[Individual articles from the Fall 2016 issue of Intersections will be posted on this blog each week. The full issue can be found on MCC’s website.]
Churches have long functioned as leading actors in healthcare provision. Today, faith-based organizations (FBOs) have a high profile within the changing healthcare landscape, both in the United States and beyond. This article assesses FBO roles in healthcare and the opportunities for FBOs to improve health outcomes for the most vulnerable. Not only do FBOs draw upon healthcare practitioners motivated by religious conviction to care for the sick, their connections with congregations and other local faith
communities provide them greater access to economically and socially marginalized communities than government or for-profit health providers often have, positioning them to positively influence healthcare outcomes in those communities.
Different factors impel individuals and groups to care for the sick and vulnerable. Historians contend that many early healthcare institutions, in contrast to profit-driven systems, were motivated by faith commitments that mandated followers to care for the poor and heal the sick (Risse, 1999). The care provided in these early hospitals prompted the Roman emperor Julian to remark: “Now we can see what it is that makes these
Christians such a powerful enemy of our gods. It is brotherly love which they manifest toward the sick and poor.”
In many countries, healthcare over the past 40 years has shifted from a social service for the most vulnerable to a trillion dollar, profit-driven industry. Amidst this shift, however, faith-based health services have continued to provide an important gateway of care for economically and socially marginalized communities around the world. In many developing countries, faith-based health services provide up to 70% of healthcare to
the most vulnerable (WHO, 2007).
Core values that drive Christian FBOs are compassion and love for one’s fellow human beings created in God’s image, human beings in whom Christ is encountered (Matthew 25). These values shape an understanding of discipleship as including “consciousness of others’ distress together with a desire to alleviate it” (Neufeldt, 2011). These motivations for Christian health services have not necessarily changed over the years. However, the complexities for FBOs in providing access to care have increased dramatically as they not only navigate relationships with the public healthcare sector (government-run hospitals, clinics and more), but also face the rapid growth of the for-profit healthcare industry.
One response of healthcare FBOs has been to undertake more collaborations with the public healthcare sector, collaborations that build on the distinctive strengths of both partners. The public healthcare sector has financial, material and political resources that are critical to the development and implementation of health services, especially to marginalized communities. Likewise, the faith-based sector has a reputation for successfully mobilizing communities to action by leveraging their engagement and trust. As churches and FBOs collaborate with the public sector, there is an increased possibility for success. In the Democratic Republic of Congo, for example, the Congolese government
partners with faith-based hospitals (many of them initially founded by foreign mission agencies and then later turned over to the control of Congolese churches) to implement national health priorities and extend the state’s ability to provide healthcare to isolated communities: Congolese Mennonite hospitals, with support from MCC, have been part of such efforts. Public healthcare institutions and the faith-based healthcare sector need one other and increasingly recognize the wisdom in collaboration. Ray Chambers, a United Nations Special Envoy, has acknowledged that ambitious global health targets such as the Sustainable Development Goals “would simply be unachievable without the engagement of the faith community” (quoted in Duff and Buckingham, 2015).
One method of improving health outcomes at the community level is through the implementation of care groups. The care group approach is a community-based strategy for promoting behavior change by engaging local health educators. Groups are made up of ten to 15 volunteers who regularly meet together with FBO staff for training and supervision. Care groups create a multiplying effect to equitably reach targeted households with activities aimed at promoting specific health behaviors (such as getting one’s children vaccinated and adoption of breastfeeding). The community-based volunteers who are central to the care group model are enmeshed in the lives of target communities and are thus well positioned to catalyze and reinforce the creation of new community health norms.
Churches and other local faith communities are typically key sources of volunteers for the care group model. Relationships fostered among care group volunteers and their neighbors in targeted communities are activated through the care group model to create more durable change in health behaviors. A review assessing the effectiveness of community-based interventions using care groups to promote maternal and child health
and nutrition has shown the benefits of such approaches when it comes to reducing maternal illness, stillbirths and newborn deaths (Lassi, 2010). These positive impacts can be traced to changes in household behaviors and practices, such as improved tetanus immunization rates, use of clean birth kits, facility births, early initiation of breastfeeding and seeking care for newborn illnesses.
Through the new Luann Martin Legacy Fund initiative in eastern Africa, MCC is partnering with local Anabaptist groups and other faith-based organizations who are adopting the care group model to promote maternal and child health and nutrition. Projects in this initiative will mobilize volunteers in local faith communities to participate in care groups
resourced by FBOs that promote new health behaviors among pregnant women and mothers of newborns and young children. FBOs participating in this initiative will give particular attention to how the volunteer-based care group health promotion activities intersect and collaborate with governmental health departments so that care group efforts help meet national maternal and child health and nutrition goals.
The effort to build healthy communities around the world, especially for vulnerable groups and those in crisis, will require the collaborative efforts of the faith-based and public healthcare sectors. Leveraging the trust and reach of churches and faith communities is an essential element in the ongoing efforts to increase positive health outcomes for economically and socially marginalized communities.
Beth Good is MCC health coordinator and lives in eastern Congo.
Learn more:
Duff, Jean F. and Warren W. Buckingham. “Strengthening of Partnerships between the
Public Sector and Faith-Based Groups.” The Lancet 386/10005 (2015): 1786-1794.
Lassi, Zohra S., Batool A. Haider and Zulfiqar A. Bhutta. “Community-Based Intervention
Packages for Reducing Maternal and Neonatal Morbidity and Mortality and Improving
Neonatal Outcomes.” Journal of Development Effectiveness 4/1 (2012): 151-187.
Neufeldt, Aldred H. “An Ethos of Faith and Mennonite Mental Health Services.” Journal of Mennonite Studies 29 (2011): 187-202.
Olivier, Jill, et al. “Understanding the Roles of Faith-Based Health-Care Providers in Africa: Review of the Evidence with a Focus on Magnitude, Reach, Cost, and Satisfaction.” The Lancet 386/10005 (2015): 1765-1775.
Risse, Guenter B. Mending Bodies, Saving Souls: A History of Hospitals. New York: Oxford
University Press, 1999.
World Health Organization (WHO). “Faith-Based Organizations Play a Major Role in HIV/AIDS Care and Treatment in Sub-Saharan Africa.” February 8, 2007. Available at
http://www.who.int/mediacentre/news/notes/2007/np05/en/.
Luann Martin Legacy Fund announcement: https://mcc.org/stories/mcc-receive-1-million-legacy-gift
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