International Family Planning: Christian Actions and Attitudes Christian Connections for International Health (CCIH) Survey of Member Organizations Douglas Huber MD MSc, Evelyn Rong Yang MHS, Judith Brown PhD, Richard Brown MD MPH 25 August, 2008 Presented at USAID, Washington DC.
What is CCCIH? Christian Connections for International Health (CCIH) is an organization that promotes international health and wholeness from a Christian perspective CCIH provides field-oriented information resources and a forum for discussion and networking CCIH has 92 member organizations that work in over 150 different countries
Why this survey? Christian faith-based organizations (FBOs) play a large role in the international health service delivery CCIH members are very active in HIV/AIDS, TB and malaria Survey is attempt to ascertain activities and attitudes towards FP and RH
Family Planning Survey: Expected Outcomes Increase knowledge of member actions & views; inform ourselves & international community Strengthen member activities & partnerships for FP/RH services Enable CCIH & FP/RH Working Group to better serve members Understand & respect our diversity; identify common ground and aspirations for future
Survey Methodology Survey of 5 types of CCIH Member Organizations (n=92) Health service providers Health information providers National networks health org. (Africa, Asia) International support organizations Other CCIH members Survey: e-mail, follow-up telephone calls; selected in-depth interviews; and web site reviews 73% response rate (67 of 92)
Findings CCIH Member Organizations CCIH members present in 151 countries; multiple members in many offices, programs, drug procurement and logistics Combined annual revenue: $3.4 billion (for 27 CCIH members with revenue on web site) Strong interfaith collaboration & service provision, often with Muslims in Africa and Asia Frequent CCIH member partnerships and inclusive national networks of Christian health facilities In-country presence 100+ years for several organizations
Does your organization provide FP services (methods, information) or assistance to your program units/partners/members? (65 respondents) % respondents 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Yes No
What are the 3 most popular FP methods among the ones your organization or your partners provide? (n=12) Condoms Oral contraceptives Injectables IUDs Fertility awareness methods often mentioned by in-country Christian health networks, especially for Catholic providers and Muslim populations
Acceptable Contraceptive Methods Variable Responses: offer all methods local programs & individuals choose methods must be approved by the organization and faith leadership only natural methods Several questioned IUD mode of action Some mentioned abortion, to say it was out of the question
FP integration - organizations already doing or would consider doing (21 respondents) HIV/AIDS testing and care Child health PMTCT Prenatal and maternity - postpartum or postabortion (HTSP) Other 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% % respondents
In the settings where your organization works, what are the greatest obstacles for couples in achieving their desired spacing and number of children? (35 respondents) Cultural resistance Misconceptions or rumors about family planning Lack of training Religious opposition Lack of human resources Lack of contraceptive supplies Fear of contraceptive methods Inadequate monitoring, evaluation, or management info systems Planning and budgeting Proposal development Other 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% % respondents reporting as obstacle
Does your organization prefer NOT to use any of the following terms? [some terms not used/not applicable] (47 respondents) Population control Birth limitation Birth control Contraception Family planning Natural f amily planning Child spacing Birth spacing Healthy timing and spacing of children Family health Reproductive health Other 0% 10% 20% 30% 40% 50% 60% 70% % respondents reporting "prefer NOT to use"
What does your organization think about the effect of increasing FP use on the following? [Queried as generic outcomes, not as MDGs] (35 respondents) Reducing child mortality Improving maternal health Reducing poverty Promoting gender equality and empowerment of women* Strong effect Weak effect Unknown effect Achieving universal primary education* 0% 20% 40% 60% 80% 100% % respondents * 34 respondents
Would your organization like do more in family planning? [Includes members not having FP activities] (57 respondents) Yes No Undecided/Don't know 0% 10% 20% 30% 40% 50% 60% % respondents
Within a country Views on FP differ among CCIH members depending on regional religious leaders Within organizations admin vs. medical staff US vs. international branch among various countries
Needs of US-based CCIH members Buy-in from their own leadership (mentioned a few times by US support organizations) Needs of overseas CCIH members e.g., training, supplies, informational materials All Christian health networks in survey (Africa & Asia) want to do more but need support Training (or updates) on FP methods, services, contraceptives for HIV+ women
Conclusions CCIH members favor FP as an important component of international health including PMTCT. Many see large need & want to respond FP & RH are widely acceptable terms, particularly if mean voluntary prevention of pregnancy and explicitly exclude services or promotion of induced abortion Members vary on the FP methods they would provide
Recommendations to CCIH and CCIH FP/RH Working Group Bring common understanding about the work & views on FP for CCIH members- you can t have a maternal health program without FP Provide connections for CCIH members to link with funding sources & technical input We are very pleased CCIH is doing this survey & wanting to help Christian organizations provide FP Facilitate partnering among CCIH members, especially with providers of commodities and drugs. Consider educational efforts for US member constituencies on FP needs & desires to improve access by international partners
Recommendations (con t) Advocate & Educate for Policy and Practice Find support to: 1. Disseminate FP survey results 2. Document FP activities of CCIH members to inform members and international community Strengthen programming Collaborate with international health organizations to achieve wider support of CCIH member activities & strengthen their family planning efforts
Thank you!