Respected Participants, Good Morning!
Many thanks for having me here, I feel honored to have the privilege of speaking with audience of your
caliber on an important topic that is closely related to our lives. I would try to narrate a case study that
depicts an effort to integrate religious understanding regarding family planning and reproductive health
in my country, Pakistan. But before that, let me give you a synopsis of country’s demographics and
history of family planning program.
As many of you might be aware that Pakistan is the 6th most populous country in the world map with an
estimated population of 185 million. 92% population is Muslims followed by Christians, Hindus and
other minorities. The predominant Muslim majority is led by Sunni population and 20% are Shia. The
Sunni sect is further divided into two factions, Deobandi and Brelvi, like Catholics and Protestants in
Christianity.
Pakistan was among the first country in South Asia region that started its family planning program in late
50s and established a dedicated Ministry to oversee its administration. But despite of this trail blazer
effort, the contraceptive prevalence rate in country has not been able to achieve significant increase.
There have been various analyses done to understand why after having universal knowledge of FP in
country; the change in practice has not matched to it. There are many social and cultural determinants
of this effect but religious beliefs are considered as an important one in shaping people’s behavior for
use of contraception. The government has recently included working with religious leaders as an
important strategy for improving the program outcomes. The religious leaders are sensitized on Family
Planning and Reproductive Health to serve as Champions for our cause. They have been brought into
state media channels to give statements in support of small family and spacing to benefit mother’s
health. There have not been any formal assessment to measure its impact but overall it is considered as
an important strategy for this movement.
Packard Foundation has been investing in Pakistan since late 1999 for Population and Reproductive
Health program. Being a private Foundation, it has an edge to be innovative and to take risks in trying to
attempt new strategies. One such was to introduce a module on “Reproductive Health and Islam” for
service providers of public sector. The task was led by group of 12 leadership fellows that was sent on a
study tour by Foundation to Alexandria, Egypt for reviewing the work on Islam and Family Planning done
by Al-Azhar University; the most authentic university for Islamic teaching. The group came back and
decided to draft a Module on same lines but contextualizing it to country. The leadership fellows started
the work with a public sector institute in Lahore known as Institute of Public Health.
Reproductive Health was chosen as the focus since it had gained priority after the international
conference on population and development held in Cairo in September 1994. Much attention has been
paid to Reproductive Health at local, national and international levels by the public as well as private
Health sectors; however the religious dimensions of RH have not been given significant importance for
answering many queries which may arise while dealing with the RH clients and patients.
Institute of Public Health, Lahore being a training & research institute took the responsibility of this
daunting task with the objective to improve the knowledge and practices of health care providers with
regards to Islamic perspective of different components of RH. This was hoped to improve their
communication with the communities which in turn will help in the provision of people friendly
Reproductive Health services.
For this purpose a Need Assessment Survey of the Health Care Providers was conducted through
questionnaire based interviews. The results of this survey clearly showed that knowledge of the Health
Care Providers was quite deficient with regards to the Islamic perspective of the important RH
components. At the same time it was encouraging to note that the Health Care Providers were much
interested in improving their knowledge in this area. On the basis of these findings this curriculum was
designed. Reproductive Health is a very broad area but in this curriculum only practically important
components of RH have been comprehensively addressed. Although Communication Skills is not a
component of RH, this was added knowing that interpersonal communication is the foundation of
human interaction. Good communication is fundamental to successes of any program or services.
The format of the chapters in the Module comprises of “Objectives”, “Preamble”, “Situation Analysis”,
“Introduction”, a brief about the “Technical Aspects” of the topic and the “Islamic Perspective”. The
main emphasis in each chapter is on the “Islamic Perspective” of these components which is the aim of
writing this curriculum. For this purpose the Islamic provisions on RH as contained in the sources of
Islam like the Holy Quran, Hadith (Sayings, deeds and approvals of the Holy Prophet (PBUH)) and Fiqh,
have been taken. The Islamic literature and Islamic Books written by authentic Islamic Scholars were
searched and renowned Islamic Scholars were consulted. It was expected that this curriculum would
help the Health Care Providers in enhancing their knowledge and clearing their concepts about the
“Islamic Perspective” of Reproductive Health. This was expected to help them to have a better
communication with clients leading to the improvement of quality of Reproductive Health Care services.
The Module comprises of nine sections; Reproductive Health and Women Rights, Safe Motherhood,
Newborn and Infant Care, Adolescent Health, Family Planning, Abortion, Sexuality and Sexually
Transmitted Infections, Infertility, Communication Skills. Each section deals with medical and technical
information about the subject followed by Islamic perspective.
