Governments around the world—including many in the Islamic world—support fami- ly planning programs to enable individu- als and couples to choose the

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Governments around the worldÑincluding many in the Islamic worldÑsupport fami- ly planning programs to enable individu- als and couples to choose the number and timing of their children. The development of modern contraceptives, organized family planning pro- grams, and international agreements on family planning have given new impetus to old debates: Are Muslim individuals and couples permitted to use family planning? Can governments be involved in providing family planning information and services? This report gives an overview of Muslim countriesÕ policies on and support for family plan- ning and modern contraception. It reviews Islamic jurisprudence and justifications for sanctioning family planning, drawing from Family Planning in the Legacy of Islam, written by the late Dr. Abdel Rahim Omran. 1The International Context Organized family planning programs that provide modern contraceptives and related services have become increasingly common worldwide in the last 40 years. These programs have aimed to improve the health of women and children and to slow population growth in countries where rapid population growth is seen as a barrier to socioeco- nomic development. The United Nations 1994 International Conference on Population and Development (ICPD) and the 2000 Millennium Development Summit called for universal access to family plan- ning information and services. Islamic countries attending the ICPD generally endorsed the confer- enceÕs Programme of Action with the reservation that they would interpret and adopt its recom- mendations in accordance with IslamÑa position necessary for Muslim countries to take the confer- ence recommendations home for implementation. The ICPDÕs Programme of Action focuses on human development and provides a holistic framework for slowing population growth and improving peopleÕs lives. The Programme calls for a wide range of investments to improve health, education, and rightsÑparticularly for women and childrenÑand to provide family planning services in the context of comprehensive reproduc- tive health care. A central recommendation of the Programme is universal access to a full range of safe and reliable family planning methods. IslamÕs position on family planning and the circumstances under which it can be practiced has a direct bearing today on how Muslim countries can achieve their development goals, including the ICPD goals. The ICPD Programme of Action acknowledges that the implementation of its rec- ommendations Òis the sovereign right of each country, consistent with national laws and devel- opment priorities, with full respect for the various religious and ethical values and cultural back- ground of its people, and in conformity with uni- versally recognized international human rights.Ó 2Muslims in the World Today About one-fifth of the worldÕs populationÑ1.25 billion peopleÑis Muslim. Muslims are diverse, varying by race, language, and the degree of their religious conservatism. Spread around the globe, some Muslims live in countries influenced or ruled by Islamic law and some live in countries with secular governments. ISLAM AND FAMILY PLANNING by Farzaneh Roudi-Fahimi POPULATION REFERENCE BUREAU This overview of Islam and family planning ispart of a series of PRB policy briefs on the Middle East and North Africa that analyze population, environment, reproductive health, and development linkages. The series aims to increase knowledge and discussion of popula- tion, health, and development issues. The viewsexpressed here are those of the author and the cited works and do not necessarily reflect the views of the Population Reference Bureau orits sponsors.

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Muslims represent the majority population in about 48 countries and territories clustered in Asia and Africa (see Table 1). Indonesia has the largest Muslim population of any countryÑnearly 193 million of its 219 million people (88 percent). India, the second-largest country in the world, has about 130 million Muslims, constituting 12 per- cent of its population. About 15 percent of IsraelÕs population is Muslim. The Family and Contraception In Islam, contraception is mainly addressed in the context of marriage and family. As a social system, culture, and civilization, Islam considers the fami- ly the basic unit of society. The Quran, IslamÕs holy book and the primary source of Islamic law or Shariah(see Box 1), views marriage as sacred and identifies the husband and wife as the princi- pals of family formation. The Quran has a number of references to marriage, including the following: And one of [GodÕs] signs is that He has created for you mates from yourselves, that you may dwell in tranquility with them, and has ordained between you Love and Mercy. AL-ROUM (SURA 30:21) It is He who created you from single soul and therefrom did make his mate, that he might dwell in tranquility with