CHAPTER TWO

LITERATURE REVIEW

The world population explosion has caused political leaders to look upon
national and regional birth control projects as vital. Support for regulation of
individual fertility has been evident in all cultures, and at all times, even in
those societies in which social and religious rules have favoured the
abundant production of children. As the secularization of Western society
and scientific enquiry gained momentum during the modern period,
knowledge of reproduction increased and was applied to control human
population growth. The various methods of contraception and their
development through the years from the ancient ideas to the modern era are
presented. Each approach to fertility control has its advantages and
disadvantages. No one method is perfect for everyone, for every clinical
setting, and in every culture. Higher levels of fertility have been associated
with 'traditional', religious prohibitions on some forms of birth control,
'traditional' values about the importance of children and the priority of
family, and 'traditional' family and gender roles reinforced by religion. The
attitude of the main religious groups to contraceptive practice is discussed.
PIP: Discussion of cultural and religious perspectives on family planning was
traced from ancient times to the present. The roles of the main religious
groups: Jewish, Roman Catholic, Prostestant, Islamic, Hindu, and Buddhist
and the roles today of religion were covered. Traditional methods are
indicated for females, males, and both, with additional focus on those
methods most used today. There has always been support for regulation of
individual fertility regardless of whether the religious rules favored many
children. In ancient times, population growth was slow due to poor harvest,
famine, war, poor nutrition, epidemics; and natural causes. Modern
preventive medicines and modernization have had a positive effect on
population growth. The current growth rate is .7% or 170 persons/minute.
Since the world fertility surveys of the 1970s, there has been strong support
for fertility control in almost all societies, but a gap still exists between desire
and practice. In ancient times, withdrawal or anti conception rites were used;
there was also evidence of quasi-scientific techniques such as female seed
pod condoms or root tampons. The Greeks articulated and wrote about
population control, including methods; abortion and infanticide were
accepted. Both Aristotle and the ancient Egyptians recommended covering
the cervix and vagina with Cedar oil. In the Medieval period, Arabic sources
suggested prolonged nursing as an anti conception technique. During this
period, St. Augustine promulgated for Christians the notion that
contraception was sinful; abortion and homicide were equated. In the early
modern period, the condom gained popularity, particularly for disease
prevention. Knowledge of reproductive physiology advanced the possibilities
for contraception. The occlusive pessary, which was based on ancient
Egyptian devices, was developed and is still used today as the cervical cap.
Experimentation was conducted with cervical rings at the turn of the century;
oral contraceptive empirical research was conducted during the 1930s, but
was not applied for another 30 years. There has been a convergence in birth
patterns in modern times for the main religions in low fertility countries, but
there have been differences in form of contraception used. Religious
expression and values continue to influence the family, but education is an

important means of achieving effective contraceptive use.

Condoms used to illustrate the story

Religious, cultural beliefs hindering family

planning in Nigeria – Service Provider
ByAyodamola Owoseye

September 26, 2017

Reading Time: 2 mins read

Religious inclination and cultural beliefs are holding back service providers
in Nigeria from encouraging unmarried young people to prevent unwanted
pregnancy through family planning.

Dimos Sakellaridis, Country Director, DKT International, said this on

Tuesday in an interview with PREMIUM TIMES against the backdrop of the
World Contraception Day.

The Day is usually celebrated on September 26.

Mr. Sakellaridis said many women in Nigeria, especially those who are
single, find it difficult accessing family planning kits or having the freedom
of choice because family planning providers are generally biased about
providing it to them.

“It should be pointed out that in most cases, this stems from the providers’
religious inclination or cultural beliefs. Some healthcare providers are
biased and also have limiting perception about family planning,” he said.

“This bias also prevents them from either offering family planning services
or make them to give wrong information to women seeking family planning
services.”

Mr. Sakellaridis pointed out that a major challenge is that many women
have misconceptions about family planning which prevents them from
seeking contraception when they have a need for it.

“This and the perception of most of the providers is posing a great

challenges on the field throughout Nigeria when detailing commodities to
suppliers,” he added.

In a bid to promoting family planning, Nigeria earlier this month launched a

new new campaign “Green Dot” to give 7.3 million women access to family
planning and close the contraception gap in the country.

The “Green Dot” would serve as the official marker for public and private
locations where people can obtain family planning that are safe, affordable
and effective.

The aim is to reduce maternal and infant morbidity and mortality in the
country as Nigeria currently ranks one of the highest in maternal mortality
rate in the world.

