Lesotho
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Rural communities vouch for birth control

By Liapeng Raliengoane

MOKHOTLONG – A 35-year-old Mpati* (not her real name) from Manganeng Village in Libibing revealed that her husband never had problems with her using contraceptives and related her experience with a method of birth control called Sayana Press as harmonious.

She disclosed that her body has never had any challenges with it.

“I recommend contraceptives to all women because they assist in child spacing and in reducing unwanted pregnancies,” Mpati declared.

Sayana Press is an injection birth control option for women, with a very small needle, that they can administer to themselves in order to prevent pregnancies for 3 months. A woman using Sayana Press will need a new injection every 3 months, a total of 4 injections every year.

The Lesotho Demographic and Health Survey (2014 LDHS) states that Mokhotlong district has one of the highest rates of unmet need for family planning in the country, at 25%, compared to 18% nationally. It also has the lowest Contraceptive Prevalence Rate (CPR), at 48%. This scenario leads to high rates of unplanned pregnancy, school drop-out, child marriage, teenage pregnancy, unsafe abortion and maternal deaths.

An interview with a Village Health Worker (VHW) from Tlokoeng, ‘Mabonang Sethathi about Sayana Press revealed that clients like it. She served four women from her village who used and preferred it two of them have left for work in the lowlands while the other two have gone to fend in neighbouring villages. She started working as a VHW in 2016 and went for Sayana Press training in 2019.

Asked about how the villagers feel and act towards contraceptives, Sethathi said “My work is very easy in this village because the Chief works hand in hand with me. He gives me a platform in every community gathering so that I can sensitize the villagers about contraceptives. I credit this move as the major influence for the villagers to understand and accommodate family planning.”

Tlokoeng Botsola Village Chief Nakeli Kente said he started in 2019 to give a Village Health Worker a slot in all community gatherings so that the community is well informed and knowledgeable about various types of birth control so that they can make informed decisions.

Chief Kente declared that he has realized that the community is interested in the information provided by the VHWs. He also indicated that the reason he affords this contraception talk is for families to make good child spacing and to avoid being involved in crimes due to unplanned pregnancies.

Dwelling on the importance of contraception, a villager from From Tlokoeng Khotso Mpesi revealed that birth control assists in the avoidance of bearing many children as recently food, clothing and job security are a problem, so feeding and clothing many children poses a burden and some children might even end up being hired out to herd animals. Mpesi said contraceptives help families and women to decide how many children they want and have them in an acceptable and convenient spacing.

According to World Health Organization (WHO) 2017 estimates: 214 million women of reproductive age in developing regions have an unmet need for contraception. Reasons for this include: limited access to contraception, a limited choice of methods, fear or experience of side effects, cultural or religious opposition, poor quality of available services and gender-based barriers.

On another note, a VHW from Ha Nepo ‘Masetima Nkere expressed that the women from her village use contraceptives and prefer the ones that take long before renewal, like Depo, because the health facility is very far thus, those longer methods are time savvy for them. She also distributes condoms and started being a VHW in 1992.

In the case of a VHWs from Mapholaneng ‘Maitumeleng Lenepa, pointed out that women from her village do use and favour contraceptives. She added that this year, a method of village health workers distributing family planning pills was introduced, she has not yet started distributing but will start in October. This was done so that the communities can get contraceptives conveniently, especially for those who live very far from health facilities.

The United Nations Population Fund (UNFPA) Sexual and Reproductive Health and Rights Coordinator Blandina Motaung indicated that the unmet need for family planning is at 18% countrywide, 21% in rural areas and 25% at Mokhotlong, which is the highest of all districts.

“Sayana Press is targeted at women who live in places very far from health facilities so that they may help themselves at home, thus relieving them from having to go to health facilities for birth control,” Motaung held forth.

She specified that UNFPA’s responsibility is to see that everyone accesses family planning and it is engaged with the Government of Lesotho to provide commodities. The UNFPA works to support family planning by ensuring a steady, reliable supply of quality contraceptives, strengthening national health systems, advocating for policies supportive of family planning and gathering data to support this work.

To mark the World Contraception Day which was yesterday (26 September) UNFPA partnered with local journalists who regularly cover Sexual and Reproductive Health and Rights stories to undertake a field visit to Mokhotlong where the first cohort of VHWs was trained on the newly introduced family planning method, self-injection depo (Sayanna Press) in September 2019. The purpose was for the journalists to interview the trained VHWs and clients in a bid to continue advocacy for the use of this Family Planning method.

World Contraception Day this year will focus on the supplies UNFPA delivers to serve women and girls’ sexual and reproductive health needs. This will also be done through a campaign – It’s a match! A campaign that takes educational content about contraception to digital conversations. Facts about contraceptive protection via text messages and online profiles are presented in engaging animations and visual content.

World Contraception Day takes place on September 26th every year. This annual worldwide campaign centres on a vision where every pregnancy is wanted.