’s groups, faith leader networks, after-school clubs, and outreach programmes to marginalized groups, to empower them to contribute to the UNFPA Adolescent and Youth Platform for Action.  Invest and participate in multi agency cross sector research initiatives looking at the impact of local faith actors on sexual and re- productive health (for example the Joint Learn- ing Initiative on Local Faith Communities). [I] UN CONVENTION OF THE RIGHTS OF THE CHILD, ARTICLE 14. [II] UNICEF (2012) ‘PARTNERING WITH RELIGIOUS COMMUNITIES FOR CHILDREN’, UNICEF NEW YORK, P. 7. [III] THERE ARE SOME STUDIES FROM THE UN INCLUDING WORLD HEALTH ORGANISATION (2007) ‘APPRECIATING ASSETS: MAPPING, UNDERSTANDING, TRANSLATING AND ENGAGING RELIGIOUS HEALTH ASSETS IN ZAMBIA AND LESOTHO’, WHO GENEVA, HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.WHOWHOWHOWHOWHO. INTINTINTINTINT/////MEDIACENTREMEDIACENTREMEDIACENTREMEDIACENTREMEDIACENTRE/////NEWSNEWSNEWSNEWSNEWS/////NOTESNOTESNOTESNOTESNOTES/2007//2007//2007//2007//2007/NPNPNPNPNP05/05/05/05/05/ENENENENEN/////INDEXINDEXINDEXINDEXINDEX.HTMLHTMLHTMLHTMLHTML PLUS SOME A NUMBER OF DOCUMENTS FROM THE BERKLEY CENTRE FOR RELIGION, PEACE AND WORLD AFFAIRS AT GEORGETOWN UNI- VERSITY, WASHINGTON HTTPHTTPHTTPHTTPHTTP://://://://://BERKLEYCENTERBERKLEYCENTERBERKLEYCENTERBERKLEYCENTERBERKLEYCENTER.GEORGETOWNGEORGETOWNGEORGETOWNGEORGETOWNGEORGETOWN.EDUEDUEDUEDUEDU///// AND INTERNATIONAL RELIGIOUS HEALTH AS- SETS PROGRAMME AT CAPE TOWN UNIVERSITY SOUTH AFRICA HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.ARHAPARHAPARHAPARHAPARHAP.UCTUCTUCTUCTUCT.ACACACACAC.ZAZAZAZAZA///// ACCESSED JUNE 27TH 2012 [IV] UNFPA (2010) ‘GUIDELINES FOR WORKING WITH FBOS’ UNFPA NEW YORK, UNAIDS (2011) ‘STRATEGIC FRAME- WORK FOR PARTNERING WITH FBOS’ UNAIDS GENEVA, UNICEF (2012) ‘PARTNERING WITH RELIGIOUS COMMUNITIES FOR CHILDREN’ UNICEF NEW YORK. [V] UK DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (2012) ‘FAITH PARTNERSHIP PRINCIPLES’ DFID, LONDON. [VI] KARAM, A (2008) ‘CULTURE MATTERS – LESSONS FROM A LEGACY OF ENGAGING WITH FAITH BASED ORGANIZATIONS’ UNFPA, NEW YORK. [VII] RAKODI, C (EDS) (2010, RELIGIONS AND DEVELOPMENT RESEARCH PROGRAMME RAKODI, BIRMINGHAM UNIVERSITY, BIRMINGHAM HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.RELIGIONSANDDEVELOPMENTRELIGIONSANDDEVELOPMENTRELIGIONSANDDEVELOPMENTRELIGIONSANDDEVELOPMENTRELIGIONSANDDEVELOPMENT.ORGORGORGORGORG/////INDEXINDEXINDEXINDEXINDEX.PHPPHPPHPPHPPHP?????SECTIONSECTIONSECTIONSECTIONSECTION=1=1=1=1=1 ACCESSED JUNE 15TH 2012. [VIII] THE BERKLEY CENTRE FOR RELIGION, PEACE AND WORLD AFFAIRS AT GEORGETOWN UNIVERSITY, WASHINGTON