Flexibility and pragmatism in promoting health: an experience of synergy between health and religion in the Islamic Republic of Iran.

In the Islamic Republic of Iran, religion has traditionally played a central role in the lives of the people. Following the Islamic Revolution in 1979, it has also become integral to the country's governance. Since the Revolution, an exceptional synergy has arisen between the domain of religion and the health sector in the development of family planning policies, which have resulted in dramatic changes in population growth and fertility: the population growth rate decreased from 3.9% (1986) to 1.2% (2000) and total fertility from 6.8 (1984) to 2.1 (2000). The extraordinary aspect of this experience is that the position of religious authorities changed from one of opposition to one of active promotion of family planning. This paper describes the establishment and course of family planning programmes in Iran and makes use of interviews with two main protagonists of this experience (Dr Alireza Marandi--Minister of Health 1984-1989, 1993-1997; Dr Hossein Malekafzali--former Deputy Minister of Health). It is hoped that dissemination of this experience outside of the Islamic Republic of Iran will encourage the development of similar dialogue and synergy between religion and health in other countries.