Hesperian Health Guides
Change attitudes about family planning
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In many cases, an action plan will include strategies to change negative ideas about family planning. This is especially important when there are political obstacles, myths, and cultural or religious reasons why family planning is not available to all women.
- 1 Challenge myths
- 2 Who has the power to influence?
Many negative ideas about family planning come from myths or beliefs about contraceptives that are not true. Providing accurate information about different birth control methods can help people question their beliefs and think about the benefits of family planning. The information in this chapter can help.
Who has the power to influence?
Different attitudes and political views can interfere with women’s right to plan their families and prevent unintended pregnancies. This next activity, a role play, can be used to look more closely at who really has the power to influence women’s choices. You can also use this activity to spark debate, raise questions about different attitudes to family planning, and discuss how to most effectively challenge or address negative attitudes.
Activity Role play a panel discussion on family planning
- Make a list of political obstacles to family planning, and a list of attitudes and beliefs that can positively or negatively influence women’s access to family planning. Choose 3 to 5 obstacles from these lists to use in the role play.
- Ask 3 to 5 people to play the roles of people who have specific points of view for or against family planning. Explain to the actors that their role is not to imitate a real person but instead to speak as someone from a particular group or institution that has promoted a certain point of view. Ask these participants to sit at a table or stand in a row and identify each person with a prop or a sign.
- Ask 2 to 3 people to play the roles of journalists who will ask the panel questions about family planning. Prepare some questions with the journalists before the role play starts.
- Have the journalists start the activity by taking turns asking their prepared questions.
Why should the government fund family planning clinics in our country?We lose money every time a worker slows down because she’s pregnant. She quits, then we have to hire a new person who takes time to train.Educating youth about sexuality and family planning makes them more responsible. I don’t want students dropping out because of pregnancy.Babies are gifts from God! In my opinion, the government should have nothing to do with so-called family planning.
- Give the audience a chance to ask questions or make comments to the panel.
- After the role play, have all the actors remove their signs or props and return to the group. Ask the group to reflect on the activity. These are some questions you might use to guide the discussion:
- Which points of view support family planning only for some women? Which women are not included? Why?
- Which attitudes put women’s needs first? How do these attitudes affect women’s ability to make their own decisions about using birth control?
- How can we respond to opinions that question or oppose family planning?
- How can we take action with these new ideas to work for change?
Find leaders who can be allies
Use an activity like Make a power map to help identify those with the power to influence attitudes and access to family planning, and to develop strategies for how to enlist support and work with allies. Here are some examples of ways that groups have successfully worked with religious and community leaders to make contraceptives more widely available.
Work with religious leaders. Some people use religious teachings or writings to say that family planning is wrong. But many religions in the world support child spacing, especially because this protects the health and lives of women and children. This is true for people of many faiths, including Muslims and Catholics.
You can often build support for family planning by asking religious leaders who believe in its value to speak about this in the community. When people hear that family planning does not go against their religious teachings, it can be a big relief. Finding ways to work within people’s religious faith to support their choice to use family planning is usually more helpful than expecting people to ignore or change their beliefs.
Integrate family planning with indigenous culture and traditions
Indigenous communities may distrust family planning services because some programs have pressured indigenous and poor women to use certain methods or to be sterilized. But indigenous leaders are finding ways to integrate family planning into community health services in a way that encourages women to choose birth control methods they are comfortable with.
One example is a clinic in Ecuador called Jambi Huasi, which means "House of Health" in the local Quechua language. Health workers in the clinic speak Quechua, and they understand and respect traditional healing ceremonies and beliefs. The clinic has a local healer on staff and a medicinal plant garden. The pharmacy dispenses both traditional and Western medicine. Jambi Huasi integrates family planning into a broad range of services for women, children, and families. Couples have begun to space their pregnancies for health reasons, and the numbers of women and children who have died has dropped dramatically. Because cultural traditions are respected, women are using the services with confidence.
Building respect with community leaders opens up discussions about family planning
The Community-based Health Planning and Service project in Ghana, Africa wanted to make primary health care more accessible in Navrongo, a remote, rural community. To do this, they worked closely with traditional social organizations and also brought nurses from the district health centers to live and work with the community. The project organized discussion groups of peers who would be comfortable speaking honestly in front of each other about common health issues — young men, older men, young women, older women, and community leaders. Family planning was one of the many topics they discussed.
When asked what would make family planning more usable, women said they wished for more privacy when it was provided, and wanted help putting men more at ease about it. Men spoke about the status of having many children, loss of control of their household when they are not consulted about spacing children, and fears that a woman using family planning will leave her husband.
The organizers also learned that people might be more willing to use family planning if they lost fewer children to illness. This was already a main goal of the health project. And when the nurses treated men for illnesses, they gained their trust and were able to explain birth control options and respond to the men’s concerns. The relationships nurses built with families also helped them intervene in conflicts between men and women arising from family planning use.
The Navrongo project relied on the participation of community leaders — chiefs, elders, heads of households, and the leaders of community groups. This respect meant that the chiefs and elders welcomed members of the project to attend traditional durbars, or public meetings, where matters of collective concern are discussed. There organizers could explain to concerned men how modern birth control methods help people with their traditional desire to space births. And many local leaders told men not to quarrel with their wives who used family planning.
Working through the durbars, the project facilitated many more community discussions on health. The project also asked community leaders to invite women to attend the durbars, traditionally a male-dominated forum. At first women were reluctant, but the project increased their participation by inviting women’s groups, such as choirs or church groups, market associations, and political networks. This enabled women to participate in other community discussions as well.