HTTPHTTPHTTPHTTPHTTP:/:/:/:/:/ /////BERKLEYCENTERBERKLEYCENTERBERKLEYCENTERBERKLEYCENTERBERKLEYCENTER.GEORGETOWNGEORGETOWNGEORGETOWNGEORGETOWNGEORGETOWN.EDUEDUEDUEDUEDU///// ACCESSED JUNE 27TH 2012. [IX] INTERNATIONAL RELIGIOUS HEALTH ASSETS PROGRAMME AT CAPE TOWN UNIVERSITY SOUTH AFRICA HTTPHTTPHTTPHTTPHTTP://://://://:// WWWWWWWWWWWWWWW.ARHAPARHAPARHAPARHAPARHAP.UCTUCTUCTUCTUCT.ACACACACAC.ZAZAZAZAZA///// ACCESSED JUNE 27TH 2012. [X] VAN SELM, J & KOSER, K (EDS) ‘ SPECIAL ISSUE: FAITH BASED HUMANITARIANISM IN CONTEXTS OF FORCED DISPLACE- MENT’, JOURNAL FOR REFUGEE STUDIES VOL. 24, NO. 3, SEPTEMBER 2011 [XI] JOINT LEARNING INIT IATIVE ON LOCAL FAITH COMMUNIT IES H T T PH T T PH T T PH T T PH T T P ://://://://://WWWWWWWWWWWWWWW. J L I F L CJ L I F L CJ L I F L CJ L I F L CJ L I F L C . C O MC O MC O MC O MC O M/////E NE NE NE NE N///// LOCALLOCALLOCALLOCALLOCAL_____FAITHFAITHFAITHFAITHFAITH_____COMMUNITIESCOMMUNITIESCOMMUNITIESCOMMUNITIESCOMMUNITIES///// ACCESSED JULY 17TH 2012. [XII] UN CONVENTION OF THE RIGHTS OF THE CHILD, ARTICLE 4. 2 12 12 12 12 1 [XIII] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 7. [XIV] UNICEF (2012) ‘PARTNERING WITH RELIGIOUS COMMUNITIES FOR CHILDREN’ UNICEF NEW YORK – SEE REACHING THE MOST VULNERABLE, P.10, NON VIOLENCE, P.19 EDUCATION, P.23, GENDER EQUALITY, P.43. [XV] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 9. [XVI] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 30. [XVII] UN CONVENTION OF THE RIGHTS OF THE CHILD, ARTICLE 19 [XVIII] ICPD +5 PARAGRAPH 73.C [XIX] ‘INTERFAITH DECLARATION TO IMPROVE FAMILY HEALTH AND WELL-BEING’, GLOBAL INTERFAITH CONFERENCE, NAIROBI 29 JUNE 2011 HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.DSWDSWDSWDSWDSW-----ONLINEONLINEONLINEONLINEONLINE.ORGORGORGORGORG/////INTERFAITHINTERFAITHINTERFAITHINTERFAITHINTERFAITH ACCESSED JULY 31ST 2012. [XX] BAKAN, D. (1972) ADOLESCENCE IN AMERICA: FROM IDEA TO SOCIAL FACT. IN J. KAGAN AND R. COLES TWELVE TO SIXTEEN: EARLY ADOLESCENCE. NEW YORK: NORTON. [XXI] ICPD+5, PARAGRAPH 73.A. [XXII] ICPD+5, PARAGRAPH 5. [XXIII] UN CONVENTION OF THE RIGHTS OF THE CHILD, ARTICLE 5. [XXIV] UN CONVENTION OF THE RIGHTS OF THE CHILD, ARTICLE 5 AND ICPD +5 PARAGRAPH 75.E. [XXV] UNFPA (2012) ‘REMARKS ON DELIBERATIONS FROM INTERNATIONAL PARLIAMENTARIANS' CONFERENCE ON THE IMPLE- MENTATION OF THE ICPD PROGRAMME OF ACTION’ ISTANBUL MAY 24 – 25TH 2012. [XXVI] UK DEPARTMENT FOR INTERNATIONAL DEVELOPMENT (2012) SECTION 3 AGREEING TO DISAGREE IN ‘FAITH PARTNERSHIP PRINCIPLES’ DFID, LONDON. [XXVII] KARAM, A (2009) ‘INTEGRATING HUMAN RIGHTS, CULTURE AND GENDER IN PROGRAMMING – PARTICIPANTS TRAINING MANUAL’, UNFPA