The Minister of Health, Isacc Adewole, at the launch had emphasised the
need to radically promote family planning especially among the
reproductive age (15- 45) if the country was to prevent demographic
explosion which would lead to economic disaster.

In order to achieve effective family planning culture, Toyin Saraki, wife of

the Senate President, during the launch had called on the government to
also focus its campaign on youth.

She said most youth do not talk about contraception usage and there is little
or no data to know their level of compliance.

Mrs. Saraki said it is a known fact that some youth engage in sex and they
too need to have enough knowledge on contraception and where to access it
without prejudice or fear of being judged.

According to World Health Organisation, the promotion of family planning

and ensuring access to preferred contraceptive methods for women and
couples is essential to securing the well-being and autonomy of women,
while supporting the health and development in communities.
The health agency said allowing women to choose whether, when, and how
many children to have leads to progress on global health goals.

It also helps break the cycle of poverty, and puts families, communities, and
countries on a stronger, more prosperous and sustainable path, it said.

for FP. Most formal religious leaders are male; however, women's organizations in churches and
women leaders have substantial influence in matters of reproductive health.

To empower religious leaders to use evidence-based arguments in support of FP, we trained leaders
in advocacy, provided technical information about FP, and had discussions on the biblical support for
FP.
The training was adapted from the Advance Family Planning Project's advocacy portfolio, which
focuses on quick wins and helps advocates: (1) understand the policy environment; (2) make
effective, evidence-based arguments, and (3) document, validate, and share results to allow for
strategy revisions.18 CHAZ's advocacy plan noted18:
CHAZ will train church leaders in the use of the quick wins strategy to ensure that long-
term changes are broken down into incremental changes that combine to produce
meaningful and lasting change.
The FP sensitization used World Health Organization guidelines on contraception, which were also
compatible with those of their ministries of health (MOHs). The biblical discussion was key to
enabling religious leaders to discuss their theological interpretations of biblical passages with each
other and agree on relevant passages from the Bible for use in publicly sharing about FP from a
Christian perspective (Box 1).19

active membership in the Family Planning Technical Working Group (FPTWG), it was asked to
co-chair the first FPTWG advocacy subcommittee. Dr. Kennedy Malama, Permanent Secretary,
Technical Services, Zambian MOH, stated that the FPTWG was very effective in its advocacy
role.23 CHAZ was also tasked to be the focal point civil society organization for FP2020 in
Zambia.

Increasing Demand for FP

In addition to using their church platforms to inform people about FP and refer them appropriately,
the religious leader FP champions used a variety of communications tools to reach the public,
including television, radio, social media, online media, and periodicals (Supplement). The initiatives
to increase demand were coordinated with other partners (e.g., FPTWG in Zambia).

8 17 Condemnation of modern contraception due to religious beliefs has been linked to lower family
planning use. [17][18][19][20] However, religions are not similar in their views on contraceptive usage,
and they can affect practices differently. 17 21 Also, religious teachings affect individual choices
differently across affiliations and social contexts. ...

... [26][27][28] Islam allows for different interpretations of the Quran and the Sunnah, leading to
variations in the acceptance of contraception. 18 29 30 While some conservative Muslims argue
against any form of contraception, other schools permit fertility regulation for birth spacing. 18 30
Previous studies investigating family planning barriers among African Muslims have identified that due
to Islamic beliefs mandating women to grant their husbands unrestricted access to their bodies and
the potential resulting pregnancies, 19 20 their concerns about family planning practices goes beyond
fate for the afterlife, as they also fear domestic violence if their husbands suspect them of seeking
contraceptives. ...

... 32 Within Catholicism, periodic abstinence methods are allowed for birth spacing in specific cases,
such as when a pregnancy would be associated with health or socioeconomic risks. 18 21 33
Analogous to Catholicism, Eastern Orthodoxy also sees marital sex as a mean of procreation and
marital unit but it differentiates between types of contraceptives, accepting condoms and withdrawal
but rejecting hormonal contraceptives and sterilisation. 18 21 While some more conservative
Protestant denominations are against contraception, Protestantism, in general, takes a more flexible
approach to secular issues, including an acceptance of modern contraceptive use. ...

An additional year would lead to a 2% reduction in mFP, while an additional birth would lead to a 40%
increase in mFP use ( Table 3). The interaction between age and parity indicates that the likelihood of
mFP was higher among women within the youthful age (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)
with at least 3 births (Fig 2). Compared to women in non-slum mainland areas, women residing in
mainland slums were twofold more likely to use mFP. ...

