She crawled into the family planning service room tent later than 03:00 pm when all service providers who came to Ntonda – Chindongo mobile clinic in Mangochi district almost alerted one another of dismounting the tents, a call to pack and go home, as there was no sign of the next incoming client.
She is 16 and came for loop contraception which she knew from a Form 4 school friend at Ntonda Community Day Secondary School. Being a Form 1 girl, seriously immersed in a relationship with her Form 3 boyfriend from a private secondary school in the area, Abigail Sitola received the family planning service because she is mindful of her dream to complete her secondary education to become a motor vehicle mechanic. “I have a relative who fixes cars and I think it’s a great job I would do in the future” Sitola expressed her ambition.
“This friend apart from being my school mentor is also a neighbor and taught me more about loop because she started using this method for some time now. She also said that loop contraceptive has no side effects like body pains, uncontrolled menses, and dizziness,” Sitola explained.
She added that “We started having sex with my boyfriend and I now fear the unintended pregnancy at my age.” Sitola illustrated that the fact that her friend is completing the final secondary education class, she was even encouraged more to opt for a contraceptive.
“I should be honest that my mother and aunt are very supportive and have been encouraging me to get to the FPAM mobile clinic to access the contraceptive method of my choice.
Our community health worker, Getrude Kachepatsonga, has been teaching us about protection from unintended pregnancies and sexually transmitted infections since last year but I could not make such a decision until now that I found it necessary,” Sitola said.
Sitola stressed that she is geared to teach more girls of her age about contraceptives because she thinks not all girls of her age in and out of school do have adequate information and where to access contraceptive services because some girls do not belong to youth clubs as herself stated. “Some were threatening me that they insert heavy metals and injure women during insertion of the loop. Some said loop kills and it moves to the heart. I just disregarded all that and I have not even felt any pain and this is what my friends need to know that nurses at FPAM clinics are just friendly and very smart at service provision,” she explained.
The senior chief counsel of Group Village Head (GVH) Chindongo under Senior Chief Nankumba in the district, Emmanuel Kaizi, showed no shock that young girls were actually accessing contraception services at the FPAM mobile clinic. “Before 2015, 2 out of 20 girls would complete final primary school education, but now, child marriages, and teen pregnancies are decreasing, and the number of youth patronizing the mobile clinics is increasing hence the positive news. We encourage parents and guardians to promote family health and allow youth to protect themselves from unintended pregnancies and sexually transmitted infections and link them to static and mobile clinics for integrated services,” Kaizi said.
The senior chief counsel added that the “closure of schools in 2020 due to Covid-19, affected his area because some girls fell pregnant as many would no access timely health services.”
“I promote openness about contraception among girls because I’m a living testimony of permanent contraception and I know why girls need to protect themselves from unwanted pregnancies and sexually transmitted infections for them to complete their education and become responsible women as I do. I have two girls and I also keep two other girls from my sister. I engage them continuously to keep reminding them about health and economic problems that come due to teen pregnancies and why their future matters most.
Mobile outreaches bring us accurate information because they help answer most questions parents and youth have about how contraception works. Some parents still believe contraception would cause infertility in their children in the future but mobile clinics dispel this with support from testimonials who have children now and our area has learned a lot already,” said Josephine Chalimba, mother of Abagail Sitola. She added that it’s not easy for parents and youth to travel to static clinics just to listen to health education on contraception, unlike mobile clinics that come to people’s doorstep.
Youth Friendly Health Services (YFHS) focal person for the Nkope health area, Chikondi Banda, indicated that youth are encouraged to access HIV testing and counseling and family planning services because they find the health workers so inspiring, friendly and trusted. “Service statistics of the first half of 2021 has shown that 1405 youth accessed counseling services, 702 demanded HIV testing and counseling services, 92 accessed sexually transmitted infections services, and 388 got contraception services,” Banda said. The trend of YFHS is actually increasing more importantly because youth find mobile clinics so friendly and convenient on their doorsteps.
A total of 26 clients came to access family planning and other sexual and reproductive health services at Ntonda – Chindongo FPAM mobile clinic and six of them were under the age of 19. FPAM continues to provide family planning services to all people of reproductive age to ensure that the Ministry of Health efforts to lower the unmet family planning need of 19% among the married and 40% among the unmarried according to SRHR Policy 2017 – 2022. In principle, this is also a response towards Agenda 2063 that focuses on empowering the youth to enjoy their human rights and contribute to their countries development including support for planetary health.
The current FPAM mobile clinics in Mangochi are being funded by UNFPA through Sexual Reproductive Health and Rights Integration project.