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A Marie Stopes nurse explains to mother-of-three Kadidja Toudjani how a contraceptive implant works in Niger's village of Libore, about 20km southeast of the capital Niamey, Niger November 2, 2017. REUTERS/Tim Cocks(reuters_tickers)
By Tim Cocks
DAKAR/LIBORE, Niger (Reuters) - Mabingue Ngom, the head of the U.N. Population Fund in West Africa, knows that if he wants to cut birth rates he can't ignore religion.
Population experts like Ngom are worried that if West Africa's population continues to grow at its current pace - the region has the highest birth rate in the world - it will drive fiercer competition for scarce water and farmland, and fuel malnutrition, conflict and ever more economic refugees.
West African governments, U.N. agencies and charities also want to cut maternal mortality rates, which are higher in West Africa than anywhere else in the world, according to U.N. Population Fund (UNFPA) figures.
(Family planning in West Africa - http://tmsnrt.rs/2zWftuY)
But imams who follow the puritanical Wahhabist form of Islam and some traditional religious leaders across the region regularly preach against the use of contraception, saying Western nations are pushing birth control because they fear being outnumbered by Africans.
Some imams cite a passage in the Koran imploring Muslims to "go forth and multiply", and family planning is seen by many in the region as a Western plot to curb the spread of Islam.
"The West's policy is about reducing our numbers," said Hassane Seck, an imam in Dakar influenced by the Wahhabist tradition. "Because of their perverse promotion of contraception, women in Europe are no longer fertile, but ours are. There are going to be many more of us, and they're afraid.".
To counter that message, population experts are trying to co-opt moderate clerics.
Which is why, at a meeting in September with half a dozen senior Senegalese clerics, Ngom avoided the issue of overpopulation and focussed on values espoused in the Koran: the need for better maternal health and the need to ensure parents have resources to feed and educate their children.
"You can come with your Powerpoint and make nice speeches and achieve nothing. People will be even more hostile," he told Reuters. "If you want to change things, you have to engage them."
After listening to Ngom speak, Bou Mouhamed Kounta, deputy head of Senegal's Islamic Supreme Council, warned that family planning in Senegal was taboo. But, he added: "We are ready to work with you, because I can see that UNFPA respects religion."
For planners worried about growth rates, the starkest case remains Niger, a poor country stretching into the Sahara desert. According to U.N. projections, its population will triple by 2050 to 72 million, yet because of frequent droughts it already struggles to feed its people.
The fertility rate in Niger has been the highest in the world for the past decade and has been above 7 children per mother for a quarter of a century, according to U.N. figures.
More than one in five women are married by the time they are 19 and for every 100,000 births in Niger, 553 mothers die. In neighbouring Chad, the maternal mortality level is 856 per 100,000 births. It is only 12 in the developed world.
Attempts by Niger to lower its birth rate have been fiercely resisted by traditional leaders - known as marabouts - and some imams. Measuring the extent of Wahhabist influence in West Africa is hard, but they control many of the region's most strategic mosques, such as the main university houses of worship in Senegal and Niger.
On Niger's religious TV stations, preachers promise hellfire for anyone practising family planning. At a large mosque in the southern city of Maradi, an imam denounces contraception as a "plot by the whites to reduce us", two reproductive health workers based there, who declined to be named, said.
When UNFPA and Niger's President Mahamadou Issoufou tried to introduce sex education in schools in 2015, angry mobs burnt the text books outside U.N. offices. Three years earlier a bill banning girls being taken out of school for marriage provoked such a backlash it had to be axed.
Back then, Ngom wondered whether decades of telling Africans they were having too many babies was counterproductive. He decided the family planning message needed to be nuanced and has held dozens of meetings with moderate imams, always wearing a bubu, the traditional Muslim robe of his native Senegal.
"In a world of suspicion, of mistrust, how you put things is more important than the issues themselves," he told Reuters in Dakar. "You need to know your audience."
Atamo Hassane, head of Niger's family planning unit, agrees.
"To 'limit' or 'reduce' population, those are two words you just can't use," Hassane told Reuters in Niger's capital Niamey. "If you do, every marabout ... is going to be against you."
He said using family planning to space out births won't be enough to tackle population growth but hopes that once people start to use contraception they will see the benefits, use it more, and birth rates will then start to fall.
Other moderate clerics include Sheikh Ali Ben Salah, Niger's former minister of religious affairs.
"Islam is clear: you can't just have children without considering how you're going to feed, clothe and educate them," Salah told Reuters at a conference on child marriage in Dakar.
"So family planning is part of Islam. The problem only comes if you want to stop at a certain number."
UNFPA had a breakthrough in July when Chad's highest Islamic authority hosted a symposium with the U.N. agency and 1,200 regional religious leaders - unprecedented for the subject of family planning.
"I told them family planning will reduce maternal mortality by a third. Who doesn't want to do that?" Ngom said.
Cheikh Abdeldahim Abdoulaye, secretary general of Chad's Supreme Council of Islamic Affairs, told Reuters he had backed the U.N. programme because the Koran permitted the spacing out births, primarily for the sake of better maternal health.
'CHILDREN GOD WANTS'
Aminatou Bakah, a Nigerien aid worker for charity Marie Stopes International, which provides contraception and family planning advice in 37 countries, said they had long struggled to shake off the idea they were a tool of Western interference.
"They called us 'Marie Stop', because we want to stop people having children," she said. "We had to explain that, no, we want to help you plan, not just get pregnant by pure chance."
At a pop-up clinic run by the charity in Libore, 20 km (13 miles) outside Niamey, mothers with young children wait for advice on contraceptive methods.
In the village of jagged acacia trees, clay houses and a mosque, all nine of the mothers interviewed by Reuters said they didn't want to have fewer children and were using contraception only as a temporary reprieve from child birth.
"I would have 15 children if that's what God wants," said Rahinatou Kadri, 24, a mother of four.
Her husband, who is an imam, has two other wives, the oldest of whom has 16 children, she said. Keen not to be outdone, when her husband said he wanted another child, Kadri dutifully came back to have her contraceptive implant removed.
"Our religion doesn't permit us to stop having children," said Mariane Hamadoun, 34, a mother of five.
Thanks partly to such views, the birth rate in some African countries has defied predictions that it would fall as the continent gets more prosperous, as has happened in Europe, Asia and the Americas.
But attitudes may be changing. Lamodi Soulye, 39, a devout Muslim and worker in a Chinese restaurant in Niamey, was one of 28 siblings from one father and three different mothers.
He remembers occasionally going hungry, and dropping out of school with only basic primary education.
"My father lacked the resources to keep us," he said. "I decided not to do the same thing to my children."
He plans to stop at three.
(Editing by David Clarke)