NEW YORK. [XXVIII] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 10. [XXIX] UNFPA, (2011), ‘SEXUAL AND REPRODUCTIVE HEALTH FRAMEWORK’, UNFPA NEW YORK, P.4. [XXX] INTERNATIONAL CONFERENCE ON POPULATION AND DEVELOPMENT, ARTICLE 7.41 [XXXI] UNAIDS (2011), ‘SECURING OUR FUTURE’, UNAIDS, GENEVA, P. 32. [XXXII] WORLD HEALTH ORGANISATION ( ) ‘SOCIAL DETERMINANTS OF HEALTH’, P.83 [XXXIII] WORLD HEALTH ORGANISATION ( ) ‘SOCIAL DETERMINANTS OF HEALTH’, P.83 [XXXIV] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 9. [XXXV] REINIKKA, R & SVENSSON, J (2008) ‘WORKING FOR GOD? EVIDENCE FROM A CHANGE IN FINANCING OF NOT-FOR-PROFIT HEALTH CARE PROVIDERS IN UGANDA’, P.13 HTTPHTTPHTTPHTTPHTTP://://://://://SITERESOURCESSITERESOURCESSITERESOURCESSITERESOURCESSITERESOURCES.WORLDBANKWORLDBANKWORLDBANKWORLDBANKWORLDBANK.ORGORGORGORGORG/EXTDEVDIALOGUE//EXTDEVDIALOGUE//EXTDEVDIALOGUE//EXTDEVDIALOGUE//EXTDEVDIALOGUE/ RRRRRESOURCESESOURCESESOURCESESOURCESESOURCES/W/W/W/W/WFFFFFG-NG-NG-NG-NG-NOVOVOVOVOV-9-2008.-9-2008.-9-2008.-9-2008.-9-2008.PDFPDFPDFPDFPDF ACCESSED JUNE 30TH 2012. [XXXVI] BARRERA-OSORIO, F, ANTHONY PATRINOS, H, & WODON, Q (ED.S) (2009) ‘EMERGING EVIDENCE ON VOUCHERS AND FAITH-BASED PROVIDERS IN EDUCATION - CASE STUDIES FROM AFRICA, LATIN AMERICA, AND ASIA’, WORLD BANK WASHINGTON DC. WORLD HEALTH ORGANISATION (2007) ‘APPRECIATING ASSETS: MAPPING, UNDERSTANDING, TRANS- LATING AND ENGAGING RELIGIOUS HEALTH ASSETS IN ZAMBIA AND LESOTHO’, WHO GENEVA, HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.WHOWHOWHOWHOWHO.INTINTINTINTINT///// MEDIACENTREMEDIACENTREMEDIACENTREMEDIACENTREMEDIACENTRE/////NEWSNEWSNEWSNEWSNEWS/////NOTESNOTESNOTESNOTESNOTES/2007//2007//2007//2007//2007/NPNPNPNPNP05/05/05/05/05/ENENENENEN/////INDEXINDEXINDEXINDEXINDEX.HTMLHTMLHTMLHTMLHTML ACCESSED 27TH JUNE 2012. [XXXVII] WORLD HEALTH ORGANISATION (2007) ‘APPRECIATING ASSETS: MAPPING, UNDERSTANDING, TRANSLATING AND ENGAG- ING RELIGIOUS HEALTH ASSETS IN ZAMBIA AND LESOTHO’, WHO GENEVA, HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.WHOWHOWHOWHOWHO.INTINTINTINTINT/////MEDIACENTREMEDIACENTREMEDIACENTREMEDIACENTREMEDIACENTRE///// NEWSNEWSNEWSNEWSNEWS/////NOTESNOTESNOTESNOTESNOTES/2007//2007//2007//2007//2007/NPNPNPNPNP05/05/05/05/05/ENENENENEN/////INDEXINDEXINDEXINDEXINDEX.HTMLHTMLHTMLHTMLHTML ACCESSED 27TH JUNE 2012. [XXXVIII] THE ANGLICAN COMMUNION PUBLICALLY STATED ITS SUPPORT FOR CONTRACEPTION WITHIN MARRIAGE AT THE 1930 LAMBETH CONFERENCE H T T PH T T PH T T PH T T PH T T P ://://://://://WWWWWWWWWWWWWWW . B B CB B CB B CB B CB B C .COCOCOCOCO .U KU KU KU KU K/////R E L I G I O NR E L I G I O NR E L I G I O NR E L I G I O NR