I advocated for provision of oral contraceptives at the community level by community health workers who provide injectable contraceptives to ensure women in underserved communities are able to access contraceptives. I was also able to train 500 health care workers in more than 250 facilities in 15 focus districts in long-acting and reversible contraceptives (LARCs). This increased uptake of LARCs, resulting in a more than 90 percent increase in couple-years of protection.
I also advocated for youth-friendly health services and trained more than 250 peer educators to provide sexual and reproductive health information to fellow youths. I ensured commodity security by minimizing stock-outs during program implementation both at community and facility level through supervision of facilities, noting stock levels for possible action.
Malawian women in rural communities and youth have challenges accessing family planning, especially LARCs, leading to unwanted pregnancies. This prompted me to advocate for increasing these marginalized groups’ access to family planning, which I did by training providers in hard-to-reach areas to provide these services to the women and the youth. I also ensured that outreach in hard-to-reach areas included provision of family planning services and LARCs.
The biggest challenge I faced was that despite training family planning providers in LARCs, the pressure and demands of their day-to-day work kept them from actually providing the services. As such, women still faced challenges to access LARCs. To overcome this, community-based family planning providers were encouraged to refer clients who wanted LARCs to an outreach clinic which provided LARCs once a month. In hard-to-reach areas where demand was very high, advance campaigns promoted the fact that family planning services would be available for a week as part of outreach services.
The biggest challenge in my country is that despite a rise in contraceptive prevalence rate, the total fertility rate remains extremely high, indicating that most families still want a higher number of children, which puts the lives of the mothers and children at risk. The other challenge is the cultural beliefs which prevent first-time mothers from using family planning methods. Most of the time, women start using family planning methods when they already have four or five children.
In the next 5 years, I want to contribute to my country's goal of increasing the contraceptive prevalence rate to 60 percent. To achieve this, I will work to ensure family planning services are available to women in hard-to-reach areas and that youth are able to access services without discrimination by sensitizing parents, community leaders and gatekeepers. I want to contribute to a culture that sees the value of having a few, well-taken-care-of children, which will benefit us all.