Reproductive Health: Empowering The Women Of Mozambique

Hortencia Tembe had her first child at the age of 16. She lives in a small, rural village in the south of Mozambique. Having only attended school up to 3rd grade level, she understood the challenges she faced if she had more children. She says, “After the birth of my first child, I immediately started with family planning, but the cost of travelling to a health unit simply became too expensive.” Hortencia, like many women in her village, now has five young children to care for. This is the result of poor family planning support structures within many rural villages – not only in Mozambique, but in most developing countries.

Because of the extreme poverty in the region, large families within rural communities place enormous pressure on natural resources, often resorting to taking much more than the natural systems can restore. Another cause for concern is that as the communities grow, so does the tension between human settlements and wildlife who share the same land, resulting in severe conflict in which both species suffer the consequences.

Concerned about the impact of these problems on communities and ecosystems, Peace Parks Foundation launched a community health programme with a specific focus on reproductive health, as part of its conservation efforts in Mozambique’s Maputo Special and Ponta do Ouro Partial Marine Reserves.

The first phase of the project, saw the Foundation enter into a strategic planning partnership with Blue Ventures, a UK-based conservation agency that develops transformative approaches for catalysing and sustaining locally led marine conservation.

Blue Ventures recognises complex links between poor health, unmet family planning needs, food insecurity, environmental degradation and a vulnerability to climate change. To address these challenges holistically, the organisation developed an approach which integrates community health services with marine conservation and coastal livelihood initiatives. Blue Ventures’ population, health and environment support officer, Urszula Stankiewicz shared, “If women have access to family planning, they can be autonomous and be involved in both economic activities and conservation programmes. This promotes food security and decreases pressure on natural resources which ultimately positively impacts conservation in the area.”

Sustainable solutions investigated
In 2016, Peace Parks Foundation embarked on a journey of discovery to learn as much as possible from Blue Ventures – even travelling to Blue Venture’s projects on Madagascar’s west coast where they spent several days immersed in holistic community-based work and tailored interactive training sessions covering a variety of technical Population-Health-Environment topics.

This collaboration led to the development of a detailed strategy to ensure that communities gain access to family planning services and contraceptives and are informed about their reproductive rights. The process also identified the need for the appointment and training of community-level champions, or so-called activistas (community health workers).

Enter the activists
With the initial strategy as a solid road map, AMODEFA, a Mozambican-based non-profit organisation that specialises in community health projects, was appointed mid-2017 as an implementation partner. With support from Peace Parks Foundation, they are responsible for training and supporting 15 activist as community health representatives. Ten of these activistas have concluded their training and already passionately taken up their new duties in the villages bordering the reserves.

After meeting the activista working in her village, Hortencia was re-motivated to join a family planning programme. She says, “I felt very relieved to learn that I would no longer need to regularly spend about 200 meticais in transportation just to go to the health unit for contraceptives. This motivates my partner to also support my decision to take the medication.”

A lack of formal education also has an impact on women’s attitudes towards contraceptives. Maria Ndala, a 34-year-old mother of six is her husband’s third wife. Her two sister wives each has five children. Her mother had refused to send her to school saying that it was more important for her to start working and contributing to the family’s income. Maria says, “I have always been aware of family planning, but there were many myths surrounding the use of contraceptives, so I was too scared to use them. The costs involved in traveling to the clinic also made it very difficult. After the activists explained how the birth control medication worked I decided to start taking the pills, because our family simply cannot afford to support any more children.”

Family planning interventions within rural and impoverished communities will go a long way in supporting women such as Maria and Hortencia to meaningfully contribute towards economic growth and development within their communities.

The next phase of this project will aim to include increased access to reproductive health information and services, and broaden the scope of intervention to also include access to information and basic healthcare. Lessons learned from the successes achieved here will be used to develop and implement similar projects in other transfrontier conservation areas across the region.