ABOUT - NATURE OF THE WORK

"Though often hidden from Western view, religion is so overwhelmingly significant in the African search for wellbeing, so deeply woven in the rhythms of everyday life, and so deeply entwined in African values, attitudes, perspectives and decision-making frameworks that the inability to understand religion leads to an inability to understand people’s lives." - Steve De Gruchy, 2006

Nature of the Work

When ARHAP was launched in 2002, it was necessary to argue for the importance of religion in the public health and development landscapes. This centered on the often substantial impact of religion in people’s health decisions, and on the lack of visibility to formal health systems of religious entities despite their contribution at the local level. The resultant lack of an alignment between public facilities and religious entities working in health and development is seen as an obstacle to enhanced health outcomes.

The initiative was born to better understand and mobilize religious health assets globally for the health of the public – and critically understood health to be a powerful lens on broader development concerns.

ARHAP/IRHAP has evolved over time to include a deliberately diverse body of people – individuals and institutions from Africa, in the USA and Europe, each with her or his own disciplinary expertise and practical background. What binds this group is a common commitment to a cause: altering the conditions, policies and practices that block the achievement of healthy people in healthy societies, based on a common hunch – that religious entities and religious health assets are an important clue to that end. And equally central, a common conviction – that no one person, discipline, institution or angle of inquiry is sufficient, and that, whatever the difficulties, a profoundly collaborative enterprise is not a luxury but an essential requirement for any advance.

Given that the required theory and conceptual framework for such engagement was largely missing – it was also assumed that any adequate response to this gap would require working from the ground up, from the actual conditions of communities in various societies and the complex ways of thinking and being that members of communities live by.

IRHAP seeks to develop a systematic evidence base of religious health assets (RHAs) to align and enhance the work of religious health leaders, public policy decision-makers and other health workers in their collaborative efforts to meet the challenges of development, and to promote sustainable health, especially for those who live in poverty or under marginal conditions. The diverse range of interests can be broadly captured by the question:

What potential lies in religious entities and the assets they hold, tangible and intangible, for enhancing the health of the public, especially where health systems are in crisis or collapsing as the challenges increase and the hopes of medical science and the public health movement of the twentieth century are regularly thwarted?

Guiding Assumptions

Importantly, this work begins with a positive view of faith-inspired initiatives in health in the first instance, hence the description of them in terms of 'religious health assets', which is understood much more broadly than the more traditional focus on facilities such as hospitals and clinics. At the same time, a naïve view of the role of religion would undermine our grasp of the necessary social realities; hence, we recognize the need to balance the positive with a clear grasp of the limits and possible negative impact of religious traditions or faith-based practices in particular contexts.

We are interested in focusing on what these religious health assets are, how they work, and what potential exists for strengthening them without undermining the very things they offer or destroying them through inappropriate interventions or engagements.

We see the work of IRHAP, like that of ARHAP, as vitally engaged in the emergence of a much needed contemporary movement of people, groups and institutions that are rethinking the potentially transformative role of religion and religious entities in health and development. Cognizant of the ways in which religion and religious entities may act that does not enhance the health of the public, IRHAP nevertheless seeks that which is generative about them, that which already or potentially, in a myriad local and trans-local contexts, positively contributes to the health of all

Certain assumptions have guided this collaboration from the outset:

That religious entities are widely present on the ground in many contexts where health crises are most urgent
That no matter how impoverished, under-resourced or isolated such religious entities might be, they nevertheless represent or contribute major assets to health in their contexts
That these assets are both tangible and intangible
That they have a public impact on health (besides providing particular health services)
That they need to be understood in relation to each other, as part of a complex and significant social reality
That properly assessing, appreciating and enhancing their potential will produce better alignment between public health interventions and the religious structures with which they might partner

Objectives

IRHAP’s overall objectives are as follows:

To strengthen baseline information and evidence of religious health institutions, networks and communities
To articulate conceptual frameworks, analytical tools, and measures that will adequately define and capture religious health assets from multiple perspectives, across geographic regions and different religions, in order to align and enhance the work of religious health leaders and public policy decision-makers in their collaborative efforts
To develop a network that will include nodes of scholars, practitioners, religious as well as public health leaders
To build capacity in future leaders of both public health and religious institutions
To provide evidence to influence health policy and health resource allocation decisions made by governments, religious leadership, inter-governmental agencies and development agencies
To disseminate and communicate results and learnings widely and regularly

Pushing the Research Agenda and Theory Building

The relationship between religion and health at the individual level is increasingly well researched and understood. However, the understanding of community and institutional relationships between religion and health is still at a nascent stage.

The needs and potential opportunities for intervention are dramatic, but it is not very clear what organizational and cultural assets exist that can be built upon. The potential that many assume for mobilizing religious health assets and bringing them to scale is only beginning to be systematically studied.

The tendency in the literature and the dominant social science models is to treat 'religion', and by implication 'religious health assets', as a sub-category of some other set of categories — e.g. economic, anthropological, sociological categories. While this approach must inform our work, there is reason to believe that the social sciences generally are 'religion-blind'. Hence, most criteria and categories used to study religion look for something quantitatively measurable and 'objectively' present. Alternatively they seek something that is derivative of another social dimension, e.g. the economy, or a cultural tradition.

What is largely missing from most studies that might inform our work is the dimension of religion that is 'internal' to faith based communities or organizations, an element that explains their motivations, commitments, attitudes, actions and relational or associational strengths on the basis of their own self-understandings and world-views. This dimension is harder to take into account in defining religious health assets, particularly in any way that makes for easy identification, replicability and generalization — the requirements of a mapping process that would be useful to policy makers and other decision makers. However, the magnitude of the HIV/AIDS pandemic has already forced decision makers to try to engage all aspects of these assets as agencies struggle to plan expanded programs.

This necessarily complex approach makes demands on all aspects of religious health assets, including those traditionally countable and those that are obviously necessary (for example shared loyalties and care giving), but difficult to quantify.

This is precisely the research focus of IRHAP: To develop criteria and related assessment tools that will enable a richer, more dynamic and ultimately more productive approach to religious health assets and their contribution to health in Africa and elsewhere.

Guiding Question

The guiding research question for IRHAP can be broadly defined as:

In the context of major health crises (linked to environmental and social conditions), given the widespread engagement of faith-inspired organizations and initiatives in health activities, what criteria, categories and related assessment tools will engender a richer, more dynamic and more productive view on 'religious health assets' (RHAs), their contribution to health, and their alignment (or lack of it) with public health systems?