Steve Fouch

Putting faith in global healthcare

Steve Fouch is CMF Head of Communications. He has worked in community nursing, HIV & AIDS and palliative care. He serves on the International Board of Nurses Christian Fellowship International.
The views expressed do not necessarily reflect those of CMF.


drinking_waterI have long argued on this blog that there needs to be a greater engagement with faith based organisations and faith communities in health care planning and delivery in the UK and around the world. It is always encouraging when the wider medical community says the same thing back to you!

Yesterday, the Lancet launched a series of papers on the role of faith groups in the delivery of healthcare. A launch event was held in Washington DC as part of a wider conference on the role of religion in delivering on the about-to-be-launched Sustainable Development Goals (or SDGs).

Evidence for the breadth and depth of religious organisations’ engagement with health and healthcare is sketchy. Jill Oliver’s paper explored the gaps in this knowledge. Almost certainly in Sub-Saharan Africa faith groups do play a significant role, but the evidence suggests it may not be quite as big as some say (estimates go from 20-50% of all healthcare provision, but this is almost certainly inaccurate), and the quality is not always as good as some would proclaim. However, there is evidence that especially Christian mission hospitals and church based health programmes are more prevalent in poor rural communities that are less well served by government and private services. Furthermore, there is also evidence that the overall patient satisfaction with the care received is higher than for secular providers. But there is little known about the role of non-Christian religious healthcare in the rest of the continent, let alone that provided in Asia and other regions of the developing world.

The role of faith communities in health has become increasingly controversial. Issues around sexual and reproductive health (SRH), abortion, female genital mutilation (FBM), immunisation, harm reduction, violence against women, HIV, stigma, sexuality and gender have all created tensions for secular bodies working with faith groups. Missionary work, with an emphasis on sharing faith also creates problems for secular bodies, and engagement with faith practices and spirituality is something of a blind spot. Yet there have been many instances in all of these areas where a constructive engagement between governments, international bodies such as the WHO, secular NGOs, faith based organisations (FBOs) and faith communities have led to effective partnerships to tackle these and other health issues. The plea from Andrew Tomkins’ second paper is very much for a greater faith literacy amongst secular bodies and for a greater health literacy by faith leaders.

How do we work together better then? We are facing a potentially significant turning point in global health and development, with the official launch of the Sustainable Development Goals (SDGs) in New York this September. Goal 3 – ensuring health lives and promoting well-being for all at all ages, is one that could see a significant increase in access to affordable, appropriate healthcare for the world’s poorest people. The third paper in the series by Jean Duff argues that governments will need to engage with Civil Society to achieve this, not just in healthcare delivery, but in wider public health measures. This will mean in many (if not most!!) nations a significant engagement with faith groups. Faith beliefs affect health, faith communities bring people together and communicate ideas and values that affect health in the wider community, faith based organisations are actively engaged in health care work at primary, secondary and even tertiary levels. Not every faith group will work with secular bodies, not every religious entity will be appropriate to work with. But where we have common ground and common interest in the well-being and human flourishing of our communities, we have to work together.

The key message that comes across from this Lancet is that, with more than 80% of the world’s population adhering to one or other religion or spiritual tradition, the impact that religion and religious practice can have on health, and with FBOs being significant providers of healthcare, the indifference or active hostility towards us from some in the development and global health communities is, frankly, counterproductive. There will be some, hardcore sceptics and secular ideologues who will decry this, but the evidence against their position is mounting, and theirs is becoming a more marginal viewpoint. There has long been a plea for greater faith literacy among secular institutions and media in the West, and a growing recognition of the role that faith is increasingly taking in the modern world, for good and ill. Religion is not withering on the vine, it is flourishing, changing and engaging with the modern (or post-modern) world.

Christians have been engaged with health issues since the first century. Care for the sick, the vulnerable and the dying is an integral expression of our faith. It may be an expression that the Western church and missionary movement has forgotten in the last sixty or seventy years, but in so many parts of the world it is still a vital part of the life, worship and mission of the church. While we may not always agree with all the agendas of secular development agencies, UN bodies and national governments, on the whole we share the same concerns, and want to find common ground to work together. Yes, the churches need to become more literate in health and health needs, in the ethics of healthcare, and the role of health in the worship and mission of God’s people. But we also need the secular institutions to stop ignoring or side-lining the work we do.

Churches and church hospitals are often the only local infrastructure in many poor communities – we were there long before the donors, with their three to five year funding cycles turned up, and will be there long, long after they have gone off after the next new priority to occupy them. We were working for the health of women and children, the dying, people living with HIV, those suffering the mental and physical scars of war and intercommunal conflicts long before the MDGs were agreed, and will be long after the SDGs will be wrapped up in 2030.

Posted by Steve Fouch
CMF Head of Nursing



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