Arrested development

Improving maternal and child health by promoting the Islamic concept of responsible parenthood 

Arrested development
In Pakistan, according to the National Nutrition Survey Report (2011), 38% of children are malnourished as they do not have access to nutritious and affordable food. Another 45% of children less than 5 years of age are stunted, 11% are wasted, and 30% are underweight.

About 14% of women are undernourished and 51% are anaemic due to a lack of a proper diet and repeated pregnancies. Nearly 37% of women are giving birth to a child in an interval of less than 2 years after the preceding birth, thereby, increasing the risk of pre-term births and underweight babies who face far greater odds of early death.

Repeated pregnancies are also contributing to the high number of maternal deaths. On average, each woman in Pakistan gives birth to 3.8 children whereas in Iran, Malaysia, Turkey, Bangladesh, Indonesia, Saudi Arabia, Kuwait, UAE and Qatar, the average is less than three children as cited by United Nations Population Division in 2013.
About 14% of women are undernourished and 51% are anaemic due to a lack of a proper diet and repeated pregnancies. While 45% of children less than 5 years of age are stunted, 11% are wasted, and 30% are underweight

As a result of repeated pregnancies, 14,000 mothers die each year in Pakistan whilst giving birth. In comparison, women in several other Muslim countries face far lower risk of pregnancy-related deaths. According to estimates prepared by the World Health Organization, the United Nations Children’s Fund, the United Nations Population Fund, in 2014, the annual maternal death toll is only 6 in Qatar, 9 in Kuwait, 89 in Saudi Arabia, 340 in Iran, and 150 in Malaysia.

Pakistan’s appalling maternal and child health statistics clearly indicate that, far from adding healthy and productive citizens to our society, we are in fact merely enlarging the pool of illiterate, weak and poverty-stricken masses. The fact that 25 million children are out of school and out of 1,000 children born, 55 die within the first month after birth bears testimony to this reality. Each of these deaths is totally unacceptable in an Islamic society.

Islam clearly outlines and emphasizes the rights of all family members including the husband, the wife and children and lays out the foundation of a healthy, harmonious and peaceful family life. The Holy Quran enshrines the prerequisites and obligations of couples before and after marriage and also goes on to define what one should aspire to achieve as an outcome of marriage.

In verse 74 of Surat Al-Furqan in the Holy Quran, the Almighty enjoins the believers to pray: “Our Lord, grant us from among our wives and offspring comfort to our eyes and make us an example for the righteous.” (25:74) Truly, solace to the eyes can come from children and wives who are healthy, educated and pious ‘momins’ (believers). To achieve this end, the Holy Quran stresses the need for proper premarital planning and preparations. According to verse 33 of Surat An-Nur in the Holy Quran: “But let them who find not the means [wherewithal] for marriage abstain [from sexual relations] until Allah enriches them from His bounty.” (24:33)

Marriage in Islam is seen as a sacred obligation that has to be fulfilled with responsibility and, therefore, cannot be taken lightly or casually. Only those individuals must enter into the contract of marriage who, according to the Holy Quran, have by the grace of the Almighty, attained a state of being “ghani,” i.e., have the means to be financially independent or well off in order for them to be able to pay the dower and afford the requirements of marital life i.e the ability to clothe, provide shelter and security to the family (referred to as ‘Nafkah’ in Islamic jurisprudence). In order to be “ghani”, the head of the household has to have a secure and proper source of livelihood. Until that status has been achieved, the Holy Quran prescribes the practice of abstinence and remaining chaste.

According to a Hadith of the Prophet Muhammad (PBUH) in such situations, one should keep fasts, as fasting compels one to be patient and pious (as quoted by Abdullah ibn Mas’ud RA). Through the above verse, Islam lays the foundation of responsible parenthood. In our age, responsible parenthood implies “the will and ability of parents to respond to the needs and aspirations of their family and children by providing them with proper care and supporting them in attaining the best possible future”. This also includes a responsible determination of the number, spacing and timing of their children.

In Surah Al-Baqarah, verse 233, the Holy Quran ordains mothers to breastfeed their children for two years: “Mothers shall suckle their children for two whole years; (that is) for those who wish to complete the suckling.” (2:233). This right of the child to be breastfed for a prolonged period of two years is not only nutritionally and immunologically beneficial for the child but also enables couples to space their pregnancies by delaying conception. Birth spacing is a potent means to lower maternal and infant mortality as it protects the mother and the child from the risks of repeated pregnancies.

Fortunately, there is now a growing consensus among the prominent ulema of the country that birth spacing is not contrary to the teachings of Islam and that they are willing to play their role in widely spreading this message. Globally, there is also now an increasing trend of involving faith-based organizations in changing behaviours and adopting healthy lifestyles.

By more widely spreading the correct Quranic concept of the rights of mothers and children  we can improve the health of our people and families as a whole.

The writer is a public health specialist working in the development sector