T03-O-03 “Mothers are not machines”. Perspectives of religious leaders, health professionals and community leaders about family planning in Pakistan

Abstract

Objective This study describes perceptions of opinion leaders; the religious, health, and community leaders and the barriers they both identify and create for family planning among the reproductive age group in slum areas of Karachi, Pakistan. Design and Methods A qualitative study using semistructured interviews and a purposive sample of 20 opinion leaders (8 religious leaders, 6 health professionals and 6 community leaders) was conducted. Thematic analysis was used to generate themes. Results All leaders supported the central theme, that ‘mothers are treated as machines’ by the husbands and inlaws, and disapproved of consecutive pregnancies. Islam does not approve of acts of subjugation upon the weak, especially mothers. Further themes identified by opinion leaders include ‘mutual decision making in childbirth and family planning as valued’; the benefits of family spacing and planning’; and ‘willingness of the people to accept new ideas and ways of treatment’. Some religious leaders viewed ‘spacing as conditional and considered family planning as a sin and a Western conspiracy’ against Muslim people. Nevertheless, building capacity for understanding and cooperation between opinion leaders was reported as a way resolve issues of family planning. Conclusion Genuine ‘opinion leaders’ in Pakistani society play a powerful role as advocates for reproductive health and family planning programs. Cooperation among religious leaders and health professionals for the provision of information, counselling and advocacy on this issue may be an achievable way forward.