... We found that women who considered religion not to be very important in their daily life were more
likely to use mFP. Religion is well known as one of the most important determinants of population
(believer's) behaviors, including healthcare seeking [23][24][25]. In some religions, birth control
through modern FP use is taken to contradict their religious beliefs. ...

... The use of long-acting reversible FP methods was found to progressively increase with parity and
was highly used among those with 4 th parity and above. When we introduced the interaction between
age and parity, we found that women within the youthful age (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)
(25)(26)(27)(28)(29)(30) with at least 3 births where more likely to use mFP. Additionally, the odds of
mFP were observed to regressively reduce with the increase in recent period of sexual intercourse. ...

Additionally, religion might restrict certain practices concerning sexual and reproductive health (Pinter
et al., 2016). Perceptions of health and disease might also differ in different cultures, which can
influence ideas about the body, reproduction, and contraception (Ay et al., 2007;Sahin & Sahin,
2003). ...

... Firstly, in cultures with more conservative gender roles, attitudes towards family planning are often
also more conservative. This is also the case for very religious communities (Pinter et al., 2016). Thus,
if certain family planning practices are forbidden by their religion or culture, women in these groups
might have negative attitudes towards contraception use (Alomair et al., 2020). ...

... The migration background of women residing in Flanders, however, is very diverse, with large
groups from neighbouring countries, the Maghreb countries, Sub-Saharan Africa, and Eastern Europe,
all of which have major differences in their cultural practices. For example: While abortions are widely
accepted in Russia (Karpov & Kääriäinen, 2005), they are not in Turkey (MacFarlane et al., 2017); While
the catholic church completely condemns abortions, other Christian branches and other religions such
as the Islam and Hinduism allow more interpretation (Pinter et al., 2016); and lay believes of health
and illness are very different in, for instance, Britain and in Uganda (Furnham et al., 1999). ...

The religious education curriculum does not include information on modern methods of contraception.
These results are similar to those found in the study by Pinter et al. [26], which shows that the Holy
Koran does not inform directly about family planning. However, in different suras, the Qur'an refers to
the protection of the family. ...

... He does not want the hard way for you". Islam is a simple religion of ease, where there should not
be either rigidity or excesses that would only serve humans [26]. It was also explained that religious
leaders are firm in prohibiting most contraceptive methods and any recourse to abortion, as the Bible
points out in the book of Genesis. ...
... Studies abound in the same direction, justifying that losing control over women's fertility is the fear
of losing control over their sexuality that worries [29,30]. These interpretations of modern, which
ultimately dictate a point of view and direction for action, are partly based on ignorance of the
programs [24,26]. ...

Religious disapproval of contraception is far from universal, however. Although formal prohibitions are
stronger in Roman Catholicism than in any other faith (Maguire 2003;Christopher 2006;Srikanthan and
Reid 2008;Pinter et al. 2016), the Catholic Church exercises an outsized influence in world affairs
(Boyle, Kim, and Longhofer 2015). In 1992, the Vatican orchestrated an alliance between conservative
Catholic and Muslim countries to block references to contraception at the UN Conference on
Environment and Development in Rio de Janeiro (Maguire 2003). ...

... Official publications condemned family planning as a form of "prostitution" within the family and
counseled abstinence as the only acceptable method for avoiding conception (Kapor-Stanulovic and
Beric 1983). A more liberal line developed over time, and today most Orthodox churches permit
married couples to use contraceptive methods that do not induce permanent sterility or terminate
pregnancies (Zion 1992;Srikanthan and Reid 2008;Pinter et al. 2016). ...

... While pronatalist injunctions are not absent from Islamic doctrine, 4 Muhammad is believed to have
condoned withdrawal as a method for preventing conception. By extension, most contemporary
schools of Islamic jurisprudence authorize temporary or reversible contraceptive methods, although
permanent procedures such as sterilization are prohibited (Omran 1992;Atighetchi 1994;Shaikh
2003;Jeffery, Jeffery, and Jeffery 2008;Pinter et al. 2016). Between 1971 and 1990, five pan-Islamic
conferences on population policy affirmed the permissibility of contraception, 5 and the Aceh
Declaration of 1990 "endorse [d] effective and safe contraceptive methods which are not antagonistic
to Islamic Shariah" (International Congress on Islam and Population Policy 1990: 4). ...

