Local organizations, UNFPA driving family planning promotion
It has been more than a decade since World Contraception Day made its inception on 26th September 2007. It was specifically meant to create awareness of contraception and other family planning methods. This year marked its 14th anniversary.
But to many South Sudanese, the day never meant anything, especially in a culturally conservative society with a negative perception towards family planning.
The South Sudan National Family Planning Policy provides that matters relating to contraception be discussed or related services offered when a woman goes for antenatal, delivery, and postnatal care services. However, this aspect has been particularly lacking in the country’s nascent health sector.
A study titled “Social Norms and Family Planning Decisions in South Sudan” jointly conducted by five authors from the University of Melbourne, Royal Tropical Institute, Vrije Universiteit Amsterdam, reveals that the maternal mortality ratio in South Sudan stands at 789 per 100,000 live births, and a contraceptive prevalence rate of 4.7%, making the situation one of the worst in the world.
The research also shows that in some communities, the social norm which expects couples to have as many children as possible remains well in place.
A more recent 2017 study by the WHO, UNFPA, UNICEF, and World Bank on global maternal mortality estimates shows the MMR of South Sudan down to 1,150 deaths per 100,000 live births. Despite the decrease, this figure remains one of the highest in the world. According to UNFPA, family planning could reduce MMR by up to 30 percent. Currently, UNFPA provides 100 percent of family planning supplies to South Sudan’s public health sector.
While the perception of contraception remained largely negative, South Sudanese local organizations have taken it upon themselves to spur awareness on contraception. They have made a gradually steady stride, which would otherwise be impossible without support from the United Nations Population Fund (UNFPA).
In March 2019, Data Emmanuel Gordon, the now Acting Executive Director at Okay Africa Foundation initiated a family planning campaign targeting young people. Condom use was at the center of his initiative. He told The City Review in an exclusive interview why the country should join the rest of the world in supporting family planning.
“Contraception is very important in the sense that it brings attention to the different family planning methods. When you talk about contraception, you have to categorize them into short-term and long-term methods,” he said, breaking down some available methods of contraception that are easily accessible to South Sudanese.
“Now, for example, for short-term methods, we have condoms, which many people do not believe is a form of contraception. Condoms prevent unintended pregnancies. We also have oral contraceptive pills. Then we have injectables that are effective for three months. Those ones are mostly the short-term methods of family planning.”
“Now we have the long-term methods, which include the IUD or intra-uterine device, the implant, which is put just beneath the skin, and many others,” he said. The family planning advocate also mentioned vasectomy as a permanent method for men.
Enlightening young people
In a country where more than half of the population are youth, Mr. Gordon says the majority have no basic understanding of the concept of family planning. This, he points out, is one of the reasons for the observance of the World Contraception Day – to create awareness.
“More than 80% of young people do not know any contraceptive methods. Talking about family planning raises awareness on the various types of contraception and why each one is important. Awareness also allows every person to be able to make a choice, an informed choice on which type or method they want,” he stated.
In March 2019, Mr. Gordon started a project he hardly imagined would succeed but just had to do it as a concerned citizen driving awareness on family planning. He started distributing condoms to young people in a country where stigma and misconception about this particular family planning method are high.
The Condomize! Don’t Compromise campaign started in March 2019. Mr. Gordon got the first box of condoms containing 7,200 pieces of condoms from UNAIDS. By the time it finished, he had to look at other sources to sustain the campaign.
“Then UNFA came in. I was hosting a health program on the radio and was able to interview the UNFPA family planning supplies specialist. He just asked me to place the request for condoms through my organization and I got the condoms for free,” Gordon narrated. Since then, the campaign became stronger and moved forward in partnership with UNFPA.
“UNFPA also supported us with training. They trained more than 20 Condomize campaign ambassadors after the official launch of the campaign. Now it’s now a national initiative headed by the Ministry of Health, together with the South Sudan AIDS Commission, and other partners who also joined to support,” he said.
“The Condomize campaign came in a way that there was less discussion on condom use, whether for prevention of unintended pregnancies, HIV and other sexually transmitted infections because talking about matters that relate to sex is considered a taboo,” Mr. Gordon explained. “People do not want to discuss or talk about it.”
In many places in East Africa condoms are sold in shops everywhere. In South Sudan, however, it is extremely rare to find condoms sold in shops. This is where the Condomize campaign became a big help.
The condom promotion campaign targeted sexually active people who are mostly young people but also included older age groups.
Mr. Gordon and his team leveraged the power of social media to reach even more youth around the country as opposed to only the capital, Juba. In South Sudan, the most used social media platform statistically is Facebook.
“I made sure I promoted the campaign on social media and that is why now most people call me Mr. Condomize, Don’t Compromise. Using social media allowed the campaign to reach our target audiences easier and faster because people are able to send me messages asking for condoms. I ask for their location and I bring the condoms discreetly,” Mr. Gordon said.
He believes that stereotyping and the stigma around condom use is because of a lack of knowledge on the benefits of condoms, particularly the triple protection it brings – protection from unintended pregnancies, from HIV, and from other sexually transmitted infections. Condom is also the only family planning method that has no side effects.
Mr. Gordon told City Review that the intense contraceptive campaign leveraged by social media continues to yield success as many young people are now opening up to discuss reproductive health issues.
“I keep talking about condom use as it relates to sex, family planning, prevention of HIV and STI in every forum that I am invited to talk. That is consistently the starting point for every discussion. And now because of that and because of the other Condomize ambassadors, we now have a network. We post uniform information on social media and the messages multiply in reach because each of us has our own followers,” he said.
Because of the concerted efforts, the campaign has built its own advocates. This is an achievement because more people now talk about condoms.
The Condomize campaign, according to Mr. Gordon, would be more successful if taken to all the 10 states across the country and that awareness on family planning methods like condom use would be more effective.
However, persistent insecurity and poor road network linking the capital Juba to other states make the outreach beyond the capital almost impossible.