Philip Chinkhokwe | August 22, 2022
It’s a Thursday afternoon and Chimwemwe Makhumula walks slowly into Banja la Mtsogolo clinic and sits on a wooden chair in the waiting area. Ms. Makhumula is one of many young women who visit the clinic secretly to buy contraceptives. She uses them to prevent unwanted pregnancies, since she is a college student and not yet married. To avoid social disapproval, Ms. Makhumula doesn’t discuss her use of contraceptives with anybody. Ms. Makhumula says there is a great need to create platforms where adolescent girls and young women can freely discuss sexual and reproductive health and make informed decisions. Ms. Makhumula says she will continue going to the Banja la Mtsogolo clinic because she receives support and access to accurate information about using contraceptives.
It’s a Thursday afternoon and the sun is engulfed by clouds, bringing cold weather to Kawale township in Lilongwe, the capital city of Malawi. Chimwemwe Makhumula walks slowly into Banja la Mtsogolo clinic and sits on a wooden chair in the waiting area.
The 26-year-old college student looks exhausted. Since early morning, she has been delivering sausages and peanut butter and collecting money from customers.
Ms. Makhumula says: “I have come to seek sexual and reproductive health services. I am waiting for the clinicians to come back from lunch. Although I am very tired, I cannot go home and come back another day because I live about 10 kilometres away from the clinic.”
Ms. Makhumula is one of many young women who visit the clinic in secret to buy contraceptives. She uses them to prevent unwanted pregnancies, since she is a college student and not yet married.
She explains: “I cannot tell my mother or even my friends that I am going to the clinic to access reproductive health services. I come here because it is a safe place where I can express myself freely and get the support I need.”
To avoid social disapproval, Ms. Makhumula doesn’t discuss her use of contraceptives with anybody. She says that, in this community, there is prejudice against unmarried people who are sexually active.
For instance, when one of her friends got an abortion, she received a lot of negative comments from community members about secretly accessing abortion services from the clinic.
Ms. Makhumula explains: “When my friend secretly had an abortion, people in the area insulted her. They called her a prostitute and said a lot of bad things. She couldn’t withstand the prejudice and relocated to a different area.”
According to Ms. Makhumula, religion is another factor that stops her from speaking freely about contraceptives and sexual and reproductive health services.
She says, “I am a Christian and it is very difficult to start this discussion with friends from the same church because they may speak negatively about my spiritual life.”
Ms. Makhumula says there is a great need to create platforms for open discussion so that adolescent girls and young women can talk about sexual and reproductive health together and make informed decisions. She says this would help break the silence about sexual and reproductive health services among girls and women, and start to reduce the stigma attached to these services.
She adds: “Young women and girls are shy and fear to speak out to friends and relatives about reproductive health issues. But for me, this is my body and I need to control and take care of it.”
Idah Savala is the sexual and reproductive health specialist at Banja la Mtsogolo, a leading institution in Malawi that aims to improve the quality and accessibility of sexual reproductive health services for young people. Ms. Savala says that adolescent pregnancy is one of the major causes of school dropout among 13 to 18-year-old girls in Malawi.
She adds, “Often, contraceptive use is associated with a promiscuous lifestyle. Such unfounded judgements silence young women and hinder them from accessing contraceptives.”
According to Ms. Savala, lack of awareness and limited education on sexuality and sexual and reproductive health services makes the problem worse.
She explains the consequences of this lack of awareness: “There are many young people who are struggling with the consequences of unintended pregnancy and sexually transmitted infections, including HIV and AIDS.”
Ms. Savala adds: “Adolescent girls and young women are vulnerable to sexual abuse and gender-based violence. But many suffer in silence to avoid being shamed because of society’s negative attitudes, gender stereotypes, and religious teachings.”
She says there is a need for increased awareness and knowledge about using contraceptives in order to deal with society’s misconceptions.
She explains: “This could help encourage many young women and girls to adopt contraceptive use. This may be a solution to break the silence, [and to] improve self-awareness and openness to contraceptive practices.”
Ms. Makhumula says she will continue going to the Banja la Mtsogolo clinic because she receives support and access to accurate information about using contraceptives.
She says: “I used to be shy to express myself, especially when I met male clinicians or someone I know. I didn’t want to speak to someone I know, fearing that my information would get out to other people. But I feel free to discuss contraceptives with staff at the clinic.”
Chimwemwe Makhumula’s name was changed in this story to protect her privacy.
This resource is undertaken with the financial support of the Government of Canada provided through Global Affairs Canada as part of The Innovations in Health, Rights and Development, or iHEARD, project. The project is led by a consortium of: Farm Radio International, CODE, and Marie Stopes International (MSI) and implemented in Malawi by Farm Radio Trust, Women and Children First, Girl Effect, and Viamo.
Photo: An opened package of oral birth control pills. Credit: Bryancalabro via Creative Commons.