It was evident in 1994 at the International Conference on Population and Development that while a majority of delegations agreed to a profound shift in population policies away from counting people to empowering women, most also understood that there had to be room to accommodate distinct national priorities and cultural differences. Since those momentous days in Cairo a decade ago, what is also emerging is a global patchwork of coalitions and alliances no two really the same that are proving to be the best and most appropriate way to get things done.

People in diverse cultures all over the world, and the international agencies and nongovernmental organizations helping them tackle reproductive health challenges, have been devising a fascinating array of partnerships to fit their own political, religious and cultural environments.

The message seems to be: If it works, go for it. There is a growing confidence in local solutions, with outsiders playing valuable but limited supportive roles. These partnerships seem to hold the promise of real sustainable progress Some of the ad hoc coalitions are not new. Indeed, in countries that were already making significant changes in womens rights and womens health before Cairo, these forces were already in play a generation or more ago. Often, Cairo gave them the muscle and the action plan they needed to prod governments and overcome reticence about speaking out publicly on sensitive or embarrassing topics.

In Brazil, for example, a strong urbanized womens movement they have no hesitation in calling themselves feminists took advantage of political turmoil and the end of military rule in the 1980s to lobby successfully for changes in laws governing family life and for broad guarantees of equality in a new constitution. Now Brazilian feminists work with a range of other groups and institutions.

They have begun cooperating with recently created mens organizations trying to reduce domestic violence through changes in behavior and attitudes toward women, an area in which Brazilians feel confident that they have taken a lead in Latin America. Brazilians are proud to say that they raised the issue of domestic violence as a violation of womens rights in 1993 in Vienna at the international human rights conference. Within the country, ending family violence is constitutionally a duty of the state, which recognizes women and men as equal partners in a marriage.

Feminists work with local authorities, too. In Rio one example is Cepia, a womens rights NGO that trains police officers and health workers in the handling of sexual abuse victims. It also focuses on teens, where birthrate are soaring, said Cepias founder, Jacqueline Pintagui.

For many teenagers who have nothing, she said in a conversation in Rio, it is something to be pregnant. Later in the town of Pirai, a young woman who had recently given birth to twins told me that she got pregnant just because she wanted to try motherhood.

The hierarchy of the Catholic Church has not been an ally of womens rights groups, Pitangui said, adding that in Rio the Catholic leadership opposes not only abortion but also emergency contraception the morning after pill and condom distribution. But women are confident that if the church can impede some developments, it can no longer stop the movement for a more liberalized reproductive health system, Pitangui said.

In Ghana, reproductive health and safe sex programs have not met organized resistance from major religious organizations, Christian or Muslim. Campaigns to abolish traditional customs harmful to girls have also not been blocked. In fact, in Ghana religious leaders have become an important part of the solution, not the problem, say health and population experts.

It is not against any religion to create happiness in this world and in the hereafter, said Hafiz Ahmad J. Saeed, who directs reproductive health programs for the Ahmadiya Muslim Mission in Accra. He said his work has been helped substantially by the shift of emphasis from birth control to family planning. “For a religious person, talking of birth control is not acceptable,” he said. “You don’t control birth, you plan it.”

“There is no verse in the Holy Koran which is against planning a family,” he said. “We don’t have a problem at all talking about family planning issues. There are no inhibitions. There is no taboo.”

The moderate Ahmadiya Muslims of the Accra region have been holding large rallies to take messages about reproductive health and AIDS prevention to people outside the capital. Ahmadiya leaders say they have attracted as many as 50,000 people to outdoor meetings, where the messages are direct: genital mutilation is not Islamic, AIDs victims deserve our compassion and “Don’t shift the blame on God.”

Mission leaders say that one of their biggest challenges, especially in remote areas of the north bordering Burkina Faso, is to persuade Muslims to abandon the philosophy that any setback – including AIDS – is the will of God. The mission is working with UNFPA to organize workshops on modern medicine in an Islamic context. It also cooperates in programs devised by the Planned Parenthood Association of Ghana, part of the International Planned Parenthood Federation.

Dr. Mubarak Osei Kwasi, an epidemiologist with the Ahmadiya mission, says that he is often called upon to clarify teachings and dispel rumors about modern medicine, including vaccines. As in nearby Nigeria, some grassroots Islamic leaders in Ghana had been preaching that polio vaccine was a Western plot to sterilize Africans. Mubarak says that people will believe the vaccine is safe “if the message comes from us.”

At Young & Wise, an offshoot of the Planned Parenthood Association of Ghana that is devoted to taking messages of abstinence and safe sex to boys and girls as young as 10, Delah Banuelo, the project officer, said that his organization is invited to a variety of churches and mosques to talk about reproductive health. Religious leaders are a valuable part of the mix in changing attitudes and behavior in Ghana, he said.