E L I G I O N/////R E L I G I O N SR E L I G I O N SR E L I G I O N SR E L I G I O N SR E L I G I O N S /////C H R I S T I A N I T YC H R I S T I A N I T YC H R I S T I A N I T YC H R I S T I A N I T YC H R I S T I A N I T Y/////C H R I S T I A N E T H I C SC H R I S T I A N E T H I C SC H R I S T I A N E T H I C SC H R I S T I A N E T H I C SC H R I S T I A N E T H I C S///// CONTRACEPTIONCONTRACEPTIONCONTRACEPTIONCONTRACEPTIONCONTRACEPTION_1._1._1._1._1.SHTMLSHTMLSHTMLSHTMLSHTML ACCESSED JULY 30TH 2012. 2 22 22 22 22 2 [XXXIX] INTERFAITH DECLARATION TO IMPROVE FAMILY HEATH AND WELL-BEING – NAIROBI (2011) HTTPHTTPHTTPHTTPHTTP://://://://:// WWWWWWWWWWWWWWW.WILSONCENTERWILSONCENTERWILSONCENTERWILSONCENTERWILSONCENTER.ORGORGORGORGORG/////SITESSITESSITESSITESSITES/////DEFAULTDEFAULTDEFAULTDEFAULTDEFAULT/////FILESFILESFILESFILESFILES/I/I/I/I/INTERFAITHNTERFAITHNTERFAITHNTERFAITHNTERFAITH%20D%20D%20D%20D%20DECLARATIONECLARATIONECLARATIONECLARATIONECLARATION%20%20%20%20%20ONONONONON%20F%20F%20F%20F%20FAMILYAMILYAMILYAMILYAMILY%20%20%20%20%20 PPPPPLANNINGLANNINGLANNINGLANNINGLANNING%20J%20J%20J%20J%20JUNEUNEUNEUNEUNE%202011.%202011.%202011.%202011.%202011.PDFPDFPDFPDFPDF ACCESSED JULY 15TH 2012. [XL] WORLD HEALTH ORGANISATION DEFINITION OF HEALTH HTTPSHTTPSHTTPSHTTPSHTTPS://://://://://APPSAPPSAPPSAPPSAPPS.WHOWHOWHOWHOWHO.INTINTINTINTINT/////ABOUTWHOABOUTWHOABOUTWHOABOUTWHOABOUTWHO/////ENENENENEN/////DEFINITIONDEFINITIONDEFINITIONDEFINITIONDEFINITION.HTMLHTMLHTMLHTMLHTML ACCESSED JUNE 15TH 2012. [XLI] PATHFINDERS INTERNATIONAL (2005) ‘BUILDING PARTNERSHIP WITH FAITH-BASED ORGANISATION: INTEGRATING YOUTH FRIENDLY SERVICES INTO THE HEALTH DELIVERY SYSTEM OF THE GHANA CHRISTIAN HEALTH ASSOCIATION OF GHANA’ PATHFINDER INTERNATIONAL USA. [XLII] WORLD HEALTH ORGANISATION ( ) ‘SOCIAL DETERMINANTS OF HEALTH’. [XLIII] A GOOD EXAMPLE OF CHRISTIAN TEACHING ON SEXUAL AND REPRODUCTIVE HEALTH IS - SCHUELLER, J (2006) ‘FAMILY LIFE EDUCATION: TEACHING YOUTH ABOUT REPRODUCTIVE HEALTH AND HIV/AIDS FROM A CHRISTIAN PERSPECTIVE’, (FAMILY HEALTH INTENTIONAL) AND RESOURCES FROM TEARFUND. [XLIV] WHO/UNICEF (1999) ‘MEASUREMENT OF ADOLESCENT DEVELOPMENT: ENVIRONMENT, CONTEXTUAL AND PROTECTIVE FACTORS’ (REPORT OF A TECHNICAL CONSULTATION – WASHINGTON) P. 16. [XLV] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 10. [XLVI] FURBEY, R, DINHAM, A, FARNELL, R, FINNERON, D & WILKINSON, G ‘FAITH AS SOCIAL CAPITAL- CONNECTING OR DIVIDING?’ (JOSEPH ROWNTREE, 2006, BRISTOL), P.5. [XLVII] MASH, R & MASH, JM ‘ A QUASI-EXPERIMENTAL EVALUATION OF AN HIV PREVENTION PROGRAMME BY PEER EDUCATION IN THE ANGLICAN CHURCH OF WESTERN CAPE’ BMJ OPEN 2012 (2). [XLVIII] THERON, LC & THERON, AMC, ‘A CRITICAL REVIEW OF STUDIES INTO SOUTH AFRICAN YOUTH RESILIENCE, 1990- 2008’, IN SOUTH AFRICA JOURNAL OF SCIENCE, VOL. 106, NO 7/8 (2010), P. 255. [XLIX] WHO (2007) ‘ HELPING PARENTS IN DEVELOPING COUNTRIES IMPROVE ADOLESCENTS’ HEALTH’, WHO GENEVA, P. 8. [L] NYABERA, F & MONTGOMERY, T ‘TAMAR CAMPAIGN CONTEXTUAL BIBLE STUDY MANUAL ‘ (FECCLAHA, 2007, KENYA) H T T PH T T PH T T PH T T PH T T P ://://://://://W W WW W WW W WW W WW W W . F E C C L A H AF E C C L A H AF E C C L A H AF E C C L A H AF E C C L A H A . O R GO R GO R GO R GO R G ///// U P L O A D SU P L O A D SU P L O A D SU P L O A D SU P L O A D S /T/T/T/T/TA M A RA M A RA M A RA M A RA M A R %20C%20C%20C%20C%20C A M P A I G NA M P A I G NA M P A I G NA M P A I G NA M P A I G N %20/T%20/T%20/T%20/T%20/T A M A RA M A RA M A RA M A RA M A R %20C%20C%20C%20C%20C A M P A I G NA M P A I G NA M P A I G NA M P A I G NA M P A I G N %20%20%20%20%20 CCCCCONTEXTUALONTEXTUALONTEXTUALONTEXTUALONTEXTUAL%20B%20B%20B%20B%20BIBLEIBLEIBLEIBLEIBLE%20S%20S%20S%20S%20STUDYTUDYTUDYTUDYTUDY%20M%20M%20M%20M%20MANUALANUALANUALANUALANUAL%20-%20E%20-%20E%20-%20E%20-%20E%20-%20ENGLISHNGLISHNGLISHNGLISHNGLISH%%%%%20V20V20V20V20VERSIONERSIONERSIONERSIONERSION.PDFPDFPDFPDFPDF ACCESSED JULY 12TH 2012. [LI] WORLD COUNCIL OF CHURCHES (2011) ‘CREATED IN GOD’S IMAGE -FROM HEGEMONY TO PARTNERSHIP’, WCC, GENEVA. [LII] UNFPA, PATHFINDERS INTERNATIONAL, SAVE THE CHILDREN, ADVOCATES FOR YOUTH, CARE ‘ (2007) ‘COMMUNITY PATHWAYS TO IMPROVED ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH’, P. 5. [LIII] THE GALLUP WORLD SURVEY WAS CONDUCTED IN 2006, 2007 AND 2008, ASKING REPRESENTATIVE SAMPLES ACROSS 143 COUNTRIES WHETHER RELIGION WAS AN IMPORTANT PART OF THEIR LIVES. ACCORDING TO THIS SURVEY, THE MEDIAN PROPORTION OF RESPONDENTS, ACROSS COUNTRIES - WHO SAID THAT RELIGION IS IMPORTANT IN THEIR EVERYDAY LIVES WAS 82%. THE MAIN FINDINGS ARE SUMMARISED HERE HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.GALLUPGALLUPGALLUPGALLUPGALLUP.COMCOMCOMCOMCOM/////POLLPOLLPOLLPOLLPOLL/114211//114211//114211//114211//114211/ALABAMIANSALABAMIANSALABAMIANSALABAMIANSALABAMIANS----- IRANIANSIRANIANSIRANIANSIRANIANSIRANIANS-----COMMONCOMMONCOMMONCOMMONCOMMON.ASPXASPXASPXASPXASPX [LIV] KING, P. E & ROESER, R. W, (2009) ‘RELIGION AND SPIRITUALITY IN ADOLESCENT DEVELOPMENT’, IN HANDBOOK OF ADOLES- CENT PSYCHOLOGY, P. 443. HTTPHTTPHTTPHTTPHTTP://://://://://ROBERTROESERROBERTROESERROBERTROESERROBERTROESERROBERTROESER.COMCOMCOMCOMCOM/////DOCSDOCSDOCSDOCSDOCS/////PUBLICATIONSPUBLICATIONSPUBLICATIONSPUBLICATIONSPUBLICATIONS/2009_K/2009_K/2009_K/2009_K/2009_KINGINGINGINGINGRRRRROESEROESEROESEROESEROESER_S_S_S_S_SPIRITUALITYPIRITUALITYPIRITUALITYPIRITUALITYPIRITUALITY.PDFPDFPDFPDFPDF