Religion is often an important part of the cultural fabric of communities and, as such, can influence
decision making, ideologies, and moral and ethical behaviors. 23 Religious beliefs on issues of fertility,
contraceptive adoption, and abortion can differ greatly among Protestant Christians, Catholics,
Muslims, and traditionalists. For instance, abortion is generally considered forbidden in Islam, although
most schools of thought allow for early abortion (defined as the first 40, 90, or 120 days of pregnancy,
depending on the school of thought) and for abortion in certain circumstances such as when the
mother's life is in danger. ...

... 24 The Catholic Church allows only natural methods of contraception. 23 Many religious leaders hold
beliefs that lead them to speak against modern contraceptive methods. As a result, they can greatly
influence the demand side of family planning and, more generally, the reproductive health and well-
being of their communities. ...

... A previous study had also found religion to be a well-entrenched factor that influenced decision-
making processes across different settings in Nigeria. 23 This study also revealed that the family
planning decisions made by the majority of women were influenced by religion. This demonstrates the
importance of addressing religion in order to increase contraceptive use in Nigeria. ...

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Citations (54)
References (52)

Abstract
Religion is embedded in the culture of all societies. It influences matters of morality, ideology and
decision making, which concern every human being at some point in their life. Although the different
religions often lack a united view on matters such contraception and abortion, there is sometimes
some dogmatic overlap when general religious principles are subject to the influence of local customs.
Immigration and population flow add further complexities to societal views on reproductive issues. For
example, present day Europe has recently faced a dramatic increase in refugee influx, which raises
questions about the health care of immigrants and the effects of cultural and religious differences on
reproductive health. Religious beliefs on family planning in, for example, Christianity, Judaism, Islam
and Hinduism have grown from different backgrounds and perspectives. Understanding these
differences may result in more culturally competent delivery of care by health care providers. This
paper presents the teachings of the most widespread religions in Europe with regard to contraception
and reproduction.

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Citations (54)
References (52)
... 8 17 Condemnation of modern contraception due to religious beliefs has
been linked to lower family planning use. [17][18][19][20] However, religions
are not similar in their views on contraceptive usage, and they can affect
practices differently. 17 21 Also, religious teachings affect individual choices
differently across affiliations and social contexts. ...

... [26][27][28] Islam allows for different interpretations of the Quran and the
Sunnah, leading to variations in the acceptance of contraception. 18 29 30
While some conservative Muslims argue against any form of contraception,
other schools permit fertility regulation for birth spacing. 18 30 Previous
studies investigating family planning barriers among African Muslims have
identified that due to Islamic beliefs mandating women to grant their
husbands unrestricted access to their bodies and the potential resulting
pregnancies, 19 20 their concerns about family planning practices goes
beyond fate for the afterlife, as they also fear domestic violence if their
husbands suspect them of seeking contraceptives. ...

... 32 Within Catholicism, periodic abstinence methods are allowed for birth
spacing in specific cases, such as when a pregnancy would be associated
with health or socioeconomic risks. 18 21 33 Analogous to Catholicism,
Eastern Orthodoxy also sees marital sex as a mean of procreation and
marital unit but it differentiates between types of contraceptives, accepting
condoms and withdrawal but rejecting hormonal contraceptives and
sterilisation. 18 21 While some more conservative Protestant denominations
are against contraception, Protestantism, in general, takes a more flexible
approach to secular issues, including an acceptance of modern contraceptive
use. ...

Association between women’s empowerment and demand for family

planning satisfied among Christians and Muslims in multireligious
African countries

Article

Full-text available

 May 2024

 Franciele Hellwig
 Yohannes Dibaba Wado

 Aluisio J D Barros
View

Show abstract

... An additional year would lead to a 2% reduction in mFP, while an

additional birth would lead to a 40% increase in mFP use ( Table 3). The
interaction between age and parity indicates that the likelihood of mFP was
higher among women within the youthful age (20)(21)(22)(23)(24)(25)(26)
(27)(28)(29)(30) with at least 3 births (Fig 2). Compared to women in non-
slum mainland areas, women residing in mainland slums were twofold more
likely to use mFP. ...
... We found that women who considered religion not to be very important in
their daily life were more likely to use mFP. Religion is well known as one of
the most important determinants of population (believer's) behaviors,
including healthcare seeking [23][24][25]. In some religions, birth control
through modern FP use is taken to contradict their religious beliefs. ...

... The use of long-acting reversible FP methods was found to progressively

increase with parity and was highly used among those with 4 th parity and
above. When we introduced the interaction between age and parity, we
found that women within the youthful age (15)(16)(17)(18)(19)(20)(21)(22)
(23)(24)(25)(26)(27)(28)(29)(30) with at least 3 births where more likely to
use mFP. Additionally, the odds of mFP were observed to regressively reduce
with the increase in recent period of sexual intercourse. ...

