For a lot of men in Mangochi District, sexual reproductive health (SRH) services such as the use of contraceptives are a female-led affair. Most men in Kalino Village, Traditional Authority Issa Mponda seldom encourage their wives to use contraceptives.
There are a lot of misconceptions that surround the use of contraceptives. Some sections of the public believe youths who use contraceptives before the birth of their first child will have problems conceiving in the future.
Others believe contraceptives make men and women impotent. These misconceptions have undermined efforts to improve the reception of contraceptives among the people of Mangochi, particularly women and the youth.
Kakosa Mlenga, a health surveillance assistant under Katema Health Centre in Mangochi, has seen these misconceptions first-hand.
He says: “We are still dealing with misinformation and myths on contraceptives and also resistance from parents to allow their adolescents to access contraceptives.
“I have hospital passports in my possession belonging to various youths who are afraid of their parents if they get to know that they are using contraceptives.”
Major Dyman, 25, has made it his mission to reverse these misconceptions and help the people of their communities become more aware of the benefits of using contraceptives and how they can help improve their lives.
His mission began in 2018 when he began working as a community-based distributing agent (CBDA) after undergoing training by the Family Planning Association of Malawi (Fpam) which focused on promoting awareness of the various types of contraceptives among the youth and women.
Says Dyman: “I make sure I advise my fellow youths on the best practices in life and how they can protect themselves from unplanned pregnancies and sexually transmitted diseases, including HIV and Aids.”
Dyman accepts that living in a community where a health facility is about 20 kilometres away makes it hard for women and the youth to access SRH services.
He said: “My fellow youths are becoming parents at a tender age. They cannot fend for themselves and their children. In the end, the responsibility of providing for an extended family increases, a development which makes the people in our community prone to poverty.”
To avert this challenge, Dyman says he makes sure that he provides the contraceptives to all who need them when they are available.
He goes door to door, asking his fellow youths if they want condoms and pills, which are their most preferred contraceptives.
He says he can withstand minor challenges such as moving around the area and usually having a low stock of supplies as long as he fulfils his core mission.
Says Dyman: “We all know Mangochi is known for young people flocking to South Africa in search of greener pastures. This is one of the reasons we need more contraceptives because when the husband returns, the woman can never be sure of his HIV status.
“So, we are a community that badly needs these SRH services. Our population is growing and it is normal for a girl to have two children by the time they turn 20. This is bad as she has to drop out of school and be a mother.”
Statistics from the Ministry of Gender, Community Development and Social Welfare show that between March and July 2020, the number of teen pregnancies in the Southern Region rose by 9.84 percentage points to 22 272 from 20 276 cases recorded during the same period in the previous year.
When carrying out his duties as a CBDA, Dyman uses the opportunity to encourage his fellow youths to work hard in school if they want to achieve their dreams.
He says: “There is a lot that everyone of us can do to save our young girls from unplanned pregnancies and it starts with mentoring the people, mostly young men, to understand that they should always use protection when having sex.
“I believe if we target the boys who think contraceptives are for women, we will create a generation that will respect women’s rights.”
The government of Malawi, with funding from the Royal Norwegian Embassy and technical support from UNFPA, Unicef and WFP, implemented the UN Joint Programme on Girls Education III (UNJPGE III).
The project aims at strengthening and consolidating gains made in its previous iterations, phase I and II, by bringing together stakeholders from different sectors to address the barriers of access to quality education for girls and boys.
UNJPGE III also addresses education, nutrition, safety and integrated reproductive health concerns in a rounded manner by focusing on other aspects like life skills and community engagement.
So far, the project has been successful, improving awareness on contraceptives in the areas it has been implemented.
Christopher Isaac, 16, from Mtandamaha Village, Traditional Authority Kachindamoto in Dedza District says he has better access to contraceptives since the youth ambassadors started operating in his area.
He says: “[Before], I could not gather the courage to step into a shop to buy condoms. I used to rely on a friend to buy for me, but whenever he was not around, I would put my life at risk by having unprotected sex.
“I no longer go to the hospital to get free condoms or buy from a hawker. I am now dealing with my fellow youths when it comes to accessing these services. For me, having them around has helped a lot because we can now express ourselves more freely to them than to an older person.”
Elsewhere, Atupele Tsoka, 18, and a mother of one, was abandoned by her husband who left for South Africa in 2020 in search of greener pastures. She says the biggest challenge is that men resent the use of contraceptives.
She says: “We need more contraceptives and they should be long-term ones. This is because most women can get the injection method or the loop without the husband’s knowledge, unlike when one is using pills. So, if health surveillance assistants provide long-term methods, it will help a lot of women.”
Atupele says the availability of the CBDAs and mobile clinics has reduced the stress that women experienced when due for an injection or loop services.
According to Fpam executive director Donald Makwakwa, the project has helped a lot of youths in the target districts to access quality and adequate SRH services.
He says: “Most of our young people are sexually active and if they slip, it is obvious most of them end up getting pregnant and dropping out of school. As an implementing partner, Fpam believes in educating the youth and through service provision, a lot of the youth, though sexually active, are now able to continue with their education which is the overall objective of this project.”
The 2020 Rapid Assessment Study of Teenage Pregnancies and Child Marriages during Covid-19 in Malawi indicates that inadequate and lack of funding for implementation of activities related to youth friendly SRH services continues to be a major challenge in the country.
According to the report family planning is a critical basic health care that can have positive long-term effects on women and young girls and the country’s economy.