Seeking contraceptives, failing to get them

There is big, but subversive business going on along Victoria Avenue in Blantyre. Vendors are taking advantage of the gap in access to contraceptives to sell condoms, mainly, to those who feel shy to walk into the People’s Trading Centre (PTC) shop along the avenue and buy the protective.

As you drive towards the People’s shop parking space, what welcomes you are the eyes of airtime and newspapers vendors and others, including traffic warders along the avenue. Everyone wants business, more so as they know they may benefit from the “keep change” system.

“It is not ordinary business per se,” reveals Rashid Chuma, an airtime dealer. “We just help them and usually, they tell us to keep the change as a token.”

He reveals that most of their customers are motorists and says the common condoms brands bought are the Rough Rider, Bareback and Magnum.

The cost of these condoms varies from K700 (about $1) to K1 500 (about $2) and Chuma says if given K1 000 for a pack, he expects to keep K200 or more.

The story is the same at Namiwawa People’s shop as one of the vendors outside the premises reveals helping some customers to access condoms.

It is not only the famous people that are hit this way in their quest to get a condom.

Lucy Soko of Ndirande Township in Blantyre reveals that twice she became a victim of poor access to Sexual Reproductive Health (SRH) services, particularly condoms.

“It was just one of those moments when your loved one visits you and after chatting you end up wanting to have sex. That is exactly what happened. None of us had planned for it, so we had no condoms. What happened led to my second child,” she said.

Although things happened this way for Soko, condoms were just within reach at Ndirande People’s shop and other shops within the Ndirande market area.

Some till operators in selected supermarkets in Blantyre revealed that they have seen people waiting for queues to clear to purchase condoms.

“They go round and round our shelves while others wait in cars. Others send boys who sell items outside the shop. It is a crisis, we need to find a solution,” explains one Namiwawa People’s shop employee whose identity he did not want disclosed.

Margaret Magombo of Kachere Township emphasises that she cannot queue for condoms both at a health facility and supermarkets.

“The moment you ask or carry the condoms, everyone knows you are going to have sex,” she explains.

In supermarkets, condoms are displayed at the counters, an environment both Soko and Magombo describe as unattractive.

Not surprising though, in hotels and schools, condoms are placed in toilets and Magombo, who works with Concerned Youth Organisation (CYO)—an organisation promoting SRH services in Blantyre, among others—says this is effective.

While health experts celebrate increased availability of contraceptives such as condoms, research shows that access and use remains a challenge.

Soko and Magomgo say, usually, culture and misconceptions play key to this.

A study titled Attitudes Towards Contraceptive Use among Adolescence in Malawi by Kamuzu College of Nursing (KCN) researchers found that both negative and positive themes emerged from the sampled adolescents’ narrations.

Negative attitudes arose from challenges, disadvantages, misconceptions and beliefs and values that disapprove the use of contraceptives among adolescents. It is these that led to Soko’s second unplanned pregnancy.

The factors also affect married people.

The 2010 Malawi Demographic and Health Survey (MDHS) found that 26 percent of married women have an unmet need for family planning with four percent of them having a need for spacing births and 12 percent for limiting births.

The figures are provoking among the adolescence as the survey says the contraceptive prevalence rate for girls and young women aged 15-19 years is 29 percent.

Low use of contraceptives is blamed for the high rate of unplanned pregnancies. The MDHS reports that every year 106 000 teenage girls get pregnant due to low uptake of contraceptives.

In an earlier interview, United Nations Population Fund (UNFPA) assistant representative Dorothy Nyasulu said cultural beliefs are crucial factors in contraceptive use and blames it on information gap. She says there is a long way to convince people that contraceptives are not a private thing.

“A lot has to be done on culture. Most countries are failing to attach cultural initiatives against natural factors such as population growth, unplanned pregnancies and sexual transmitted infections,” she said.

Grace Kumwenda, programmes manager for Pakachere Institute for Health and Development Communications, says she has seen both married people and adolescence failing to buy condoms at supermarkets because of the environment, perception, mindset and attitude.

She said: “As a married person, one wonders what people would think if they see me carrying condoms when they know I am married? Would they not think I have multiple sex partners?”

A 2013 qualitative formative research by Pakachere reveals that different age groups of the population face challenges to access contraceptives. This is what led Pakachere to establish a sex workers’ clinic to address their SRH concerns.

Dignitas International also initiated a teen club to reach teens with SRH and HIV and Aids support services. Such programmes are said to have increased access and service demand as the two groups feel safe to visit such places. n