Intra-urban inequalities in modern family planning use in Uganda’s

urban settings: the role of place of residence, socio-economic,
family, and individual factors

Preprint

Full-text available

 Apr 2023

 Rornald Muhumuza Kananura

 Catherine Birabwa

 Ronald Wasswa

 Peter Waiswa
View

Show abstract

... Additionally, religion might restrict certain practices concerning sexual and
reproductive health (Pinter et al., 2016). Perceptions of health and disease
might also differ in different cultures, which can influence ideas about the
body, reproduction, and contraception (Ay et al., 2007;Sahin & Sahin,
2003). ...
... Firstly, in cultures with more conservative gender roles, attitudes towards
family planning are often also more conservative. This is also the case for
very religious communities (Pinter et al., 2016). Thus, if certain family
planning practices are forbidden by their religion or culture, women in these
groups might have negative attitudes towards contraception use (Alomair et
al., 2020). ...

... The migration background of women residing in Flanders, however, is very

diverse, with large groups from neighbouring countries, the Maghreb
countries, Sub-Saharan Africa, and Eastern Europe, all of which have major
differences in their cultural practices. For example: While abortions are
widely accepted in Russia (Karpov & Kääriäinen, 2005), they are not in Turkey
(MacFarlane et al., 2017); While the catholic church completely condemns
abortions, other Christian branches and other religions such as the Islam and
Hinduism allow more interpretation (Pinter et al., 2016); and lay believes of
health and illness are very different in, for instance, Britain and in Uganda
(Furnham et al., 1999). ...

The social profile of women requesting abortion care in Flanders,

Belgium - An analysis of subsequent abortions and of abortion care
during the first wave of the COVID-19 pandemic

Thesis

Full-text available

 Feb 2022

 Leen De Kort
View

Show abstract

... The religious education curriculum does not include information on

modern methods of contraception. These results are similar to those found in
the study by Pinter et al. [26], which shows that the Holy Koran does not
inform directly about family planning. However, in different suras, the Qur'an
refers to the protection of the family. ...

... He does not want the hard way for you". Islam is a simple religion of ease,
where there should not be either rigidity or excesses that would only serve
humans [26]. It was also explained that religious leaders are firm in
prohibiting most contraceptive methods and any recourse to abortion, as the
Bible points out in the book of Genesis. ...

... Studies abound in the same direction, justifying that losing control over
women's fertility is the fear of losing control over their sexuality that worries
[29,30]. These interpretations of modern, which ultimately dictate a point of
view and direction for action, are partly based on ignorance of the programs
[24,26]. ...

Knowledge, beliefs and perceptions of religious leaders on modern

contraceptive use in Burkina Faso: a qualitative study

Article

Full-text available

 Jul 2021

 Abibata Barro

 Gustave Noufou Nana

 Dieudonné Soubeiga

 Patrice Ngangue
View

Show abstract

... Religious disapproval of contraception is far from universal, however.

Although formal prohibitions are stronger in Roman Catholicism than in any
other faith (Maguire 2003;Christopher 2006;Srikanthan and Reid 2008;Pinter
et al. 2016), the Catholic Church exercises an outsized influence in world
affairs (Boyle, Kim, and Longhofer 2015). In 1992, the Vatican orchestrated
an alliance between conservative Catholic and Muslim countries to block
references to contraception at the UN Conference on Environment and
Development in Rio de Janeiro (Maguire 2003). ...

... Official publications condemned family planning as a form of "prostitution"

within the family and counseled abstinence as the only acceptable method
for avoiding conception (Kapor-Stanulovic and Beric 1983). A more liberal
line developed over time, and today most Orthodox churches permit married
couples to use contraceptive methods that do not induce permanent sterility
or terminate pregnancies (Zion 1992;Srikanthan and Reid 2008;Pinter et al.
2016). ...

... While pronatalist injunctions are not absent from Islamic doctrine, 4
Muhammad is believed to have condoned withdrawal as a method for
preventing conception. By extension, most contemporary schools of Islamic
jurisprudence authorize temporary or reversible contraceptive methods,
although permanent procedures such as sterilization are prohibited (Omran
1992;Atighetchi 1994;Shaikh 2003;Jeffery, Jeffery, and Jeffery 2008;Pinter et
al. 2016). Between 1971 and 1990, five pan-Islamic conferences on
population policy affirmed the permissibility of contraception, 5 and the Aceh
Declaration of 1990 "endorse [d] effective and safe contraceptive methods
which are not antagonistic to Islamic Shariah" (International Congress on
Islam and Population Policy 1990: 4). ...

