In many developing countries, national health systems don’t always effectively reach certain groups of people with the information and services they need to stay healthy. Too often, the health services that are available are designed without sufficient regard for the cultures, beliefs, and traditions of those they aim to reach, and the result is that essential information doesn’t get through to its intended audiences, and that urgently important health services don’t get utilized. Many members of particularly marginalized groups — which can include teenagers who have left school or their home villages to seek work in the city, or indigenous populations living in poor, underserved rural communities — don’t know what they need to know about their sexual and reproductive health, and are particularly vulnerable to HIV infection.
FCI works with our local partners to address this challenge by developing culturally-sensitive programs for reaching vulnerable groups with the information and services they need. Working with out-of-school young people in the port city of Mopti, on the Niger River in Mali, West Africa, and with women and young people in remote indigenous villages in Ecuador, we have partnered with Interarts, with support from the Spanish Agency for International Development Cooperation (AECID), to promote sexual and reproductive health and prevent HIV.
In mid-February, Fatimata Kané, FCI’s country director in Mali, and Maritza Segura, our national coordinator in Ecuador, together with representatives from our local partner organizations, presented this work at a conference in Barcelona, Spain. This meeting, entitled “Culture and Sexual and Reproductive Health—towards a new interconnection: A day to think, discuss and act,” was organized by Interarts as an opportunity for 50 NGOs, development agencies, migrant organizations, health workers, anthropologists, and educational professionals to share best practices and exchange ideas on the links between cultural rights, sexual and reproductive rights, and health. Meeting participants emphasized that integrated programs must focus on community needs, guarantee health rights, and respect local cultures and cultural rights. Understanding a community’s culture is essential to any health project’s success and sustainability, and is particularly important in efforts to modify behaviors that may have a negative impact on sexual and reproductive health, enabling programmers to identify bottlenecks and address issues in a participatory way.
For the Barcelona conference, the representatives from FCI-Mali and FCI-Ecuador were accompanied by youth leaders from FCI’s project partners: AEJT (the Association of Working Children and Youth) in Mopti, Mali, and Ecuarunari (the Kichwa Confederation of Ecuador). The team from Mali described their work with young people in Mopti’s ‘informal sector’ (domestic workers, market vendors, artisanal apprentices, etc.), and with the traditional leaders, employers, and parents who can influence them, to raise awareness about the consequences of negative and high-risk practices and to encourage cultural change for better sexual and reproductive health. (At first, taboos about discussions of sexuality made it difficult to involve religious leaders in the project; by sensitively integrating culture and religion into our approach, however, FCI was able to facilitate constructive dialogue by showing that religious texts do not actually support female genital mutilation and other negative practices.) The team from Ecuador discussed their work with indigenous women’s and youth groups to identify the traditions, beliefs, and cultural factors that lead to increased vulnerability to HIV, and to strengthen cultural values that can help prevent HIV and its attached stigma in indigenous communities.