Two religions, two strategies, one goal:

expanding family planning in Malawi

Stronger health systems. Greater health impact.

Fabio Castao, Mexon Nyirongo, Flora Khomani, MSH

Deliwe Malema, USAID Malawi

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Background

MSH implemented the USAID-funded

Community-Based Family Planning and HIV &
AIDS Services Project (CFPHS) in Malawi-2007 to
2010:

targeting factors that determine the access

and utilization of services
to deliver quality integrated services for FP
and RH and HIV and AIDS.

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Situation
FP indicators (2007)
High TFR = 6.0
children per woman
Low CPR (National 33%)
Mangochi = 27%
Salima = 34%

Slow FP uptake due to

Access to information and
services
Religious beliefs about
family planning
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Situation
Muslim Community
20% population
limited understandings
of traditional teachings in
relation to FP
Promotes natural
methods
Use of contraceptives as
life saving alternative.
Opportunity: reduction of
maternal mortality
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Christian Community
42% of health services,
most didnt offer FP
methods
Catholic church only
supports natural methods
Promotion of natural
family planning.
Opportunity: introduction
of standard days method
(SDM)
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 Intervention:
Partnering with Faith Communities

Collaboration with:
Ministry of Health (MoH)
Quadria Muslim Association of Malawi (QMAM)
Muslim Association of Malawi (MAM)
Christian Health Association of Malawi (CHAM)

Goal: increase access to quality FP and HIV/AIDS

services in 8 districts through introduction of
innovative strategies that would resonate with
faith communities

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Strategies
Both communities:
The message - Healthy Timing and
Spacing of Pregnancy - HTSP

With Christian groups

Promotion of the Standard Days Method -
SDM among Catholics
With Muslim groups
Evidence-based advocacy to change
misconceptions about holy teachings

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Healthy Timing and Spacing of
Pregnancy
3 Messages
For the health of the mother and the baby

1. Wait at least 24 months, but not more

than 5 years, before trying to become
pregnant again

2. Wait at least six months after a

miscarriage before trying to become
pregnant again

3. Wait until you are at least 18 years of

age, before trying to become pregnant
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HTSP Toolkit:
www.k4H.org

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Program activities with Christians
groups

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 Program activities with Christians
groups
Consultative meetings with
CHAM in 8 districts
Introduction and scale up of
SDM
SDM manuals adapted and
distributed
Capacity building

Training of Trainers: 15 priests,

nuns, and catechists
Cascade training: 205 service
providers , +1,000 volunteers

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Program activities with Christians
groups

Procurement & distribution of

Cycle Beads (11,500/ 2
years)
Job aids and registars
adapted
Community outreach: parish
churches co-sponsored
events and used networks to
introduce SDM to village
leaders
Demand creation for SDM:
providers weekly radio talks
(Radio Maria Catholic station
Mangochi)
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Program activities with Muslim
groups

Engaged clerics to help interpret the Muslim

stance on family planning based on the
Quran
Allahs message says a mother should breastfeed
her children for two years after birth

That made us see very clearly that Islam does

not prohibit family planning To protect the
health of the mother, and to protect the health
of the child, the Koran says that the mother
should breastfeed her child. And so the spacing
between births should be at least two years
(QMAM)
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Program activities with Muslim
groups

Established a common
understanding about the
Islamic teachings on
family planning
Advocacy tools
developed through
community-based focus
groups
Training of 30 faith
leaders
Advocacy conference

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 Results

A Lot Quality Assurance Sampling (LQAS) study

conducted in Phalombe district where SDM was scaled
showed:
Decrease in TFR from 6.0 (2004) to 5.7 (2010)
Increase in CPR from 33% (2004) to 61% (2011)
Women said SDM triggered greater male involvement in
FP
Advocacy resulted in MAM and QMAM signing resolution
supporting issues and changing the language and
messages related to spacing and family planning
Messages continued during Juma prayers, routine
gatherings, and through Radio Islam and the Islamic
Information Bureau
Messages incorporated in the Madrassa curriculum
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 Lessons learned

Appropriate strategies that consider the needs

and beliefs of religious groups are crucial to gain
support for FP
HTSP an effective way to change the discourse
on FP among faith communities (need more
research).
Skills building for FB leaders on communication
and appropriate FP language translate into
fewer misconceptions and raising community
awareness
Engaged FB health services are an effective
platform to SDM scale up
HTSP
Management and
Sciences SDM improve access and quality of 17
for Health
 Fabio Castao
fcastano@msh.org

www.msh.org

Follow me

@fcastano11

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