Providing contraception in Madagascar

“I will never give up for the right of these women to have access to family planning services. I will continue to fight for their cause.” 

Jeannica stands in front of an outreach site, where she provides contraception in Madagascar.
Jeannica, an MSI provider in Androy, Madagascar.

Contraception in Madagascar 

In the Androy region of Madagascar, an arid, rural region at the south of the island, contraception is still taboo. Women often don’t have control over their own fertility, which can lead to unintended pregnancies and drive women to dangerous unsafe abortion.

“In our local Antandroy culture, women are seen as a kind of ‘object’, a procreation tool for their partners,” explains Jeannica, an MSI outreach provider. “Most men are against family planning completely, and women have no right to say anything about their reproductive health. Last month, like every month, I saw many cases of complications after unsafe abortions. Women use traditional and very dangerous methods because they’re afraid to ask for help.”

Jeannica is working to change that. She travels throughout the region by bush taxi or motorbike, raising awareness about the benefits of contraception. Working alongside local community health workers, she sometimes holds multiple sessions a day. These sessions inform women about the different kinds of contraception available. They also assure them that if they do decide to use it, they can do so confidentially, to avoid social stigma.  

“Demand for contraception among women is high in the Androy region, but there is currently a huge unmet need,” she says. “I am proud to be working for MSI and fighting for the fundamental rights of women across the region.” 

Jeannica, wearing a heavy backpack, rides a motorbike on a sandy road with cactuses in the background.
Jeannica travels long distances to reach remote villages with contraception.

Contraception helps women gain independence 

On a recent outreach visit, Jeannica met a 19-year-old woman with three children. She lived in a village far away. On her way to the market, she came across an awareness raising session Jeannica was holding. She joined the group, and when the session ended, she approached Jeannica with questions. 

The young woman worried that her husband and family would disapprove if she used contraception. But after three pregnancies at a young age, she didn’t want to miss the opportunity to avoid another pregnancy. She decided to receive a contraception implant that will protect her from unintended pregnancy for several years. 

Jeannica gave the young woman instructions on how to hide the implant in her arm. She also gave her her phone number in case she encounters any problems or has any questions.  

She knows that for women in this region, the decision to use contraception can be a difficult one. But she thinks that it’s ultimately worth it. “Women become more independent and productive if they have reproductive choices. They will have a more fulfilled life both emotionally and financially and will focus on how to improve their lives and the lives of their children. You can even see it in their faces, their smiles.”

Jeannica, wearing a hair net and face mask, takes a woman's blood pressure in a dimly lit health clinic.
Jeannica with a client at a recent outreach visit.

Serving her community 

As a native of Androy herself, Jeannica feels strongly about serving the women of this community. 

“My real motivation for doing my job every day is to empower women like me to break free from the barriers that prevent them from happiness. We as women have no rights and don’t currently have the role we need in the community.  

We should sensitize the community and provide them with all the necessary information on women’s basic rights, especially on reproductive health. The battle is far from won but we should not give up in the face of men’s reticence. Fortunately, MSI Madagascar and the women of the Androy region have already established a relationship of trust.” 

Nearly all of MSI’s team members are from the country they work in. Even in difficult environments like Androy, courageous providers like Jeannica are changing the conversation, confronting taboos and giving more women the chance to decide their own futures.  

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