Contraceptives: Nightmare for rural women


By Matilda Chimwaza:

LANESI — I did not know what to do

At 23, Lanesi Mankhwala of Mkwasowanjobvu Village, Traditional Authority Mtonda, in Mangochi District, never imagined that she would have four children, her oldest being five years old.

Lanesi initially envisioned that she would be giving birth every five years with, perhaps, a maximum of three children.


But the stars were not on her side as she could not realise her dream due to lack of health centres, where she could access family planning services, to enable her achieve her goal.

It is a familiar problem among most women in rural areas.

“I had originally planned to have a small family because I wanted my children to grow up healthily, and even take care of each other, but things turned out this way, with my youngest child being four months old,” the 23-year-old mother states.


The fact that there is no healthcare facility in her village might not be the biggest problem but that women like her have to cover up to 18 kilometres to reach their nearest health centre.

In the process, they find themselves thrust into the periphery of spaces in the universal health coverage initiative which seeks that everyone should access healthcare services where they are without being economically strained.

Their sad tale is shored up by the absence of readily available transport modes to and from the nearest health facility.

“Thinking about the distance to Phiri Longwe healthy facility gives me a headache. During the rainy season, rivers become dangerous to cross and very few people manage to go to either side.

“When one’s child falls sick during such times, one just sits back at home and prays to God as the river takes about four to five days to recede,” Lanesi says.


After bearing three children by the age of 23, she felt she had had enough and decided to call it quits to concentrate on taking care of those that she had ‘accidentally’ brought into the world.

She started off to Phiri Longwe Health Centre to access contraceptives that would enable her breathe easy for five years before giving birth to yet another child.

A familiar problem, however, blocked her struggle.

“I found that the river that we cross to get to Phiri Longwe Health Centre had swelled up due to heavy rains that had fallen the previous day. That was the day I needed to access my family planning products to stop me from conceiving for some time,” Lanesi laments.

With a cauldron of fear seething through her mind, she was left with no option than to return home and let the worst happen.

“I didn’t know what to do or where to turn to, so I decided to go back home and wait on the stars to determine my fate. Days later, doctors told me that I was pregnant. I was now expecting my fourth child,” she says.

If there was a health centre in the area apart from the grass-thatched building the community erected, which does not even have trained health personnel, Lanesi would have had three children only by now.

“The pregnancy was unplanned. I wanted five years to pass without getting pregnant again but accessing contraceptives, even condoms, is a big problem,” she narrates.

Now, World Vision Malawi has brought a sigh of relief to Lanesi and other women in the area by introducing an outreach clinic programme that provides family planning services.

“I am very happy that I have been able to access contraceptive products just close to my home. As it is, I will be able to stay for five years without falling pregnant with the method I have chosen,” Lanesi says.

NOT CONDUCIVE —The clinic erected by the community

Group Village Head Mkwasowanjovu concedes that the absence of healthcare facilities remains one of the major challenges his area is facing and hails World Vision Malawi for the intervention.

“This will help people in this village to be healthy and work together in development activities. Family planning is very important considering that population keeps growing against the same resources like land to cultivate on,” the traditional ruler says.

Phiri Longwe Health Centre Nurse and Midwife Technician, Alick Pindani, stresses the importance of women accessing modern family planning methods for them to have children by choice and not by chance.

World Vision Malawi Project Manager, Clement Kolove, says the main objective of the outreach clinic project is to spread sexual and reproductive health, gender-based violence, HIV and Aids as well as family planning responses to out-of-school girls and young women in their respective communities.

“The project provides HIV testing and counselling services to out-of-school girls and young women including men. Most out-of-school girls and young women now know their HIV status. Various types of family planning products are also available per traditional authority,” Kolove says.

The story of Lanesi is just a tip of an iceberg in terms of experiences women in the country, especially in rural areas, encounter in accessing health services.

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