Conceiving of Contraception: World Society, Cultural Resistance, and

Contraceptive Use, 1970–2012

Article

 Aug 2020

 Wade Cole

 Claudia Geist
View

Show abstract

... Religion is often an important part of the cultural fabric of communities

and, as such, can influence decision making, ideologies, and moral and
ethical behaviors. 23 Religious beliefs on issues of fertility, contraceptive
adoption, and abortion can differ greatly among Protestant Christians,
Catholics, Muslims, and traditionalists. For instance, abortion is generally
considered forbidden in Islam, although most schools of thought allow for
early abortion (defined as the first 40, 90, or 120 days of pregnancy,
depending on the school of thought) and for abortion in certain
circumstances such as when the mother's life is in danger. ...
... 24 The Catholic Church allows only natural methods of
contraception. 23 Many religious leaders hold beliefs that lead them to speak
against modern contraceptive methods. As a result, they can greatly
influence the demand side of family planning and, more generally, the
reproductive health and well-being of their communities. ...

... A previous study had also found religion to be a well-entrenched factor

that influenced decision-making processes across different settings in
Nigeria. 23 This study also revealed that the family planning decisions made
by the majority of women were influenced by religion. This demonstrates the
importance of addressing religion in order to increase contraceptive use in
Nigeria. ...

Role of Religious Leaders in Promoting Contraceptive Use in Nigeria:

Evidence From the Nigerian Urban Reproductive Health Initiative

Article

Full-text available

 Oct 2018

 Sunday A Adedini

 Stella Babalola

 Charity Ibeawuchi

 Mojisola Odeku
View

Show abstract

... The probable reason for the Christian religion being more likely to use
modern FP methods could be the civilization on the importance of child
spacing [64]. Likewise, it has been reported by the leaders of the Roman
Catholic church that Catholics do not have to breed like rabbits, however,
they are allowed to use temporal family planning methods and prohibited
from using emergency contraception and abortion without exception, even in
life-threatening of a pregnant woman [65]. Additionally, Protestantism has
been reported to be flexible in using family planning for the sake of family
size [65]. ...

... Likewise, it has been reported by the leaders of the Roman Catholic church
that Catholics do not have to breed like rabbits, however, they are allowed to
use temporal family planning methods and prohibited from using emergency
contraception and abortion without exception, even in life-threatening of a
pregnant woman [65]. Additionally, Protestantism has been reported to be
flexible in using family planning for the sake of family size [65]. ...
. 2) Religion: The role of religion in fertility regulation cannot be over emphasized. Pinter et al.
(2016) posits that religion is often an important part of the cultural fabric of communities and, as such,
can influence decision making, ideologies, and moral and ethical behaviors. Hence, religious beliefs on
issues of fertility, contraceptive adoption, and abortion can differ greatly among Protestant Christians,
Catholics, Muslims, and Traditionalists. ...

... Hence, religious beliefs on issues of fertility, contraceptive adoption, and abortion can differ greatly
among Protestant Christians, Catholics, Muslims, and Traditionalists. Several evidences suggest that
most religious leaders hold beliefs that lead them to speak against modern contraceptive
methods Pinter et al. 2016;Gueye et al. 2015;Agadjanian, 2013). As a result, they can greatly influence
the demand side of family planning and, more generally, the reproductive health and well-being of
their communities. ...

Religious communities' views on contraception vary. Hindu society does not prohibit contraception; all
methods are acceptable, including permanent contraception (49). Several Islam communities (in
Malawi, Ghana, and Bangladesh) have a lower level of modern contraceptive use than other religions
(28,39,41). ...

... Different religious understandings about contraception show that religion is one of the main
obstacles in contraceptive use (51). Also, some religious principles are influenced by local
customs (49). Insurance ownership in each region has a significant positive effect on modern
contraceptive use in married women. ...

The probable reason of Christian religious being more likely to use FP methods could be the civilization
of the importance of child spacing (46). Likewise, it has been reported by the leaders of Roman
Catholic church that Catholics do not have to breed like a rabbits, however they are allowed to use
temporal family planning methods and prohibited from using emergency contraception and abortion
without exception, even in life threatening of the a pregnant woman (47). Additionally, Protestantism
have been reported to be exible in using family planning for the sake of family size and the type of
contraceptive use (47). ...

