Tafele Kapatuka was left confused and anxious when the outreach vehicle that used to bring family planning services to her village stopped coming.

Just two months earlier, Tafele of Mwenda village in the Area of Traditional Authority (T/A) Chadza in Lilongwe, had received contraceptive pills from a mobile outreach team run by the Family Planning Association of Malawi (FPAM). When her supply ran out, she waited for the team to return as promised but they never did.

“I was afraid of getting pregnant again,” she says. “I already have five children, and four of them were unplanned. The thought of another unplanned pregnancy was killing me.”

With no access to contraception, Tafele felt forced to deny her husband conjugal rights leading to tensions at home.

“He could not understand. He started accusing me of sleeping with other men,” she says. “I could not afford to travel to the health facility either. It is far, and we do not have money for transport.”

Ruth Mailosi of the same village faced a different but related problem. She wanted her contraceptive implant removed so she could have another child, but the outreach clinic had stopped visiting her area too.

“I spoke to our Community-Based Distribution Agent (CBDA) who told me that the FPAM clinic would no longer be coming because American donors had withdrawn their support,” Ruth narrates.

She was deeply concerned, knowing how important those outreach clinics were for women in her village, where regular health services are scarce and difficult to access.

Patuma Machira, a community volunteer in Mwenda Village confirmed the impact.

“People here are now completely cut off from basic health services,” she said. “The nearest facility is far, and most people either walk or use bicycles, which is not practical, especially for women and children.”

Patricia Biyeni who stays in Chigwirizano, in Lilongwe District, says after noting that the outreach clinic had stopped in her Area, she had to sell a backet of maize to be able to manage a family planning method at a pharmacy.

“When I heard that the outreach clinic had shut, I was desperate for a contraception method. I then decided to sell my maize, and I used the money to purchase oral contraceptive pills at K2000 ($1.15) at the nearby pharmacy,’’ she explains.

FPAM had been running outreach clinics under two projects, Momentum Tiyeni and Tikweze Umoyo providing a wide range of sexual and reproductive health services through its Integrated Family Health Outreach Clinics (IFHOCs).

Elina Kachingwe, a mother from the area, relied on the outreach clinics for antenatal care. The closure hit her hard.

“I had all my antenatal visits at the outreach clinic. It was convenient and saved us a lot of money,” she says. “When the clinic stopped, and my delivery time came, I had to walk a long distance to the hospital, and I gave birth on the way.”

To help women like Tafele, Ruth, and Patricia among others, the International Planned Parenthood Federation (IPPF) stepped in with a support package of $2,211,215 through the IPPF Harm Mitigation Response initiative.

Jimmy Kachale, FPAM Coordinator for the initiative, said the organization resumed integrated services including family planning, HIV services, gender-based violence screening, Sexually Transmitted Infections (STI) screening and referrals, and cervical cancer screening at service delivery points previously covered by the Momentum project.

“The project is being delivered through mobile outreach clinic teams, supported by community-based awareness efforts,” Kachale says. “We shall cover 50 service delivery points across Kasungu and Lilongwe districts, reaching about 23.6% of the population affected by the USAID project termination.”

According to Kachale, two mobile teams will each conduct at least 17 outreach clinics per month totalling 323 annually.

“However, due to limited financial and human resources, the IFHOCS model will not be fully adopted,’’ he adds.

During a District Health Management Team (DHMT) meeting with FPAM, health authorities in both Kasungu and Lilongwe welcomed the return of services.

Dr. Linly Mussa, Senior Medical Officer at Kasungu District Hospital said the project is timely.

“This will help bridge the gap created in Kasungu. Teenage pregnancies are increasing, and this project will make a real difference. We are committed to working with FPAM,” she explained.

The project aims to serve 36,000 people of reproductive age (10–49 years) across hard-to-reach areas, 21,000 in Lilongwe and 15,000 in Kasungu.

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