So, perhaps surprisingly, is the army. After basic military training, young Ghanaians are encouraged to opt for a period of national service in social institutions. Young & Wise has such a volunteer, Peter Dakurah. The Center for Pregnant Teens is Kumasi is also helped by volunteer servicemen.

In Egypt, an African nation with a Middle Eastern culture, pioneers have been drawn traditionally from a more secular elite that in many ways poses a threat, not an opportunity for partnership, for Islamic conservatives on whose turf women’s rights activists work among the poor. As in Brazil, strong women, acting as individuals or in informal groups, have led movements for an end to genital mutilation, for fewer restrictions on abortion and for more women-friendly health services in general.

In Egypt a unique “old girl” network has played a role. Among the women who have succeeded in bringing changes in law and practice are a core of graduates of the American College for Girls in Cairo (now Ramses College) where Thoraya Obaid, the executive director of UNFPA, the United Nations Population Fund, was also a student.
“It was not only the knowledge the college gave us,” said Mona Zulficar, an American College graduate who is now one of Egypt’s most prominent and successful international corporate attorneys. “It was also the building of character. It made us independent-minded and able to think for ourselves.”

As a lawyer, Zulficar has been active and influential in challenging Islamic conservatives who would limit women’s rights by citing shariah law. An expert on family and citizenship laws, she took on a male-dominated establishment on its own turf, using Islamic law itself to find justification for a woman’s right to initiate divorce, for example. Like women in Brazil, Egyptian feminists have used the courts effectively and made inroads into government, particularly the ministry of health. They have found allies among officials and in Suzanne Mubarak, the wife of the President.

“Shariah and politics were once only a man’s world,” Zulficar said. “No more.”

Laos, in a landlocked backwater of Southeast Asia, is still a nominally communist country just beginning to break the habit of leaving everything to central planning. There are no local NGOs in Laos yet, so there outsiders such as the UNFPA or regional partners of the International Planned Parenthood Federation have been working with the Lao Women’s Union, a government-appointed body. Slow but steady progress in women’s reproductive health in Laos shows signs of invigorating the women’s union and strengthening the position of the most innovative of its officers.

The absence of local NGOs is a limiting factor in the development of grassroots women. There is only so much government agencies, however decentralized in recent years, can do on limited budgets. Self-help is not yet encouraged.

This situation cannot last, least of all because Laos knows that it could face a growing AIDS crisis because of the high incidence of the disease in neighboring Vietnam and Thailand, both exporters (and now importers) of prostitution and because large construction projects and more road traffic in Laos bring in migrants looking for sex locally, putting young Lao women at risk.

Officials on the National Committee for the Control of AIDS, which works across relevant government departments, say that they are very concerned about the growing mobile population. The government-run national radio has introduced a weekly call-in show to talk about these issues, and is introducing HIV-AIDS awareness programs in schools. A storefront youth center has opened in the Laotian capital, Vientiane, to provide information, counseling and some contraceptive supplies.

The African experience has shown that nongovernmental organizations are often critical to the success of reaching truck drivers and other itinerant laborers. Independent groups are a multiplier factor when resources are scarce. If the fear of AIDS has made plain talk about sex possible for the first time, as officials say, it may also lower barriers to the formation of private groups with expertise to offer. Many Lao men and women are learning to work with such groups from outside the country – Planned Parenthood Australia and Population Services International, based in Washington, D.C., are two.

John Deidrick is PSI’s representative in Laos, and he is hopeful. He has plenty of condoms to sell at low cost or give to the government to distribute free. He still gets help from the United States Agency for International Development because the organization has not run afoul of the “global gag rule” that bars American assistance to organizations that are thought to be in any way involved with abortions.

Laos, he said in a conversation in Vientiane, has no red light districts, gargantuan massage parlors or gay bars, so the sex industry is not large in any organized sense as in Thailand. The problem of AIDS is still manageable. While there are no local NGOs in the field yet, there are enough international ones willing to help.
“We have a great opportunity here,” Diedrick said. “This is one country where the NGOs and the government can make an intervention before it’s too late.”

In Ghana, Richard Turkson, executive director of the National Population Council, links the importance of decentralized government – something to which Laos has also committed itself – to the indispensability of local partnerships. Quoting the scholar Ali Masrui, he says that “Whereas the Western world is looking for a path to the moon and beyond, we in Africa are still looking for a path to the village.”

Although many African NGOs “exist only in a briefcase” and need strengthening, Turkson said, they should be encouraged to build bridges to government programs, as religious leaders and some private businesses are beginning to do.

“The ICPD dwells on partnerships as a key to sustainability,” he said. “Donor funding won’t be there forever. Partnerships with NGOs are very important simply because NGOs are able to reach populations. They can be innovative. They don’t shy away from controversial topics. They are not afraid of the soap box. We need them.”

Cited from: Coalitions At Work, Countdown 2015: Personal Stories from Around the World, Barbara Crossette, Media Center, UN Foundation, 2004.