By the time the Family Planning Association of Malawi (FPAM) team returned to Kondiyani Village in Traditional Authority (T/A) Njewa, Lilongwe, 24-year-old Ulemu Kapile had already seen her dreams take an unexpected turn.
When Ulemu learned she was pregnant earlier this year, she was not celebrating – she was in shock.
“I waited for the clinic to come,” she says quietly. “They used to come every month. But after the aid freeze, they never came back, and by the time I realized it, I was already pregnant.”
For women like Ulemu, access to contraception and other reproductive health services had always depended on FPAM’s Integrated Family Health Outreach Clinics (IFHOCs). Through projects funded by the USAID such as Momentum Tiyeni and Tikweze Umoyo, FPAM had been bringing essential health services including family planning, HIV testing, and cervical cancer screening in hard-to-reach communities.
However, when the United States government suspended aid to Malawi earlier this year, these outreach activities came to a sudden halt. The projects were fully funded by the U.S. government, and without the financial support, operations were forced to stop.
“I had just finished my pack of contraceptive pills,” Ulemu recounts. “I had nowhere else to go for another supply. I still slept with my partner, thinking maybe the clinic would come soon. But they never did.”
The five months that followed were difficult for thousands of women across Malawi who had grown dependent on FPAM’s mobile outreach clinics. Many found themselves without access to family planning methods, and some, like Ulemu, ended up with unintended pregnancies.
Recognizing the urgent need, the International Planned Parenthood Federation (IPPF) intervened with a Harm Mitigation Response Project, providing US$115,000 million to support [DM1] FPAM in resuming limited sexual and reproductive health services in affected areas.
According to Jimmy Kachale, FPAM’s Harm Mitigation Response Project Coordinator, the support came at a crucial time.
Since the onset of the project in June 2025, a total of 14,566 people have accessed integrated sexual and reproductive health services as of end September 2025. These services include both short-term and long-term contraceptive methods including condoms, HIV/AIDS services, Sexually Transmitted Infections (STI) screening and treatment, and obstetric investigationsFPAM service provider Sylvia Mitengo, who was part of the team that returned to Kondiyani Village in May[DM2] , said many women were relieved to see the outreach clinics back.
“When we resumed the services in June 2025, the women told us they felt abandoned,” she said. “Now we are encouraging them to consider long-term contraceptive methods to ensure they remain protected even beyond donor funded projects..”
Nelson Nefitale, a community volunteer in Kondiyani, confirmed that the gap left by the halted projects had a severe negative impact.
“Many women were desperate. Some felt hopeless and feared going back to unplanned pregnancies,” he said. “The support from IPPF is timely, although the current model only focuses on family planning and not the wider range of services we used to have before.”
Despite the renewed efforts, the harm has already been done for some women. For Ulemu, life has taken a turn she did not plan for, but she remains hopeful that others will not share her fate.
“Even though the clinic is back, the pain of living with an unintended pregnancy still lingers,” she says. “But I am thankful that other women will now have the help I did not have.”
The Harm Mitigation Response Project is currently being implemented in Lilongwe and Kasungu districts, offering a lifeline to communities that were left behind when the aid freeze took effect.
[DM1]This is not the correct amount. It is only us$115,000 for the 2 districts
[DM2]Which year?