her. AL-AÕRAF (SURA 7:189) And God has made for you mates from yourselves and made for you out of them, children and grandchildren. AL-NAHL (SURA 16:72) These verses suggest that tranquility is an important purpose of family life and is achieved through marriage. Also, while procreation is expected in marriage to maintain the human race, sexual relations in marriage need not always be for the purpose of having children. On this point, Islam departs from some other religions where procreation is the exclusive purpose of sexual rela- tions. From the Islamic point of view, when pro- creation takes place, it should support and endorse tranquility rather than disrupt it. Thus, contraception helps families achieve tranquility by having children when they want them and when they are prepared to have them. Because of the importance of family in Muslim societies, legal scholars from various Islamic schools of jurisprudence (see Box 2, page 3) and from various locales have given considerable atten- tion to contraception. Justifications for Contraception in Islamic Legal Study Islamic scholars studying family planning have justified contraception in several ways. They have generally argued that Islam is a religion of moder- ation and point to the principles of ÒlibertyÓ or ÒpermissibilityÓ in IslamÑthat is, everything is lawful unless explicitly designated otherwise in the Quran or in the ProphetÕs tradition ( Sunnah). PRBMENA Policy Brief 20042Table 1Countries or Territories With Populations 50 percent or More MuslimPercentCountry or territory MuslimAfricaAsiaEurope 90% AlgeriaAfghanistan or moreComorosAzerbaijan DjiboutiBahrain EgyptCocos Islands GambiaGaza Strip LibyaIran MaliIraq MauritaniaJordan MayotteMaldives MoroccoOman SenegalPakistan SomaliaQatar TunisiaSaudi Arabia ZanzibarSyria TajikistanTurkeyUAE Yemen 70% – 89%GuineaBangladeshAlbania NigerIndonesia Kuwait Kyrgyzstan Lebanon TurkmenistanUzbekistan West Bank50% – 69%Burkina FasoBrunei ChadMalaysia Nigeria Sudan

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The Quran does not prohibit birth control, nor does it forbid a husband or wife to space preg- nancies or limit their number. Thus, the great majority of Islamic jurists believe that family plan- ning is permissible in Islam. The silence of the Quran on the issue of contraception, these juristshave argued, is not a matter of omission by God, as he is ÒAll-KnowingÓ and Islam is understood to be timeless. The proponents of family planning also note that coitus interruptus, or withdrawal, was practiced at the ProphetÕs time by his Companions. The majority of theologians from almost all schools of Islamic jurisprudence agree that withdrawal is permissible with a wifeÕs consent. In Islam, a wife has the right to both sexual pleasure and reproduc- tion. (Some jurists would argue that ejaculation is essential for a woman to have orgasm, and there- fore it is necessary to have prior consent from a wife before practicing withdrawal.) Dr. Omran concluded that, ÒIn all its institu- tions and regulations, Islam addresses itself to rea- son and keeps in harmony with manÕs natural character ( fitrah ). It never fails to demonstrate its great compassion for its people, nor does it ever seek to impose undue burdens and intolerable restrictions upon them.Ó Dr. Omran specifically referred to the following quotes from the Quran: Allah desires for you ease; He desires no hardship for you. AL-BAGARA (SURA 2:185)And has not laid upon you in religion any hardship. AL-HAJJ (SURA 22:78)Allah desires to lighten your burden, for man was created weak. AL-NISA (SURA 4:28)Thus, Islam would be sympathetic to family planning if spacing pregnancies and limiting their number made the mother more physically fit and the father more financially at ease, particularly since these actions do not violate any prohibition in the Quran or in the ProphetÕs tradition (Sunnah). If excessive fertility leads to proven health risks for mothers and children, or economic hardship and embarrassment for the father, or the inability of parents to raise their children properly, Muslims would be allowed to regulate their fertili- ty in such a way as to reduce these hardships. After reviewing various sources of Islamic jurisprudence, Dr. Omran developed a list of justifiable reasons under Islam for using contra- ception. Muslims may use contraception to: Avoid health risks to a breastfeeding child from the ÒchangedÓ milk of a pregnant mother;Avoid health risks to the mother that wouldresult from repeated pregnancies, short birth intervals, or young age; Avoid pregnancy in an already sick wife; Avoid transmission of disease from parents to their offspring;PRBMENA Policy Brief 20043Box 1 Sources of Islamic Law or ShariahFor Muslims, Shariahis the Divine Law; by virtue of its acceptance, a per- son becomes a Muslim, although he or she may not be able to realize all of its teachings or follow all of its commands. The Arabic word Ò ShariahÓ(referring to Islamic law) is derived from a root that means ÒroadÓÑsug- gesting that life is a journey through this transient world and the Shariahisthe