A senior official at Matope Health Centre in Neno West is pleased that the number of young people trekking to the facility to access contraceptives has drastically declined. ALICK PONJE writes.
It is slightly beyond midday but not a single soul has knocked on the door of Casper Mtambo’s consultation room which also acts as a dispensary.
While waiting for knocking-off time, he casually fumbles through boxes bearing condoms and pills on his desk strewn with patient registers, youth-friendly training manuals and drug catalogues.
Not many young people are visiting his office these days but a medication cart that keeps what is often reserved for them is almost empty.
“At the end of the month, our records will still indicate that the young people accessed the contraceptives,” Mtambo states as he checks dates on a packet of condoms.
As he stands up, stretches his hands and strolls out of the dispensary, a young man aged 22, cycles into the health centre’s yard with a sizeable wooden box on his bicycle’s carrier.
He had last visited the facility two weeks ago and went back home with a boxful of condoms and pills which have since been consumed by youths in his community.
Mtambo, who is Matope Health Centre Senior Health Surveillance Assistant (HAS) and Primary Supervisor of Youth Community-Based Distribution Agents (YCBDAs), swiftly checks in his registers and confirms Charles Chikwasa can take the contraceptives to his village several kilometres away.
“YCBDAs like Charles play a crucial role in ensuring young people access contraceptives in their own locations. Instead of these youth travelling to this health centre, a YCBDA will take the condoms and pills to where they live,” Mtambo explains.
In a waiting area nearby, four or five women share jokes before each is assessed and given drugs for their respective ailments.
Some men too are on their way to the facility.
These adults, according to Mtambo, force young people to stay away from the health centre when they seek contraceptives.
“They fear they will be judged. Some could even meet their parents here and decided against accessing the products. The result was a rise in cases of early pregnancies,” the health official says.
He admits that the health centre—with a catchment area of nearly 20,000 people—could in a month sometimes register over 30 pregnancies and up to 20 deliveries involving young girls.
Without being sick, Mtambo says, some youths could not travel to access contraceptives and ended up in such situations.
So, each time a YCBDA cycles to the health centre to collect their batch, the Senior HSA is contented that young people who rely on the facility for health services continue accessing the crucial services where they reside.
“Cases of sexually transmitted infections [STIs] were also rampant. Some children, as young as 13-years-old, could come here to access treatment.
“We can’t pretend that they do not engage in sexual activities; that is why it is important to ensure they have access to products and services that will keep them safe,” Mtambo explains.
Today, these young people do not have to cover long distances to access crucial sexual and reproductive health services.
A programme by Save the Children, dubbed Securing Children’s Rights through Education and Protection (Screp), is building the capacities of YCBDAs so that they can undertake some minor but crucial activities such as distributing contraceptives to their peers and offering counselling services.
Charles is one of the young people who provide the services to some 18 youth clubs in Matope Health Centre’s catchment area.
“It is easy for us young people to be open with each other. In the clubs, we share various issues and encourage each other to stay safe.
“We also reach out to those who drop out of school after falling pregnant so that they can return after giving birth. It is refreshing to see that the clubs have been wholly accepted in our communities,” he says.
The Screp Programme, which is being implemented in Mzimba South, Lilongwe Urban, Neno and Mwanza with financial support from the Norwegian Agency for Development Cooperation, has further equipped distribution agents such as Charles with bicycles which they use when travelling to health facilities to order contraceptives.
Mtambo attributes the drastic decrease in the number of early pregnancies in his health centre’s catchment area to interventions in the programme.
“Evidence is there for all to see that when young people access health services of their choice in their own communities, they get protected from early pregnancies and STIs. We are handling very few cases of early pregnancies and STIs at the health centre,” he says.
He is particularly satisfied with the work that he does in safeguarding the rights of his fellow young people.
“To me, it is like serving and saving my community. I just find a lot of fulfilment in reports that we are contributing to reductions in challenges that young people face,” he says.
Charles discloses that in certain instances, he refers girls who seek some kinds of contraceptives to the health centre if there is need for further assessment.
Chifundo, 15, belongs to a club that Charles works with. She states the work of the youth distribution agents has simplified the pursuit of young people being in charge of their sexuality.
The young girl admits she would have fallen pregnant if contraceptives were not available nearby. Matope Health Centre is some 18 kilometres way from her village.
Once a week, members of the club she belongs to gather under a huge tree or in a classroom where they share information about how they can protect themselves from early marriages and pregnancies.
Sometimes officials from Community Action for Sustainable Development Organisation (Casido), the local implementing partner of the Screp programme in Neno, visit these young people to continue equipping them with skills for parrying away risks related to sexual and reproductive health.
“Now, more girls are abandoning marriage to return to school. When we hear that someone has dropped out of school, we immediately engage them and inspire them to go back,” Chifundo says.
She further asserts that even the conduct of health workers towards the youths has changed.
Apparently, some health workers would turn into self-appointed counsellors and start advising young people who seek sexual and reproductive health services against the idea.
“It was very frustrating. You could find that you have made great effort to visit a health centre only to be advised that you should concentrate on school and not engaging in sexual activities. How would you concentrate on school if you fall pregnant because you did not access contraceptives?” Chifundo queries.
Casido Executive Director David Chidakwa hopes the change that the Screp programme is bringing to communities in Neno District will be long-lasting.
He waxes lyrical about the interventions, which he says are proving crucial in protecting the rights of children.
“Such work cannot be done by one stakeholder. That is why we are working with several government ministries and departments and other partners to ensure we achieve the goal of protecting children wherever they are,” Chidakwa says.
He further states that communities are now more willing to report cases of abuse such as defilement and child marriages after being sensitised to these ills.
Chidakwa is confident that the employment of various strategies will ultimately achieve the larger goal of securing children’s rights so that they are educated and protected.
Alick Ponje is a features writer at The Times Group. He graduated from the University of Malawi with a bachelor’s degree in education, majoring in literature in English. He believes that quality reporting is critical in bringing positive change in communities. Alick is the Southern Africa Development Community journalist of the year (2020) in the television category. Follow him on Twitter @aponje