ACCESSED JUNE 1ST 2012. [LV] KING, P. E & ROESER, R. W, (2009) ‘RELIGION AND SPIRITUALITY IN ADOLESCENT DEVELOPMENT’, IN HANDBOOK OF ADOLESCENT PSYCHOLOGY, P. 449. HTTPHTTPHTTPHTTPHTTP://://://://://ROBERTROESERROBERTROESERROBERTROESERROBERTROESERROBERTROESER.COMCOMCOMCOMCOM/////DOCSDOCSDOCSDOCSDOCS/////PUBLICATIONSPUBLICATIONSPUBLICATIONSPUBLICATIONSPUBLICATIONS/2009_K/2009_K/2009_K/2009_K/2009_KINGINGINGINGINGRRRRROESEROESEROESEROESEROESER_____ SSSSSPIRITUALITYPIRITUALITYPIRITUALITYPIRITUALITYPIRITUALITY.PDFPDFPDFPDFPDF ACCESSED JUNE 1ST 2012. [LVI] WHO (2001) ‘BROADENING THE HORIZON: BALANCING PROTECTION AND RISK FOR ADOLESCENTS.’ CAH, SWITZERLAND. [LVII] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 12- 13. [LVIII] HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.ZIMBABWESCMZIMBABWESCMZIMBABWESCMZIMBABWESCMZIMBABWESCM.COCOCOCOCO.ZWZWZWZWZW///// ACCESSED 12TH SEPTEMBER 2012. [LIX] HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.WSCFGLOBALWSCFGLOBALWSCFGLOBALWSCFGLOBALWSCFGLOBAL.ORGORGORGORGORG///// ACCESSED 12TH SEPTEMBER 2012. [LX] ANGLICAN CHURCH IN BURUNDI HOLDS ENVIRONMENT AND HIV AFTER-SCHOOL CLUBS THROUGH ITS CHURCH RUN COMMU- NITY SCHOOLS SEE EGLISE DU ANGLICAN DE BURUNDI PRESS JUNE 2010. [LXI] UN CONVENTION ON THE RIGHTS OF THE CHILD, ARTICLE 4 2 32 32 32 32 3 [LXII] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 12. [LXIII] WORLD COUNCIL OF CHURCHES (2010) ‘FROM HEGEMONY TO PARTNERSHIP’ WCC, GENEVA. [LXIV] WORLD HEALTH ORGANISATION ( ) ‘SOCIAL DETERMINANTS OF HEALTH’, P.127. [LXV] THERON, LC & THERON, AMC, ‘A CRITICAL REVIEW OF STUDIES INTO SOUTH AFRICAN YOUTH RESILIENCE, 1990- 2008’, IN SOUTH AFRICA JOURNAL OF SCIENCE, VOL. 106, NO 7/8 (2010), P. 255. [LXVI] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 10. [LXVII] FOR SOME EXAMPLES SEE; ANGLICAN BOARD OF MISSION MAINSTREAMS CHILD PROTECTION TRAINING THROUGHOUT ITS PROGRAMMES. SEE ALSO WORLD COUNCIL OF CHURCHES RESOURCE ‘WHEN PASTORS PREY’ (DUE TO BE PUBLISHED- GENEVA - OCTOBER 2012). [LXVIII] FOR A FULLER DECONSTRUCTION OF THE POSITIVE AND NEGATIVE WAYS OF APPLYING SOCIAL CAPITAL SEE FURBEY, R, DINHAM, A, FARNELL, R, FINNERON, D & WILKINSON, G ‘FAITH AS SOCIAL CAPITAL- CONNECTING OR DIVIDING?’ (JOSEPH ROWNTREE, 2006, BRISTOL), P.6 - 11 [LXIX] UNICEF ‘A BUDDHIST APPROACH TO HIV PREVENTION AND AIDS CARE – A TRAINING MANUAL FOR MONKS, NUNS AND OTHER BUDDHIST LEADERS’ (BANGKOK, 2006), P.24. [LXX] INERELA WWWWWWWWWWWWWWW.INERELAINERELAINERELAINERELAINERELA.ORGORGORGORGORG ACCESSED 31ST JULY 2012 [LXXI] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 9. [LXXII] UNFPA, PATHFINDERS INTERNATIONAL, SAVE THE CHILDREN, ADVOCATES FOR YOUTH, CARE ‘ (2007) ‘COMMUNITY PATHWAYS TO IMPROVED ADOLESCENT SEXUAL AND REPRODUCTIVE HEALTH’, P. 5. [LXXIII] HAGLUND, K.A & FEHRING, R.J, (2009) ‘THE ASSOCIATION OF RELIGIOSITY, SEXUAL EDUCATION, AND PARENTAL FACTORS WITH RISKY SEXUAL BEHAVIOURS AMONG ADOLESCENTS AND YOUNG ADULTS’, IN JOURNAL OF RELIGION AND HEALTH 6/1. [LXXIV] UNFPA (2010) ‘GUIDELINES FOR WORKING WITH FBOS’, UNFPA, NEW YORK, UNICEF (2011) ‘PARTNERING WITH RELIGIOUS COMMUNITIES FOR CHILDREN’, UNICEF, NEW YORK, UNAIDS (2011) ‘STRATEGIC FRAMEWORK FOR ENGAG- ING WITH FAITH BASED ORGANISATIONS’, UNAIDS, GENEVA, DFID (2012) ‘FAITH PARTNERSHIP PRINCIPLES’ DFID, LONDON. [LXXV] A FULL LIST OF BARRIERS CAN BE FOUND IN UNICEF (2011) ‘PARTNERING WITH RELIGIOUS COMMUNITIES FOR CHILDREN’ P. 56. [LXXVI] TRANSPARENCY AND MUTUAL RESPECT ARE TWO OF THE THREE CORE PRINCIPLES OF DFID (2012) ‘FAITH PARTNERSHIP PRINCIPLES, DIFD LONDON. [LXXVII] UNICEF OUTLINES KEY VALUES, KNOWLEDGE AND SKILLS FOR UN STAFF TO BE AWARE OF IN (2011) ‘PARTNERING WITH RELIGIOUS COMMUNITIES FOR CHILDREN,’ P. 62. [LXXVIII] UNFPA (2010) ‘GUIDELINES FOR WORKING WITH FBOS’, UNFPA NEW YORK. [LXXIX] UNFPA (2012) ‘A GLOBAL CALL FOR ACTION: UNFPA ADOLESCENT AND YOUTH STRATEGY – MAKING THEIR WAY’, UNFPA, NEW YORK, P. 8. [LXXX] UNICEF AND UNAIDS BOTH PROVIDE LIST OF DIFFERENT TYPES OF FAITH BASED ACTORS IN THEIR PARTNERSHIP DOCUMENTS. [LXXXI] UNFPA (2012) ‘UNFPA’S INTER-RELIGIOUS AND INTERCULTURAL WORK 2011- 2012’ P. 4 – 5 HTTPHTTPHTTPHTTPHTTP://://://://:// WWWWWWWWWWWWWWW.UNFPAUNFPAUNFPAUNFPAUNFPA.ORGORGORGORGORG/////CULTURECULTURECULTURECULTURECULTURE/////CASECASECASECASECASE_____STUDIESSTUDIESSTUDIESSTUDIESSTUDIES/////CAMBODIACAMBODIACAMBODIACAMBODIACAMBODIA.HTMHTMHTMHTMHTM ACCESSED 17TH SEPTEMBER 2012. [LXXXII] UNFPA (2011) ‘2011 SNAPSHOTS OF UNFPA’S WORK WITH FAITH BASED ORGANISATIONS AS CULTURAL AGENTS OF CHANGE’, P. 9 CULTURAL LENS P9 HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.UNFPAUNFPAUNFPAUNFPAUNFPA.ORGORGORGORGORG/////CULTURECULTURECULTURECULTURECULTURE/////DOCSDOCSDOCSDOCSDOCS/////CULTURECULTURECULTURECULTURECULTURE_____SNAPSHOTSSNAPSHOTSSNAPSHOTSSNAPSHOTSSNAPSHOTS.PDFPDFPDFPDFPDF ACCESSED 17TH SEPTEMBER 2012. [LXXXIII] MOTHERS’ UNION FAMILY LIFE PROGRAMME HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.THEMOTHERSUNIONTHEMOTHERSUNIONTHEMOTHERSUNIONTHEMOTHERSUNIONTHEMOTHERSUNION.ORGORGORGORGORG/////FAMILYFAMILYFAMILYFAMILYFAMILY_____LIFELIFELIFELIFELIFE_____PROGRAMMEPROGRAMMEPROGRAMMEPROGRAMMEPROGRAMME.ASPXASPXASPXASPXASPX