A firmer future for family planning in Zambia's remotest communities
Marie Stopes Zambia's (MSZ) innovative family planning project is coming to an end of its funding (around €750,000) from the European Union. However, MSZ plans to continue delivering family planning services in 2016 in conjunction with other donors, says MSZ Senior Programme Manager Julia Ross.
Based in Muchinga Province, the project started in early 2013 and will come to an end in December 2015. It is one of the EU's successful small projects working with non-governmental organisations. Marie Stopes Zambia estimates that by December 2015, the project will have reached around 29,000 women with family planning services in five districts (Mafinga, Nakonde, Isoka, Chinsali and Mpika) in Muchinga Province.
A range of contraceptives are offered. One of these is the hormonal contraceptive Depo Provera, delivered to Agness Chali at Mwika Rural Health Centre by an MSZ nurse (pictured). The project also performed almost 700 bilateral tubal ligation procedures (this is one of the long-acting and permanent methods offered) and delivered an impressive 72,000 couple-years of protection. For more detail about the project's 'camping model' approach to reaching women in the remotest parts of Zambia, read our story from 2014.
Voices from the field
As the project faces its final few months, a joint team made up of staff from the EU Delegation and Marie Stopes Zambia travelled to several rural health centres in Muchinga Province in October 2015 to see MSZ mobile clinics in action, and to understand the impact and importance of the project from the point of view of those closest to it.
Safer Motherhood Action Group Volunteers, Mwika, Chinsali District
These community health volunteers are at the heart of the project's efforts to raise awareness about the benefits of family planning in underserved communities. Why do they volunteer? One female member (pictured right) said: "We help provide guidance and help others to get access to good quality services. We educate mothers about the complications which can happen after birth, especially those having a lot of children. A male member of the group said: "It is about the community, often the ones we are giving advice to are our own relatives and friends."
Dr Erwin Nyirenda, Acting Provincial Medical Officer, Muchinga Province & Mr Richard Chimfwembe, Mother and Child Health Co-ordinator for Mpika District
Dr Erwin said this about the project: "There is a change of attitude for married women to be accepted to search out to family planning services. What the EU is doing with Marie Stopes is really giving us a hand with reducing maternal morbidities. "
Mr Chimfwembe said: "We've been working well with Marie Stopes on outreach activities. It's been good because we have been limping in terms of transport – with Marie Stopes we have been able to reach a good number of clients to increase the uptake of long-term family planning methods."
Senior Chief Kopa of the Bisa people, Mpika District
Chiefs have a lot of influence on communities and have an important role in encouraging healthy behaviours. Senior Chief Kopa (pictured with the Marie Stopes team and, right, Richard Chimfwembe) is a supporter of the project, and one of the leading advocates for family planning in Zambia.
Like many countries in Africa, in Zambia there are often a number of myths and misconceptions concerning modern family planning methods. MSZ uses a variety of methods to tackle this, including telephone helplines, leaflets and group counselling. Raising awareness among local chiefs on the benefits of family planning is also a vital ingredient. In one example, the husbands of about 50 women who had hormonal implants inserted by the project were demanding that they have them removed, because they believed the implants could damage long-term fertility. In this instance, Senior Chief Kopa called a meeting with all of the husbands and explained how FP would benefit the health of their wives and families and dispelled many of the most common myths. As a result, the women were not forced to have their implants removed.
Chief Kopa said: "We are trying to learn a new culture here. When I patrol the villages and fishing camps in my chiefdom, I meet the headmen, the teachers, the clinic workers and the court and I talk to them all. We sensitise the people to family planning, and we talk to the men in a polite way to explain the benefits. I tell the men: a mother having another child while breastfeeding is bad for health. We believe in quality, not quantity!"
Godfrey Kopa, community health volunteer, Namusulwa
Godfrey is a community health volunteer who spends some of his time giving information to the men in the area. "I am there to explain benefits of family planning and to correct misunderstandings."
Describing an occasion when a younger man explained to Godfrey why he wanted his wife to get her implant removed after she started having some minor side-effects, Godfrey told him "wait a few weeks. Wait and see."
Julia Ross, Senior Programme Manager, Marie Stopes Zambia
"MSZ outreach teams work closely with the local District Medical Officers and travel to sites that they recommend – some of these are 200km from Mpika town. In addition to continuous coordination at this level, MSZ contributes to annual district planning cycles that identify service capacity gaps, plan resources, and agree expected outputs for the year. This kind of coordination ensures that MSZ delivers FP services to underserved communities while avoiding duplication of effort."
"The EU support has assisted MSZ to create an enabling environment for FP in Muchinga Province, and MSZ plans to continue delivering life-saving contraceptive services within the province after 2015 with support of other partners. The support of the local government and partners and the increased awareness and huge interest of the population in accessing these services ensures lasting impact beyond the life of the project."
In early 2016, the results of the final evaluation of the Marie Stopes project will be shared on the MSZ and EU websites. For more information about this project and other EU health projects, contact Njira Bweupe (Njira.BWEUPE@eeas.europa.eu) or Esther Bouma (Esther.BOUMA@eeas.europa.eu).