In Pakistan, we have learnt few lessons on how to talk about religious interpretation of Sexuality,
Reproductive Health and Family Planning. It is best to talk about FP in the context of mother’s and
child’s health. As Islam reinforces breast feeding for two years for all mothers hence the
interpretation is that there is promotion of birth spacing since mothers who are breast feeding for 2
years will at least take three years to have second child. There is also mention in Sunnah that
Muhammad asked his fellows to do Azal (Withdrawal) to prevent their female companions to be
pregnant. Islam supports efforts to space children; there are no verses in the Quran that forbid
family planning. "The silence of the Quran on the issue of family planning has been interpreted by
many ulema to mean that the Quran does not prohibit its practice." Birth control is permissible
according to Islam, which recognizes that the sexual act is more than just a means of procreation.
According to the teachings of the Prophet (PBUH) the practice of child spacing/family planning is
allowed and that both men and women should be involved in the discussion and decision making
around family issues such as child spacing. The matter of mother’s health is given importance as well
and use of FP methods has been approved according to religious scholars of Al-Azhar University.
From Child’s perspectives, it is stated in Quran that it is parent’s responsibility to feed, take care, and
provide housing, good education to their children. It is given as one of 13 rights of children on their
parents. This again testifies that small families or families that can be affordable within parent’s income
bracket are preferred.
Our lessons from this and other pieces of similar work confirms that religion is the most important factor
in Muslims lives, every Muslim tries to find out what Islam says about several matters or issues whether
it is related to marriage, trade, business, family or other relationships. When we engage Islamic scholars
into SRHR discussions, it is always done in the realm of marriage. Having a relationship outside marriage
is unimaginable and not accepted in Islam hence there is no way that we can frame our discussions
independent of marriage if it is about SRHR. However the issue of underage and child marriages is
something that has become a movement in Pakistan in recent years and despite opposition from some
quarters of religious factions, the Parliament has recently passed the bill to restrict minimum age of
marriage for girls as 18. This is quite a victory and has been made possible by support of strong religious
groups who endorsed the motion.
The other avenues of engaging with Islamic scholars is to talk about issues of violence against women,
taking consent from wife for second marriage as polygamy is allowed in Islam, giving rights to wife for
decisions on fertility and family size, treating daughters and sons equally etc. The issue of abortion is
divided between different sects, while one strongly prohibits that this is not allowed under any
circumstances the others believes in theory of ensoulment and declares 40 and 120 days to decide on
termination. So while abortion can be discussed under Islamic laws but it is advised that this matter
could become sensitive and controversial hence should be dealt carefully.
One aspect of SRHR that will not be allowed to discuss with Muslim scholars is the issue of
homosexuality. There are clear words in Quran about curse on those who are homosexuals and severe
punishments for those who indulge in it. We have found that this is a ‘lose-lose’ situation if a dialogue is
started on this subject and should be best refrained.
The education to young girls and boys before marriage on SRHR are framed into ‘Family Life Education”.
Through FLE, variety of subjects are covered from self-esteem, art of negotiation, gender discrimination,
right given in marriage, opposing under age marriage, bodily changes during puberty and how to deal
with it, sexual harassment, prevention of HIV/STIs and contraceptives. FLE is widely introduced by NGOs
in public and private schools in Pakistan and recently Ministry of Education has indicated its approval for
including it in country wide school system. However there are many lessons learnt in paving the way for
FLE and after getting endorsement from religious scholars that this effort has been scaled up.
Interestingly some NGOs are running this curriculum in religious seminaries known as Madrasahs as
well.
In conclusion, the religion can be used to bridge the gaps between different populations and enhances
the understanding of individual’s beliefs on health perspectives. However it is imperative that there
should be deep understanding of Islamic issues and its correct interpretations since it could backfire
otherwise. Countries like Bangladesh and Indonesia have successfully worked with religious leaders for
promoting positive reproductive health behaviors and have shown impressive results in family planning
field. There is no reason that the same strategy cannot be applied successfully at other places with
careful planning and monitoring.
Some of the advices that I would like to give to Ministry of Foreign Affairs is to remain pragmatic and
innovative but be realistic while talking to Muslim communities. As I said earlier, LGBT is a complete no-
no so should not be discussed as well as talking about sexually active youth outside marriage. The
subject of HIV/AIDS does provide an entry point to talk to young people about protection from these
infections and adopting responsible behaviors. Since you will be working with African countries where
HIV epidemic is high hence this window could be explored for SRHR education to young people. I will
also advice that you study LSBE module in Pakistan and learning from it to design your own curriculum
for Muslim population in Netherlands and in other focus geographies. The Module of Reproductive
Health and Islam could be drawn as a reference for improving HCP knowledge on the subject but this
will only be required where there is majority Muslim population like my country.
I sincerely wish Ministry of Foreign Affairs all the best in their endeavors and offer my assistance
wherever, whenever required. Thanks for your understanding about religious and cultural sensitivities
on these matters as these merit much attention but are often ignored.
Thank you for your attention.
Dr. Yasmeen Sabeeh Qazi
Some of the quotes from this Module are as below:
Rights Provided to Women by Islam
Right to Life
In the pre-Islamic Arab society, the birth of a daughter was supposed to be an economic liability and
social stigma. The daughter was a source of embarrassment and many would kill the new-born child.
