Perhaps one of the most challenging public health interventions in Pakistan is building awareness of healthy behaviors and its country-wide promotion, especially when it requires accessing women in rural areas of Pakistan. Some of the common challenges faced in this aspect include the vast diversity of religious sects, low literacy rate, deteriorating security situation, elitist mass media and its limited outreach, patriarchal society and lack of women empowerment. PAIMAN’s communication, advocacy and social mobilization strategy identified ulama (religious leaders) as a crucial link that could effectively reach out to the male community for promoting MNCH and FP issues in the midst of these challenges faced.
There are many aspects of religious doctrines in Islam that support public health issues. The need is to find common ground and openings within this system of beliefs to frame public health messages or to position development goals so they are not in direct conflict with interpretations the ulama generally share with the general public. It is crucial that before any dialogue is initiated, prevailing perceptions of religious leaders on public health or, for that matter, on development issues are carefully studied.
PAIMAN’s ulama intervention worked in some of the remotest, most challenging and security compromised districts of Pakistan. It enlisted the support of over 800 ulama for improving knowledge of people and changing behaviors of their respective communities towards the health of mothers and children. Ulama volunteered their services to spread behavior change messages in the neighborhoods. This unique intervention was implemented through a strategy that was chalked out by the ulama themselves and was a key building-block for PAIMAN in achieving its objective for improving the lives of women, newborns and children across Pakistan.
The evaluation report of ulama intervention serves as an implementing framework and key resource document for public health managers, communication professionals, and others who wish to engage ulama to achieve their development goals. One of the crucial lessons of this intervention is that working with ulama needs to be a program-oriented activity, rather than a project-oriented activity. To successfully engage and involve ulama as partners in social change, we need to change our thinking towards the ulama as well; they are experts in their field and need to be treated as such.
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Pakistan Initiative for Mothers and Newborns (PAIMAN) was a six-year (2005-2010), USAID-funded project aimed at building the capacity of the existing health system and fostering a community-based approach to ensure a continuum of care for mothers, newborns and children. One of the five strategic objectives of the PAIMAN was “increasing awareness and promoting positive maternal and neonatal health behaviors”.
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Dr. Nabeela Ali
Chief of Party
JSI Research and Training Institute, Inc.
USAID Technical Assistance Unit for Health
Fatima Malik says
I think this is an excellent intervention that employs the ulema, who constitute as the ‘game changers’ in the current immunization strategies.
Ch. Usman Ali says
Thanks for the reply. I am very optimistic but realistic too. Out of 800 Ulema I bet you will not be able to name 8 of them who fit the criteria described educated, dedicated and agents of change for removing misconceptions. They are all dream merchants and are very good at changing the mind set. I have yet to see one alam who serves before self. Talking about glass half full, I think it is fully dry for a long time for these agents of change and the proof is millions of madrassas all over Pakistan and the Killings of minorities (Muslims and non Muslims).
Other nations have learned the lessons from these dream merchants and have progressed. We have to get out of the topi drama (shenanigans for better sake in English). Again I would reiterate that a Mullah’s place is in Mosque not in Social Development or crying out loud, economic development. Yes, I am a Muslim and very proud of it but it is my personal belief not a public property and certainly a Mullah has no right to change the mindset of a common person. For that we have to educate them in science, mathematics, medicine (same way we do not believe in the village hakeems, Witch doctors) so they can make responsible choices for themselves and for the society. Regardless, you have a good article and we love you in Pakistan.
Ch. Usman Ali says
Nice Article. Dr. Nabeela’s PAIMAN project has left a lasting impact on the Mothers and New born of Pakistan from implementation and even government level policy making issues.
Ulema are root to the cause of many social issues in our society. When illiteracy runs deep these dream merchants have a flourishing business. It happens across the globe and illiteracy is directly related to poverty, We can see in Africa, South America and even have different indicators in Pakistan. We can compare how the religious leaders and other ‘Peers’ flourish in relative poor areas than more affluent ones.
Yes, we have to keep the so called Ulema involved in any process of social intervention but on parallel grounds we should promote separation of Mosque and state for a sustainable society. Yes, I am proud what I believe in and I should have right to practice but should not be going public at the cost of others.