road leading to God. For believers, Shariahis the guide of human action that encompasses every facet of human life. Thus, Islam is a religion that provides guidance for worship as well as a social system for MuslimsÕ public and private lives. The primary sources of Shariahare the Quran (IslamÕs holy book) and the Sunnah, the sayings and deeds of the Prophet Mohammad and his Companions. Also based on the Quran and Sunnahbut subordinate to them are two other sources for Shariah: the consensus of Islamic jurists and analogy. Islamic legal study relies on a series of interpretations or judgments based on the Quran and Sunnahthat are reached following strict proce- dures. Those who make it their profession to study the Quran, Sunnah, andthe procedures required to make religious judgments are qualified to make Islamic rulings (fatwas) after reaching a required level of knowledge and seniority. In declaring his fatwa, a qualified theologian is required to keep in mind some basic principles: Islamic rulings can change with changes in time and place, and the rulings should choose the lesser of two harms and preserve the public interest. Muslim scholars consider these principles when discussing issues related to family planning and contraceptive use. Since no single authority in Islam provides an exclusive interpretation of the faith, there are honest differences of opinion, including those related to family planning and contraception, that distinguish one school of jurispru- dence from another (see Box 2, page 4). For that matter, there are variations of interpretation and differences in opinion within each school, whereby a minority of theologians may express views and declare fatwasthat depart from the majority view of their school and coincide with views of other schools. In other words, the truth is not the monopoly of any one school. Muslims are encouraged to consider various opinions rather than restrict themselves to one school at all times. SOURCES: Abdel Rahim Omran, Family Planning in the Legacy of Islam (London: Routledge, 1992); and Seyyed Hossein Nasr, Ideals and Realities of Islam (Chicago: ABC International Group, 2000).

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PRBMENA Policy Brief 20044The schools of Islamic jurisprudence are called madhahib, which means ÒpathsÓ or Òways.Ó The schools represent different ways of interpreting Islam; they are not different religions, denominations, or churches such as those that exist in Christianity. All schools of jurisprudence consider the Quran and the ProphetÕs tradition ( Sunnah) as their primary sources. They differ only in relation to some interpretations, the validity of other sources of jurisprudence, and the methods of formulating a ruling. Mus lims are mainly divided into Sunni and ShiÕa. Two other groups of Muslims, the Kharijite and Zahirite, are very small in numbers and live in Oman, Algeria, Libya, and Tanzania. The Sunni Schools The great majority of Muslims in the world today belong to the Sunni schools of Islamic jurisprudence; they are found throughout the Islamic world. Sunnis were named as such because they adhere to the Sunnahof the Prophet Mohammed, including his say- ings, deeds, or tacit approval, as well as the example of his Companions. Although the Sunnis have great affection for the ProphetÕs descendants and relatives, particularly Ali and his son al-Husayn (grandson of the Prophet), they do not revere them, nor do they restrict Imamism to them exclusively, as do the ShiÕites. There are four Sunni schools, all of which are named after their founders:Hanafi.Followers are found today in most parts of the Islamic world. Hanafi was the official school of the Abbassids dynastyÑwhich ruled the Islamic empire from Iraq between 750 and 1258 A.D.Ñas well as the Ottoman Empire. Mali ki.Followers have spread to North Africa, Hijaz, and Andalus (Arab Spain). They are also now predominant in West Africa and western Sudan. Shafei.Followers have spread to most parts of the Islamic world, mainly Egypt, Iraq, Syria, East Africa, the Sudan, and parts of Asia. Hanbali.Followers are fewer in number than those of other Sunni schools but are similarly distributed. They had their center in Egypt and Syria. The ShiÕa Schools The ShiÕites (ÒShiÕa Ómeans Òthe inclinedÓ or ÓpartisansÓ) are devoted to Imam Ali, the cousin and son-in-law of the Prophet. The ShiÕa movement start- ed in the first century AH (after the hijra, or migra- tion of the Prophet in AD 622 from Mekkah to Medina) and agreed with the rest of the Islamic com- munity on every issue except that of Imamism. The ShiÕites believe that Imamism should belong solely to AliÕs descendants by Fatma, the ProphetÕs daughter. The leading contemporary ShiÕa schools are: Zaaydi. Two clusters have developed. The larger community lives in the northern regions of Yemen; the smaller cluster is found in Iran, particularly the northern section by the Caspian Sea. Twelve Imami. Followers of this ShiÕite madhhabare called Twelve Imamis or Ithna-Ashari because theyhave 12 Imams, the twelfth of whom it is believed disappeared and will return. This is the largest ShiÕite community, based mostly in Iran, Iraq, Syria, South Lebanon, Bahrain, Kuwait, Pakistan, Afghanistan, and India.Ismaili.The Ismaili ShiÕite school (or Seveners) restrict Imamism to descendants of Ismail, the son of JaÕfar al Sadig, the Sixth ShiÕa Imam. (The Twelve Imam is give Imamism to his other son, Musa al- Qazim.) Ismailis established several states, including the Fatimid Dynasty in Egypt, where they built the city of Cairo and Al-Azhar Mosque in AD 969. Despite 200 years of ShiÕite rule, however, Egypt remained Sunni. Al-Azhar has since become the citadel of orthodox Islam, mainly Sunni. In 1817, the Shah of Persia gave the Ismaili Imam the title of ÒAgh a Khan.