Allah expressed His displeasure for this barbaric custom. It is said: “For what sin was she slain.”( Surah
Al Takveer [81]-9).
Allah said, “Slay not your children, fearing a fall to poverty; We shall provide for them and for you. Lo!
The slaying of them is a great sin.” (Surah Bani Israel [17]-31). The Holy Prophet said, according to
Abdullah bin Abbas, “Anyone who has a daughter and desists from burying her alive and does not
consider her less than a son, for such a one is paradise.”(Sahih Bukhari)
The Right to Upbringing
After birth, a child needs care and proper upbringing. For this Allah has appointed the parents to do
their duty. Allah says: “Mothers shall suckle their children for two years; that is, for those who wish to
complete the suckling. (Surah AlBaqara [2]-223). The duty of feeding and clothing and nursing of
mothers in a seemly manner is upon the father of the child.” In other words the responsibility of suckling
and bringing up the child is that of the mother and taking care of the mother and fulfilling her needs of
food and dress of those of the father.
Prophet (PBUH) said, “Anyone who goes through the ordeal of bringing up two daughters and treats
them with kindness, the daughters will stand between that person and the fire of hell. (Sahih Bukhari)
Right to education
Allah said “Say O! Muhammad, My Lord Allah, augment me in my knowledge,” (Surah Taha [20]-114).
In this Ayah though the Prophet was addressed, the real audience was the ummah. For this prayer to be
accepted, every human being is urged to say and pray to Allah to increase his/her knowledge. This ayah,
with the implied prayer is vocalized by every Muslim man and woman. In another Hadith is the most
famous saying of the Prophet (PBUH): “Getting educated is the duty of every Muslim man and woman”
(Al-Muslim). Since Allah bestowed Islam on women they were drawn towards education. Thus there are
many sayings and Hadiths that have come to us through the female companions. A large majority of
women had learnt the Holy Quran and had memorized the sayings of the Prophet (PBUH) that they
recited to men, who sat behind a curtain.
No wonder in his (PBUH) days, many women were attracted to education. There is no denying
of the knowledge and learning of Aisha Siddiqa (RA); she was approached by
many learned men of her time to help them resolve problems and remove their doubts on
many situations. This happened after the demise of the Holy Prophet (PBUH). Abu Musa
Ashari is quoted, saying, “There was not a problem that she did not resolve and not a
single doubt that she did not remove with her great knowledge.”4
Imam Zehri has said the Aisha (RA) was the most learned of all and many scholars would ask her about
their problems. Her knowledge was not merely limited to Shariah or Fiqh but also extended to the
question of right and wrong, halal and haram, law, poetry, calligraphy, medicine and history.
Right to Maintenance Money
Islam made it imperative for the husband to pay the maintenance money according to his status and this
includes food, dress, medical care, a house and the necessities of life. The Holy Quran says: “The duty of
feeding and clothing of nursing mothers in a seemly manner is upon the father of the child.”(Surah Al
Baqra[2]-233) The Holy Prophet (PBUH) said: “Obey Allah in the matter of women that you accepted
them as trust from Allah and according to the Divine Will you consort with them, therefore the food
and dress of the women is enjoined upon you, according to the custom.”(Sahih Muslim)
At another place the Prophet (PBUH) urged the people to treat their wives with fairness. Jabir (RA) said
that once the Prophet (PBUH) addressed the people and said, “In dealing with women, fear Allah. They
are your tilth and have been given to you in trust. You have the right to their modesty. It is for you to
provide to them food and dress.”(Sahih Bukhari 7:127)
Right to Kindness and Fair Treatment
After her marriage the woman is practically cut off from her family and belongs to the husband’s house.
She is at the mercy of her husband. Therefore Islam has insisted on kind treatment for her and her
weaknesses and lapses ought to be overlooked.
The Holy Book says: “But consort with them in kindness” (Surah Al Nisa [4]-19). Aisha (RA) relates a
tradition of the Holy Prophet (PBUH) “Among the best are those who treat best their wives.” Another
Hadith narrated by Abu Hurera (RA) quotes the Holy Prophet (PBUH) saying: “Among the Muslims the
perfect believer is he who has good morals and is kind to his wife.”
Abortion:
Most of the Maliki 8 Jurists described abortion as completely forbidden. In their view, when the semen
settles in the womb, it is expected to develop into a living baby and it should not be disturbed by
anyone. According to Ibn Janwziyyah, 8 when the womb has retained the semen, it is not permitted for
the husband and wife, or one of them to induce an abortion. After ensoulment, however, abortion is
prohibited absolutely and is akin to murder. However, for some scholars of the Maliki School an
abortion is permissible with the consent of both parents up to day 40; it is no longer allowed after that.
Some scholars of the Hanbali School maintained that abortions are principally prohibited from day 40
onward. Others permitted abortion without restriction until day 120 and allowed in certain cases after
that.