... Likewise, it has been reported by the leaders of Roman Catholic church that Catholics do not have to
breed like a rabbits, however they are allowed to use temporal family planning methods and prohibited
from using emergency contraception and abortion without exception, even in life threatening of the a
pregnant woman (47). Additionally, Protestantism have been reported to be exible in using family
planning for the sake of family size and the type of contraceptive use (47). ...

Availability and accessibility of FP services encourage individuals to use FP methods. A study in Enugu
state Nigeria show that availability and accessibility of FP in health facilities and other factors increase
FP use by 87.1% (Pinter et al, 2016) The FP services can be delivered through the routine health facility
based approach; the community based approach and domiciliary FP services. ...
... Various men and women health volunteers were also used in passing FP messages. The community
health and FP programme in the Upper East region of Ghana used leaders of African Traditional
Religion in the discussion and implementation of FP programmes since traditional belief system also
had an effect on FP use (Pinter et al., 2016). ...

... In respect to family constitution, for example, different religious groups advocate for monogamous
family units; promoting the need for individual households which is collectively designed to provide
shelter, education, healthcare and decent education among others (Adsera 2006;Coltrane and Collins
2001;Joo 2015;Olsen 2009). However the provision of those stresses the urban fabric and surrounding
urban resources and in some instances, they have been found to contribute to issues like land tussles
in urban areas, urban sprawl and environmental degradation, and to further impact on issues like
healthcare, education, employment, security, inclusivity and equality among others (Nassar and
Elsayed 2017;Koehrsen 2017;Pinter et al. 2016). ...

... Religious decrees and text on the constitution of family, marriage and childbearing have faced
considerable pressure as they are no longer seen to be able, by a larger percentage, to withstand the
storms of secularization (Pinter et al. 2016;Adsera 2006;Kucinski 2005). Since ancient days, for
instance, religion has taught about marriage between a man and a woman, and these bore the
responsibility of bearing and rearing children (Amien 2014). ...

Faith leaders play a distinctive role in society, especially during crises, such as their
response to Covid-19 in Israel, where they guide faith communities and promote
community development (Essa-Hadad et al. 2022). Religion shapes norms, values,
ideologies, and ethical behavior (Pinter et al. 2016). Recognizing their potential, the World
Bank involves faith leaders in poverty alleviation programs, and during the Ebola
outbreak, these leaders helped contain the spread by encouraging changes in
traditional burial practices (World Vision 2015). ...
The effect of religious affiliation on sexual and reproductive health attitudes, knowledge,
and behaviours has been previously documented (ESHRE Capri Workshop Group,
2018;Langley et al., 2021;Lizotte, 2015). The Catholic Church strictly opposes
contraceptive use (Pinter et al., 2016), and adherence to this religion has been
associated with self-reported unintended pregnancy and attitudes towards abortion
legalization (Langley et al., 2021;Ogland & Verona, 2011). Thus, it is likely that the
widespread presence of Catholicism in Ecuador influenced people's perception of
unintended pregnancy. ...

However, the preservation of life also includes the well-being of the mother, and family
planning can help ensure that pregnancies are spaced out and managed in a way that is
safe and healthy for both the mother and child. Islam promotes responsible parenthood
through the use of family planning methods that are safe, effective, and in line with
religious teachings on the sanctity of life and the well-being of the family (Pinter et al.,
2016). ...
.. In a Matlab study in Bangladesh, Munshi (2006) mentioned that women a village
learnt about contraceptives from other women in the village. This study resonates with
the previous literature that states that women from the same caste and religion tend to
discuss family planning methods, resulting in clustering of the methods among them
(Bhargava et al., 2005;Pinter et al., 2016;Sk, Jahangir, Mondal, & Biswas, 2018). A
study based on the NFHS-4 data shows that contraception use can be clustered within
the household as well (Ranjan et al., 2020). ...
Among young married women, unwillingness to start a family at the time of pregnancy
and poor knowledge of reproductive health, which includes the incorrect use of
contraception, could be responsible for the prevalence of unintentional pregnancy
(Santhya 2011). Due to sociocultural factors such as religious affiliation and illiteracy,
some women are not allowed to use contraception, which probably increases the
likelihood of unwanted or unplanned pregnancy (Pinter et al. 2016;Prettner and
Strulik 2017). In both stratified and nonstratified models, we found that the use of
contraception increases the likelihood of unintentional child/pregnancy.