Ó Followers now cluster in Africa, espe- cially in Zanzibar and Tanzania, as well as in Iran, Pakistan, and India. SOURCES: Abdel Rahim Omran, Family Planning in the Legacy of Islam (London: Routledge, 1992); and Seyyed Hossein Nasr, Idea ls andRealities of Islam (Chicago: ABC International Group, 2000). Box 2 Schools of Islamic Jurisprudence

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Preserve a wifeÕs beauty and physical fitness, thereby continuing the enjoyment of her hus- band, ensuring a happier married life, and keeping the husband faithful;Avoid the economic hardships of caring for a larger family, which might compel parents to resort to illegal activities or exhausting them- selves to earn a living; Allow for the education, proper rearing, and religious training of children, which are more feasible with fewer children; Avoid the danger of children being converted from Islam in enemy territory; Avoid producing children in times of religious decline; andEnable separate sleeping arrangements forboys and girls after puberty, which is more feasible with fewer children. Some Muslims question the economic justifi- cation for family planning on the grounds that it contradicts the Islamic beliefs of tawakkul(reliance on God) and rizq(provision by God). Dr. Omran argued that the jurists found no such relationship and made the economic reasons legal. Regarding the health justification of family planning, Dr. Omran wrote, ÒWarding off the risks posed to the health of mothers and children by additional pregnancies is the most common reason for accepting contraception in Islamic jurisprudence.Ó Legal scholars interpret the QuranÕs recommendation of two years of breast- feeding and the ProphetÕs recommendation against pregnancy during lactation as an endorsement for child spacing. Rather than avoiding intercourse for two full years, which would be a hardship, couples can use contraception. Legal scholars who interpret Islam as permit- ting contraception assume that the method would be safe and practiced only for good reasons. For example, Islam does not allow the use of contra- ception to avoid female offspring. It should also be noted that while the great majority of the the- ologians believe contraception is sanctioned in Islam, they mostly limit the practice to temporary methods of family planning. An overwhelming majority of theologians who have approved the use of modern contraceptives have expressed some reservations regarding the permanent methods of female and male sterilization. Theologians oppos- ing sterilization as a family planning method con-sider the practice as interfering with GodÕs will and attempting to change what God has created. Some people disapprove of male sterilization in particular based on its mistaken analogy to castra- tion, which is prohibited by Sunnah.Opposition to Family Planning A small number of Islamic jurists and other Islamic groups oppose family planning and con- traceptive use generally on two grounds. First, they believe that withdrawal or any practice that prevents pregnancy is infanticide, which is repeat- edly condemned and prohibited in the Quran. Second, the opponents of family planning,whether jurists or nonjurists, believe that the larg- er the number of Muslims and the higher their population growth rate, the greater their power. These advocates claim that a large population is ordained by the religion and that failure to achieve it deviates from the right path. They find support for their views not only in the holy book but also in the ProphetÕs tradition. Hence, they oppose family planning, especially if it becomes commu- nity or government policy. They also claim that family planning programs, having originated in the West, represent a conspiracy to reduce the number of Muslims and diminish their power. It is not uncommon for family planning pro- grams to become politicized in Muslim societies. In recent history, opposition groups in a number of countries have rejected their governmentsÕ orga- nized family planning program as a political move, invoking Islam in support of their position. History has shown that pragmatism eventually prevails. Within days of the Islamic revolution in 1979, for example, IranÕs new leaders dismantled the countryÕs family planning program on the grounds that it was a Western plot. Ten years later, however, as Iran struggled to provide for the basic needs of its growing population, its Islamic gov- ernment reversed the policy and established one of the most successful family planning programs in the developing world. (It should be noted, howev- er, that during the 10 years after the revolution that there was no organized family planning pro- gram in Iran, the government was not restricting access to family planning services, and such serv- ices were available in public clinics as part of IranÕs overall health care system.) PRBMENA Policy Brief 20045

