According to the Demographic and Health Survey of 2015-16, Malawi is among the countries with the highest population of adolescent girls (10-19) and young women (10-24). However, though they represent great potential, they are negatively affected by gender inequity, sociocultural norms, and harmful traditional practices, all of which impede their ability to thrive, realize their aspirations, and contribute to the future development of the country.
They routinely face the threat of physical violence, early marriages, interrupted schooling, and limited access to healthcare services just to mention a few.
Although Malawi registers such an alarming rate as far as the population of adolescent mothers is concerned, the issues come with serious complications in the lives of such mothers.
To deal away with the problem of early pregnancies, family planning methods, also known as contraceptive methods are used to avoid getting pregnant. However, the United Nations Population Fund-UNFPA reports that usage of contraceptive options among adolescent girls and young women remains at 37.5%.
Several factors contribute to the low uptake of contraceptive methods in Malawi. Some of them include: cultural practices, social norms as well as myths and misconceptions about family planning methods.
In a quest to improve access to comprehensive Sexual and Reproductive Health and Rights services among adolescent girls and young women in Malawi, Her Future, Her Choice project was rolled out in 2019. The project which is expected to phase out in July 2024 is being implemented in the Central region of Malawi -Lilongwe and Balaka – in Southern Malawi.
The Centre for Alternatives for Victimized Children and Women (CAVWOC) is implementing the project with other implementing partners including; the Family Planning Association of Malawi (FPAM) and Point of Progress with funding from the Global Affairs of Canada through Oxfam in Malawi.
The project promotes knowledge on the provision of gender-responsive and youth-friendly comprehensive sexual reproductive health services among health service providers.
It also helps to improve the ability of health systems and institutions to provide gender-responsive, youth-friendly comprehensive Sexual Reproductive Health information and services.
FPAM concentrates its efforts on service delivery while Cavwoc centers on demand creation. FPAM service provider in Balaka, Melia Wella says the project has seen an influx of adolescent girls and young women accessing SRH information and services through designated mobile outreach clinics in the district.
“When we were starting the project, we found a lot of myths and misconceptions about contraceptive methods. However, with sensitization meetings that we have been conducting in our outreach clinics, the community members started opening up and now there is a significant change as many adolescent youths are flocking in large numbers to access services like long-term family planning methods, cervical cancer screening and treatment HIV and AIDS testing and others,” she said.
The project also provided technical capacity to health workers on how to best provide treatment to youths when they go to health facilities to seek medical help.
Geoffrey Chipanga, a facility in charge at Ulongwe Health centre in Balaka District laments that for a long time, youths have been dying in silence as they failed to access healthcare-sensitive services.
He agrees that poor treatment by the health workers has over time aggravated the youths to shun away from getting medical assistance at the facility. However, he says, through the project, health workers are now aware of how to handle the youths.
“Through Youth-friendly health services, youths are voluntarily flocking to our facility to access services on sexual reproductive health. They feel much more comfortable getting services and treatment through such corners,” said Chipanga.
The project has also trained Community Based Distribution Agents (CBDAs) who play a vital role in reaching out to people in the community.
The agents provide counseling on modern methods of family planning and distribute contraceptives to people within their communities. To ease their mobility challenges so that they could also reach hard-to-reach areas, the project distributed bicycles to the agents.
Hawa Jackson from Traditional Authority Amidu in Balaka District says she is excited to work as a CBDA on the project.
She said: “My role is to bring family planning methods closer to the people in my area. I am extremely overwhelmed that since 2020 when I started working in this role, there has been significant change in regards to myths and misconceptions about contraceptive methods and people are now aware of their benefits.”
The CBDAs also encourage young mothers to go back to school after they give birth.
Linly Khamula, 24, chairperson of a 30-member Chimwankhuku youth club in the area of Traditional Authority Amidu says she has benefitted a lot from the project.
The mother of 3 dropped out of school while in form 3 at Chilanga Community Day Secondary School. She got pregnant. Linly says she was not aware of the benefits of using contraceptive methods until she joined a youth club facilitated by Cavwoc through Her Future Her Choice Project. She is now aware of the importance of using family planning methods
“Initially, I was not aware of what would happen to me if I started using contraceptive methods. There were a lot of myths and misconceptions coming out from the community. However, after I started using Jadelle implant, I experienced no side effects and my husband even encouraged me to continue using this method,” she explained.
The project has also financially supported the youths through their clubs to be socio-economically independent through the provision of start-up capital and Village Savings and Loans (VSL) to enable them to run their businesses.
For instance, some youth clubs are operating bee production and they share the profits to support their enterprises. Linly fetches a daily profit of K3, 000 from her bakery business, which she says helps her to complement her family’s needs.
As custodians of culture, chiefs have also not been left out of the project.
Traditional Authority Amidu says the project has also helped to eradicate some bad cultural practices.
“In the past, Traditional leaders were at the forefront of encouraging the execution of harmful cultural practices. For instance, there is a practice called “Ndakula” which is practiced when a girl has reached puberty stage. The girl is taught how to satisfy a male partner in bed sexually. The practice has over the years exposed girls to engage in early sexual activities,” said the chief.
Currently, the project has helped Traditional leaders to formulate by-laws that would be used as a yardstick for punishing perpetrators of harmful cultural practices as well as Gender Based Violence (GBV).
Her Future Her Choice project Officer at Cavwoc, Rightwell Nyirenda says they have agreed with community leaders to continue implementing activities of the project even if the project ceases to operate.
“We believe that the communities have benefitted from the project. As a sustainability plan, we have agreed with various community leaders to continue working with different community structures readily available in their areas to promote what they have learned in the project,” Nyirenda said.
In Malawi, young people face several challenges about Sexual Reproductive Health and Rights. Some of the prevalent challenges include; limited access to SRHR education and services, limited access to information, limited access to contraceptives, and information on usage
among others.
Her Future Her Choice project seeks to empower adolescent girls and young women to secure their sexual reproductive health and rights in target regions of Ethiopia, Malawi, Mozambique, Zambia, and Canada.
The project is being implemented in Lilongwe and Balaka Districts. In Lilongwe, the project is being implemented in Traditional Authorities Malili and Chimutu by Point of progress and FPAM while in Balaka, the project is being implemented in Traditional Authorities Kalembo and Amidu by Cavwoc and FPAM.
Oxfam collaborates with the Ministry of Health and other Government Ministries, Departments and Agencies, parliamentary caucuses and committees, civil society organizations, and media in delivering the project interventions.