Passages from the Quran encourage breastfeeding for a 2-year duration, historically
leading Muslim societies to accept lactational amenorrhea as a method of child
spacing. 9,10 Writings of Muslim jurists make it clear that Islam allows for the use of
reversible methods of contraception, including oral contraceptives, condoms, coitus
interruptus, emergency contraception, injections, subdermal implants, IUDs,
spermicides, and diaphragms. 3,7,11 Muslim scholars consider these methods
acceptable for medical treatment (i.e., treatment of menstrual-related conditions),
family planning, and regulating menses to perform religious rituals (i.e., fasting in the
month of Ramadan or enabling women to perform certain aspects of the Hajj
pilgrimage, from which Muslim women on their menses are excluded). ...

Religious tenets do not only vary between denominations within a faith; their
interpretations can also vary among individuals and religious leaders of the same
denominations [88,89]. ..

Extensive literature exists on the association between fertility and

religion, much of which focuses on the alleged higher fertility and greater
resistance to FP among Muslims and traditional religionists than among
the adherents of other religions. Religion, or more precisely the religious
interpretations of the local clergy, is also an important barrier to the use
of modern FP methods.6 Religion exerts strong social, economic and
cultural influence and plays a crucial role in the acceptance of FP.
Barriers to effective contraceptive use include personal beliefs that may
be shaped by both culture and religion.5,7,8
A possible reason for the variation in the prevalence of contraceptive use
in Muslim societies could be the differences in the attitudes of religious
leaders.9–11 Islam is practised under the supervision of religious leaders
(most of whom are men), who form a kind of an elite group, whose entry
into this position is through the religious education provided in religious
schools, commonly called madrasas. The views of religious leaders carry
great weight and profoundly influence the views of those studying in the
madrasas and, through them, the behaviour of the general population.12 It
should not be assumed that religious leaders in Muslim countries are
invariably conservative, as this hinders the dissemination of positive
views on FP among the general population.3 In Ethiopia, for instance,
Islam (the religion of the Muslims) is the most important source of
information on FP. A study carried out in Ethiopia had found that Islam
was the main contextual factor that influenced FP acceptance in the
community that was studied. The perceptions and beliefs of the religious
leaders can a powerful force. Preventing pregnancy in women was seen
as a direct opposition to religious principles, especially Islam. As per
Islamic religious beliefs, birth prevention is haram (forbidden) under the
Islamic law12 which is a barrier to the use of FP.

Acceptance of FP by religious leaders was triggered by their ability to see

that FP aligned with their religious beliefs. Knowing that they did not
have to adjust or compromise their religious beliefs to support FP was
what led to its acceptance among religious leaders.12 Similarly, Azmat et
al16 found that religious leaders in Pakistan too had a strong influence on
communities and could play a key role in informing the community
about the benefits of FP. Acceptance of FP by religious leaders in this
context was influenced by exposure to FP messages and information
from health professionals.12 The Nigerian study found a significantly
higher rate of contraceptive use among women who had been exposed to
FP messages from religious leaders than among those who had not.16,17

A study in Malawi examined the role of religious leaders, who were

generally supportive of organizing such events in their communities,
especially in terms of learning about the benefits of FP and disseminating
this information to their congregations.17,18 In general, the involvement of
religious leaders in FP messages has had positive results.17 This study
further found that religious leaders’ message was a predictor of modern
contraceptive use. It can be observed here that advocacy, demand
creation and media coverage with the involvement of different important
stakeholders such as religious leaders improve the use of FP methods.17

In Burkina Faso too, religious leaders play a major role in approving or

disapproving the use of FP in communities. To date, there is lack of
information about the opinions of Burkinabé religious leaders regarding
the use of FP methods and fertility preferences. Access to and use of FP
and other RH services are still low, whereas high levels of poverty,
illiteracy and numerous cultural and religious beliefs constitute barriers
to the provision of RH services to women of reproductive age. Research
is therefore needed to understand religious leaders’ perceptions of
modern contraception and their role in influencing fertility behaviours
and FP uptake, particularly in those societies where their views can have
a significant influence on individuals’ reproductive decisions. As in many
countries around the world, Burkina Faso too has endorsed the
Programme of Action of the 1994 United Nations International
Conference on Population and Development, the 2000 Millennium
Development Summit Declaration and the 2015 Sustainable
Development Goals (SDGs) all of which call for universal access to FP
information and services.19

This study, therefore, aimed to measure religious leaders’ knowledge of

FP and their involvement in FP programmes in the town of Dori in the
Sahel region of Burkina Faso.