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Algeria has also reversed its position on family planning. At the 1974 United Nations World Population Conference, Algeria was among the countries that opposed family planning programs on the grounds that they were an imperialist con- spiracy aimed at limiting the population of the developing world. However, as part of its national development plan, the Algerian government later adopted a population policy that promoted family planning. GovernmentsÕ Support for Family PlanningNo government of an Islamic country actively limits access to family planning information and services, according to the United Nations report World Population Policies 2003 . Since the early 1970s, the United Nations Population Division has regularly sent inquiries to governments world- wide about their views and policies related to population. The great majority of Muslim coun- tries responding to the 2003 inquiry stated that they support family planning services either directly through government-sponsored outlets or indirectly through support of nongovernmental sources (see Table 2). 3In Muslim countries, as in other parts of the world, family planning services are usually provid- ed as part of maternal, child health, and primary health care. Governments believe that their role in providing family planning information and serv- ices is not only legitimate but necessary to improve maternal and child health by preventing unplanned pregnancies. A large body of evidence shows that babies born to mothers under age 20 and over age 35 face greater health risks. Also, sib- lings born three to five years apart are about 2.5 times more likely to survive to age 5 than siblings born less than two years apart. 4The governmentÕs role is particularly impor- tant in removing economic barriers to family planning by making it available free of charge or at a subsidized price for low-income families who otherwise would not be able to afford it. Governments also can play an important role in removing social and cultural barriers through the educational system and the media, as cultural and religious beliefs can sometimes prevent couples from using health services. A significant percentage of Yemeni women, for example, believe that Islam prohibits contra- ceptive use. Contraceptive use in Yemen is the lowest in the Middle East and North Africa region, and the rate of use there has changed little in recent years, increasing from 21 percent in 1997 to 23 percent in 2003 among married women. In 1997, two-thirds of Yemeni women who were not using contraception reported they did not intend to do so in the future. The most common reason they gave was the desire to become pregnant (23 percent), followed by reli- gious prohibition against family planning (17 per- cent) and their husbandsÕ opposition (9 percent). Yemen has the highest fertility in the region as well as the highest levels of child mortality and maternal mortality. 5Governments with organized family planning programs, such as Egypt and Iran, often involve religious leaders in their family planning cam-paigns. Egypt is home to Al Azhar Mosque and Al Azhar University, centers of Islamic teaching. These centers have regularly dispatched fatwas(religious rulings) in favor of modern contracep- tion, fatwaswhich the Egyptian government has used in its successful family planning campaigns. Contraceptives are available in Egypt in all gov- ernment primary health care facilities, but cultural reasons still act as barriers for many Egyptian cou- ples to access family planning services. Since the reestablishment of its national fami- ly planning program, the Iranian Ministry of Health and Medical Education in Tehran has reg- ularly dispatched fatwasto its provincial offices and down to the lower strata of the health net- work to remove any doubts that health providers or clients may have about the permissibility of family planning methods in Islam. Health clinics often display the fatwasfor their clients to see.Seeking fatwason family planning is not themonopoly of the ministry of health office in Tehran. Fatwason family planning can be soughtfrom local clergies as well. Currently, 74 percent of married women in Iran use contraceptionÑthe highest amongMuslim countries and comparable with countries such as France and those in the United Kingdom. Iran is also distinct from other Muslim countries because it closed the gap between rural and urban women in the use of modern contraceptionÑ around 55 percent of women living in both rural and urban Iranian areas use a modern method. IranÕs family planning program provides all contra- PRBMENA Policy Brief 20046

