Antananarivo, 27th July 2011: Nampoina, a community health worker for Marie Stopes International in Madagascar had just completed a visit to a client’s home.
As she was leaving she was approached by Noeline, a 39-year-old woman from the local community, who lived with her family in a slum on the edge of town.
Noeline was eager to take control of her fertility, and wanted to arrange a time to discuss the family planning options available to her with Marie Stopes International.
Madagascar has one of the highest fertility rates in the world, with women expected to give birth to an average 5.02 children in their lifetime .
82 percent of women living in Madagascar can't afford family planning
Since the age of 18, Noeline had given birth to nine children, now aged from six months to 21 years.
Like 78 percent of Madagascar’s urban population, Noeline and her family live in a makeshift house in a slum on the edge of the city. They have just two small rooms to live in, one for sleeping with a bed and mat on the floor, and one for cooking.
And like 82 percent of women living in Madagascar , Noeline couldn’t afford even the most basic forms of family planning.
At her appointment, Noeline explained that while she loved her children and was thankful they were all healthy, she didn’t want to continue living the way she was.
She felt that part of the problem was lack of access to family planning methods that would allow her to take control of her fertility and prevent any more unplanned births.
The implant works immediately and can be removed at any time
After listening to Noeline’s story, Nampoina described the family planning methods available to her. Noeline chose a contraceptive implant – a small flexible rod inserted under the skin of the upper arm which slowly releases the hormone progestogen, allowing Noeline to control her fertility by preventing the release of eggs from her ovaries.
The implant is an excellent choice for women in remote areas, because it lasts for three years and requires no further medical intervention once inserted, which reduces the need to visit clinics. The implant works immediately and can be removed at any time, allowing the menstrual cycle to return as normal.
Because she couldn’t afford the full cost of the implant, Noeline purchased a £0.06 / US$0.10 voucher from Nampoina, which she then redeemed at a local BlueStar clinic.
BlueStar clinics are social franchises supported by Marie Stopes International and because there are three close to where Noeline lives, she was able to choose her preferred doctor, centre and location and get the procedure carried out at a time convenient for her and her family.
Marie Stopes International aims to provide clients like Noeline – and the 215 million women like her around the world who don’t have access to basic family planning – the information, choice and availability they need to take control of their fertility.
Find out more about our work in Madagascar on our Madagascar website