In 2013, Ministers of Health and Education signed up to work collaboratively in the next seven years to meet the targets of the ESA Commitment. Targets 1, 3 and 4 seek to eliminate new infections, reduce early and unintended pregnancies among young people by 75%; and to eliminate child marriage, respectively. Yet writes Vitalis Chipfakacha, a Public Health Specialist, policies and programmes in east and southern Africa are still to fully incorporate perspectives on culture and harmful traditional practices.
Culture is shared patterns of behaviour, interactions, cognitive contracts and understandings that are learned through socialisation. Culture can also be defined as a collection of learned and easily identified beliefs and practices shared by groups of people, which guides their decisions, thinking and actions in a patterned way. Culture is a set of customs, traditions and values of a society or community such as ethnic group or nation. Culture also includes religion, cuisine, social habits, beliefs, music and the arts.
Cultural determinants have not been included in Sexual and Reproductive Health (SRH) and HIV programming despite the important role they play in people's behaviours. Recent research publications acknowledge the influence of religion and culture on sexual and reproductive behaviour and health-care utilization(1,2). Some researchers even go as far as hypothesising that religious and cultural influences can partly explain disparities in sexual and reproductive health outcomes. Salient cultural practices may put communities at serious risk of contracting sexually transmitted infections (STIs) including HIV.
Despite the efforts invested by governments, donors and others to reduce the burden of disease including HIV, they are still to achieve the desired effect. Gender based violence is still on the increase, teenage and unwanted pregnancies are of the rise, and HIV incidence and prevalence although drastically reduced is still a problem in many countries of Sub-Saharan Africa. This indicates a need for new development approaches that take into consideration the cultural beliefs and practices of the people. It must be recognised that sexual practices in any society are linked to socio-cultural life of communities including culture, customs and habits. However, most of the education materials we have used so far for our SRH and HIV training have Eurocentric bias and do not take into consideration the customs and beliefs of the beneficiaries of this education. We urgently need robust debate and creative new approaches that address the practices below. These are selected examples there are many more that need further investigation. I must stress upfront that there are both positive and negative aspects to these cultural practices. In fact, some initiation practices could actually serve as useful entry points for comprehensive sexuality education to adolescent boys and girls.
Common Cultural Practices that may play a role in sexual and reproductive behaviours. SADC Region:
Vitalis Chipfakacha- vchipfakacha@yahoo.com
{1) “Understanding the Role of Culture in Sexual and Reproductive Health in Mozambique”,Mdgfund. 2010 (www.mdgfund.org); {2) Thomas Bisika, “Cultural Factors that affect sexual and reproductive Health in Malawi. Journal of Family Planmning Reproductive Health Care 2008 34(2)