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”.
Dr. Nabeela Ali
Chief of Party
JSI Research and Training Institute, Inc.
USAID Technical Assistance Unit for Health