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ceptive methodsÑincluding female and male ster- ilizationÑfree of charge. The program places pri- ority on involving men in taking their share of responsibility regarding contraception. 6ConclusionFamily planning is an important health and devel- opment issue as well as a human rights issue. Muslim countries and societies are no different than the rest of the world; they aspire to reach their development goals by improving the health of their women and children. Islam should not be considered a barrier in this endeavor. Govern- ments and nongovernmental organizations in the Islamic countries as well as the international devel- opment community can support the increased use of contraception. Such efforts would help to pre- vent unplanned pregnancies as well as help fami- lies to achieve their desired family size by providing financial and political support for cul- turally sensitive reproductive health programs that meet the needs of Muslim couples. References1Abdel Rahim Omran, Family Planning in the Legacy of Islam (London: Routledge, 1992). 2United Nations, ÒProgramme of Action Adopted at the International Conference on Population and Development, Cairo, 5-13 September 1994,Ó Population and Development 1(New York: United Nations Population Fund (UNFPA), 1995): 9.3United Nations, World Population Policies 2003 (New York: United Nations, 2004). 4John Hopkins University Center for Communication Programs, ÒBirth Spacing: Three to Five Saves Lives,Ó accessed online at, on May 10, 2004. 5ORC Macro, Yemen Demographic and Health Survey, 1997 (Calverton, MD: ORC Macro, 1998): tables 4.6, 4.14, and 4.16. 6Farzaneh Roudi-Fahimi, IranÕs Family Planning Program: Responding to a NationÕs Needs (Washington, DC: Population Reference Bureau, 2002). Acknowledgments Farzaneh Roudi-Fahimi, a senior policy analyst at the Population Reference Bureau, prepared this brief with assis- tance from PRB staff. Special thanks are due to Professor Dr. Gamal Sorour, Ahmed Ragaa Ragab, and Mervat Mahmoud of the International Islamic Center for Population Studies and Research of Al Azhar University in Cairo as well as Dr. Maha El-Adawy of the Ford Foundation office in Cairo, all of whom reviewed this report and provided useful comments. Dr. Abdel Rahim Omran wrote Family Planning in the Legacy of Islam with the support of the United Nations Population Fund (UNFPA) and in collaboration with a number of Islamic institutions around the world, including Al Azhar University in Cairo, where he served as its senior population adviser. This work has been funded by the Ford Foundation Office for the Middle East and North Africa in Cairo. © Copyright 2004 Population Reference Bureau POPULATION REFERENCE BUREAU Cel ebrating 75 Years 1929-20041875 Connecticut Ave., NW, Suite 520 Washington, DC 20009 USA Tel.: 202-483-1100 Fax: 202-328-3937 E-mail: Website: PRBÕs Middle East and North Africa Program The goal of the Population Reference BureauÕs Middle East and North Africa (MENA) Program is to respond to regional needs for timely and objective infor- mation and analysis on population, socioeconomic, and reproductive health issues. The program raises awareness of these issues among decisionmakers in the region and in the international community in hopes of influencing policies and improving the lives of people living in the MENA region. MENA program activities include: producing and disseminating both print and electronic publications on important population, reproductive health, envi- ronment, and development topics (many publications are translated into Arabic); working with journalists in the MENA region to enhance their knowledge and coverage of population and development issues; and working with researchers in the MENA region to improve their skills in communicating their research find- ing to policymakers and the media. The Population Reference Bureau is the leader in providing timely and objective information on U.S. and international population trends and their implications. PRB celebrates its 75th anniversary in 2004. MENA Policy Briefs:Islam and Family Planning (August 2004) Progress Toward the Millennium Development Goals in the Middle East and North Africa(March 2004) Making Motherhood Safer in Egypt (March 2004) Empow ering Women, Developing Society: Female Education in the Middle East and North Africa (October 2003) WomenÕs Reproductive Health in the Middle East and North Africa (February 2003) Finding the Balance: Water Scarcity and Population Demand in the Middle East and North Africa (July 2002)IranÕs Family Planning Program: Responding to a NationÕs Needs (June 2002) Population Trends and Challenges in the Middle East and North Africa (October 2001) These policy briefs are available in both English and Arabic, and can be ordered free of charge to audiences in the MENA region by contacting the Population Reference Bureau via e-mail ( or at the address below. The English versions are available on PRBÕs website (

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