Market Day is Family Planning Day for the Women of Enukweni Village

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Mary Hlema, a 43-year-old mother from Enukweni village in Malawi, highlights the impact of family planning on her life. “It gives you enough space to allow kids to grow properly. When kids have followed each other very closely, it is difficult to manage them. But when they are spaced out, even when you are tied up with other tasks… the older ones can support you by taking care of the little one.”  

By using contraceptives, Hlema has effectively managed her family's size. She credits the health education lessons received at the Enukweni health facility's antenatal clinics for providing her the necessary information. Witnessing her mother's struggle to care for seven children inspired Hlema to choose a different path, ensuring that she could provide a better quality of life for her children. Hlema has four children. “Having fewer children ensures more food is available for every family member."

Enukweni Health Facility is one of the many public health facilities benefitting from USAID's support. The facility provides monthly family planning services to approximately 200 clients. The availability of USAID-funded contraceptives has enabled health workers at Enukweni to bring about positive and lasting changes in the lives of their clients. 

"When we have adequate and consistent supplies, we see a reduction in unwanted pregnancies. But when we experience stockouts, we have to turn back most of the women and adolescents. Soon after, the number of unintended pregnancies starts to rise," said Magdalene Chiwona, Senior Nurse and Midwife at Enukweni Health Facility. 

Since 2017, USAID has worked closely with Malawi’s Ministry of Health to ensure a consistent supply of family planning products throughout Malawi. The USAID Global Health Supply Chain Program-Procurement and Supply Management (GHSC-PSM) project has procured and delivered over 13 million family planning products to more than 680 public health facilities and social marketing organizations across the country. By establishing a strategic system of commodity forecasting, supply planning, procurement, distribution, and spot checks, GHSC-PSM has provided access to family planning commodities for the past five years and continues to do so.  

Magdalene Chiwona, Senior Nurse and Midwife at Enukweni Health Facility
Magdalene Chiwona, Senior Nurse and Midwife at Enukweni Health Facility
Magdalene Chiwona, Senior Nurse and Midwife at Enukweni Health Facility
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Thanks to the leadership of Malawi’s Ministry of Health and the support of USAID, GHSC-PSM, and other partners, unmet need for family planning has decreased from 17 percent in 2019 to 13.3 percent in 2022.  

While the availability of family planning commodities is essential, other barriers persist in Malawi. Deep-rooted suspicions and resistance towards family planning in certain pockets of the community, coupled with some husbands' reluctance to permit its practice, create challenges. However, many women opt for injectable contraceptives due to their discreet nature and the ability to be administered every three months without leaving any trace. 

There is a good reason why Tuesday is the day for family planning at the health facility. “Tuesday is a market day at the trading center. The women tell their husbands they are going to the market, when in fact, they are coming here for their Depo-Provera jab.” Chiwona explains. “They can return home without their husbands knowing or suspecting they have been injected. They leave their health books here and they will just be informed of their next appointment.” She says her health workers feel a huge sense of relief seeing the women in their community go home with the means to prevent an unplanned pregnancy. 


Some husbands are supportive, including Mary’s (above) and Rachel Mwaungulu’s. Since starting family planning in 2002, Rachel, a 37-year-old mother of five from Kalundavwa village, has been able to plan each of her five children's births. "It becomes difficult when you have many children... family planning helps the community take care of its children and improve their future." 

Rachel Mwaungulu with her last-born at Enukweni health facility in Mzimba. Photo by GHSC-PSM
Rachel Mwaungulu with her last-born at Enukweni health facility in Mzimba. Photo by GHSC-PSM