The power of Community Reproductive Health Promoters (CRHPs) in the promotion of SRHR/HIV information and services cannot be disputed by everyone who would decide to accompany and appreciate how the outreach mobile clinic manages to provide SRHR/HIV services to people living in hard to reach areas in all 11 districts where Family Planning Association of Malawi operates through static health facility, mobile clinic or health post.
The CRHPs who are equivalent to the Ministry of Health community health work supervisory level position of Health Surveillance Assistant (HSA) are just the queens and kings of community SRHR/HIV work. They mobilize, inform and educate communities with support from nurses and clinicians, also generalized as health service providers. These community queens and kings provide counseling and issue-certified services like short-term family planning methods. They identify and organize community mobile outreach clinics. They just make hard-to-reach areas sound so near to visit by all people from all walks of life.
In as much as they do not get all support they would dream to have, they stand a challenge in convincing every community member to understand and accept SRHR/HIV information and services like cervical cancer screening, post abortal care, gender-based violence reporting, and screening, and family planning information and services, they have a greater and successful story to share.
In Dowa, CRHP Lorretta Khembo discharges her duties to four traditional authorities of Mkukula, Mponela, Chiwele, and Nsakambewa. She reaches adolescents, young people, women, and men with SRHR/HIV information and services. She adores that the more she sees people from her area understand how contraception work like hormonal pills, injectables, and implants, the more she appreciates her efforts. “I expect the people I reach to get to the level of understanding how hormonal contraception works. It makes the girl’s or woman’s egg not mature for fertilization, makes the uterus not to get ready to hold the fertilized egg, and makes vaginal fluids thick at the door of the cervix hence making the sperm-hard to pass into the uterus,” she emphasized.
During the She Decides campaign community visit on 20th January 2020 in the district, FPAM Social Behaviour Change Communication Lead and Dowa Youth Life Center (FPAM Clinic) CRHP gathered women of Thambwe Village in Mtengowanthenga where women were answered exhaustive questions in light of understanding available family planning methods that they access at FPAM mobile clinics. Myths and misconceptions circulating contraception were dispelled.
Like other CRHPs, Khembo is not discouraged although she faces challenges of transport, communication air time, and adequate supply of family planning commodities. Her drive to reach more adolescents, youth, women, and men of reproductive age with contraception methods is limitless.
Racheal Banda is another dedicated FPAM CRHP and HTC counselor who reports to Mzuzu Youth Life Centre. She discharges her duties to Mzimba north in four traditional authorizes of Kampingo Sibande, Jalavukuba, Mtwalo, and Mpherembe.
In Mzimba north she networks with four public health facilities and directly works with Health Surveillance Assistants (HSAs), Community Based Distribution Agents (CBDAs), and Peer Educators (PEs). They help her mobilize and pass information to community members.
Mzimba north which previously seems so hard to reach with SRHR/HIV services has finally started to open up in accessing SRHR/HIV information and services through mobile outreach clinics. “We use entry meetings with chiefs to introduce the project requirements and expectations that require the community to fulfill,” she added.
Banda also explained that her job is supported by FPAM-trained peer educators and community-based distribution agents. “I sit in youth club meetings that we partnered and formed to discuss any interesting topic surrounding sexual reproductive health and rights like cervical cancer, unsafe abortion, and contraception just to mention a few topics. Young people are eager to learn and understand about family planning services. Their number in such discussions and uptake of cervical cancer screening and contraception are also growing.
Parents also gather in similar settings where discussions are harnessed. Most parents are understanding that people of reproductive age range from 15 – 49 years old hence need to extend SRHR/HIV information and services to them,” she said.
Banda also noted that projects like She Decides that focus on young people have greatly contributed to the increase in uptake of contraception like injectables, condoms, and pills.
The Mzimba north CRHP shows that there is a need to train more youth community distribution agents to build a stronger network that can serve the entire area that takes up to 40% of the district according to M’mbelwa district council socio-economic profile 2017 – 2022.
Currently, FPAM has 14 CRHPs in Karonga, Mangochi, Kasungu, Ncheu, N’neno, Dedza, Dowa, Mchinji, Mzuzu, Machinga – Liwonde, and Lilongwe districts.