ACCESSED 17TH SEPTEMBER 2012. [LXXXIV] UNFPA (2012) ‘UNFPA’S INTER-RELIGIOUS AND INTERCULTURAL WORK 2011- 2012’, P. HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.UNFPAUNFPAUNFPAUNFPAUNFPA.ORGORGORGORGORG///// CULTURECULTURECULTURECULTURECULTURE/////CASECASECASECASECASE_____STUDIESSTUDIESSTUDIESSTUDIESSTUDIES/////CAMBODIACAMBODIACAMBODIACAMBODIACAMBODIA.HTMHTMHTMHTMHTM ACCESSED 17TH SEPTEMBER 2012. 2 42 42 42 42 4 [LXXXV] UNFPA (2012) ‘UNFPA’S INTER-RELIGIOUS AND INTERCULTURAL WORK 2011- 2012’ P.2 HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.UNFPAUNFPAUNFPAUNFPAUNFPA.ORGORGORGORGORG///// CULTURECULTURECULTURECULTURECULTURE/////CASECASECASECASECASE_____STUDIESSTUDIESSTUDIESSTUDIESSTUDIES/////CAMBODIACAMBODIACAMBODIACAMBODIACAMBODIA.HTMHTMHTMHTMHTM ACCESSED 17TH SEPTEMBER 2012. [LXXXVI] UNICEF-UNFPA (2011), ‘JOINT PROGRAMME ON FGM/C: ACCELERATING CHANGE’, P. 24 [LXXXVII] WHO (1996) “ISLAMIC RULING ON MALE AND FEMALE CIRCUMCISION”, WHO REGIONAL OFFICE FOR THE EASTERN MEDITERRANEAN, EGYPT. [LXXXVIII] UNFPA (2012) ‘UNFPA’S INTER-RELIGIOUS AND INTERCULTURAL WORK 2011- 2012’ P.8 HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.UNFPAUNFPAUNFPAUNFPAUNFPA.ORGORGORGORGORG///// CULTURECULTURECULTURECULTURECULTURE/////CASECASECASECASECASE_____STUDIESSTUDIESSTUDIESSTUDIESSTUDIES/////CAMBODIACAMBODIACAMBODIACAMBODIACAMBODIA.HTMHTMHTMHTMHTM ACCESSED 17TH SEPTEMBER 2012. [LXXXIX] UNFPA ‘CULTURALLY SENSIT IVE APPROACHES’ H T T PH T T PH T T PH T T PH T T P ://://://://://WWWWWWWWWWWWWWW. U N F P AU N F P AU N F P AU N F P AU N F P A.O R GO R GO R GO R GO R G/////C U L T U R EC U L T U R EC U L T U R EC U L T U R EC U L T U R E/////C A S EC A S EC A S EC A S EC A S E _____S T U D I E SS T U D I E SS T U D I E SS T U D I E SS T U D I E S///// GHANAGHANAGHANAGHANAGHANA_____STUDYSTUDYSTUDYSTUDYSTUDY.HTMHTMHTMHTMHTM ACCESSED 17TH SEPTEMBER 2012. [L C] UNFPA ‘CULTURALLY SENSIT IVE APPROACHES’ H T T PH T T PH T T PH T T PH T T P ://://://://://WWWWWWWWWWWWWWW. U N F P AU N F P AU N F P AU N F P AU N F P A.O R GO R GO R GO R GO R G/////C U L T U R EC U L T U R EC U L T U R EC U L T U R EC U L T U R E/////C A S EC A S EC A S EC A S EC A S E _____S T U D I E SS T U D I E SS T U D I E SS T U D I E SS T U D I E S///// BRAZILBRAZILBRAZILBRAZILBRAZIL_____STUDYSTUDYSTUDYSTUDYSTUDY.HTMHTMHTMHTMHTM ACCESSED SEPTEMBER 17TH 2012. [LCI] JOINT LEARNING INITIATIVE ON FAITH AND LOCAL COMMUNITIES HTTPHTTPHTTPHTTPHTTP://://://://://WWWWWWWWWWWWWWW.JLIFLCJLIFLCJLIFLCJLIFLCJLIFLC.COMCOMCOMCOMCOM/////ENENENENEN///// ACCESSED 17TH SEP- TEMBER 2012. 2 52 52 52 52 5

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