Therese Maye Diouf BA, Director, The Challenge Initiative (TCI), West Africa Francophone Hub, IntraHealth International
Dakar, Senegal
I came across this mayor who asked his assistant to bring the TCI [The Challenge Initiative] flyer before he talked to me, because I think people might have told him, “Do you know what the lady will be talking about?” Then he asked me to come, invited me to his office, and as soon as I started describing, he said…“You know, I can’t, as a responsible mayor, be funding family planning in my city, because…family planning is against our culture.”
I just listened to him and asked, “Okay, can I now tell you what family planning is?”
He said, “You know, today I have one million something young people between the age of 18 and 20, and these are the strength of my city. And you guys, you come here, and you don’t want our women to have kids anymore, you’re depriving the young people.”
I said, “Okay, let’s just stop there. So you have one million young people age 18. Please, do just this little exercise. Go back to the health facilities in your city, and check how many kids were born 18 years back. I’m sure half of them have died. Check how many women have delivered. I’m sure half of them have passed away.” I feel like crying when I say those things. I say, “How many kids do you have in the streets begging? How many of them are in jail? How many of them are jobless? This is what family planning is all about. Family planning is about preventing unnecessary death, allowing our kids to survive the age of 5. Allowing our kids to go to school, school being a right to all of them. Allowing our young people to have jobs. This is what family planning is about. It’s about allowing the couples to have a healthy and good life. This is family planning. And no religion, no culture, can be against that.”
Je suis allée à un rendez-vous avec ce Maire qui, avant de me recevoir, a demandé à son assistante de lui apporter le flyer du TCI avant qu’il ne discute avec moi, parce que je pense que les gens avaient dû lui dire, « Savez-vous de quoi cette dame va vous parler » ? Il m’a ensuite invitée dans son bureau et des que j’ai commencé à décliner l’objectif de TCI, il a déclaré ... "Vous savez, je ne peux pas, en tant que maire responsable, financer la planification familiale dans ma ville, parce que ... la planification familiale est contre notre culture".
Je l'ai juste écouté et j'ai répondu : « D'accord, puis-je vous dire ce qu'est la planification familiale? »
Il a dit : « Vous savez, aujourd'hui, j'ai un million de jeunes entre 18 et 20 ans, et c'est la force de ma ville. Et vous, vous venez ici, et vous ne voulez plus que nos femmes aient des enfants, vous dépravez les jeunes. »
J'ai dit : « D'accord, nous allons nous arrêter là. Donc, vous avez un million de jeunes âgés de 18 ans. Veuillez faire ce petit exercice. Retournez aux établissements de santé de votre ville et vérifiez combien d'enfants sont nés il y a 18 ans. Je suis sûre que la moitié d'entre eux n’a pas survécu. Vérifiez combien de femmes ont accouché dans ces structures il y a 18 ans. Je suis persuadée que la moitié est décédée. » J'ai envie de pleurer quand je dis ces choses. Je dis : « Combien d'enfants avez-vous dans les rues, livrés à la mendicité? Combien d'entre eux sont en prison? Combien d'entre eux sont sans emploi? C'est de cela qu’il s’agit quand on parle de la planification familiale. La planification familiale consiste à prévenir les décès évitables, à permettre à nos enfants de survivre l'âge de 5 ans. Elle signifie la possibilité pour nos enfants d'aller à l'école, l'école étant un droit pour tous ; c’est aussi permettre à nos jeunes d'avoir des emplois. C'est ça la planification familiale !!! Il s'agit de permettre aux couples d'avoir une vie saine et agréable. C'est ça la planification familiale ! Et aucune religion, aucune culture, ne peut être contre cela. »
Sarah V. Harlan, Partnerships Team Lead, Knowledge SUCCESS Project, Johns Hopkins Center for Communication Programs
Advisor, Family Planning Voices
Durham, N.C., U.S.A.
Family Planning Voices is capturing stories that are coming from this immense global family planning movement. But it’s also this incredible story bank for people to use as they’re doing advocacy, or as they’re doing education, or talking to providers. So in addition to the importance of actually collecting the stories, the stories can be used in a number of different ways. So that’s what makes the collection so exciting for me. We can slice and dice it. If you’re visiting a country and talking to people about IUDs, you can look for those stories in the collection and use them in your work. And what I’ve found, especially in some of the advocacy work that I’ve done, data doesn’t always convince someone on its own, whether to change a policy or to change behavior. But if they’re actually hearing in someone else’s own words why that’s important to them, or what difference it’s made for them—or even from a provider in terms of what they’ve seen from their patients—that can really change someone’s mind.
[on taking inspiration from HONY for FP Voices]: I thought, wow. We have those stories too - can we find a way to do something like it? And I was also thinking about the fact that we’re just inundated with information and part of [K4Health’s] job is to reduce the noise and pick out what’s really important. So I liked that style - a simple portrait and a brief quote that takes a minute to read but says something really important. People can actually do that...
...Almost everyone that I talked to, when you ask them how they got into [family planning], the majority go back to an experience they had or something that they saw growing up. The situation of their mother, or friends in the community, who had a different path than they did. I feel like everyone is motivated to work in family planning by things that they’ve seen and would like to change.
David Alexander, Digital Marketing Specialist, INFORMS
Former Lead Photographer, Family Planning Voices
Baltimore, Maryland, U.S.A.
When [the Family Planning Voices team] first sat down and started thinking about these interviews and these portraits and how they would appear and be used, we were focused on building a community. A clear aspect was really providing a headshot or a professional appearance, and so that dictated the approach that I was going to take. Because I know that we weren’t making lifestyle or narrative art photography, we were focused on more of a commercial portrait style so that they could have sort of a dual use-- not just be a powerful portrait of an individual, but also something they could then reuse as a reflection of their own professional development. The other aspect is that we’re limited to this small time frame. Most of the portraits we make happen in about five to ten minutes, which from a photography standpoint is just super fast, and so I had to figure out a way to technically create really pleasing images that could happen really fast. So that’s what led me to the style. I mostly shoot in a one light style with an umbrella, so there’s one key light, and if I have enough time, I’ll usually use a separate key light for hair or bright reflection. It’s a distinct style and it’s a style that we really decided on because of the dual use and also the technical limitations of time, which I think were really important.
Clive Mutunga, Senior Technical Advisor, Population, Environment, and Development, Office of Population and Reproductive Health, USAID
Washington, D.C., U.S.A.
Whenever you talk about integration, using Population, Health, and Environment (PHE) as an example of multisectoral integration, most people are often not totally opposed to it. But I think we need to do much more than that. If you talk to a minister of environment, and talk about looking at issues of health and population, they would say, “Oh yeah, those are important for environmental issues,” but there is always the tendency to say, “Oh, then, that’s the work of the health ministry. We are fine with it, but somebody else should take care of it.” So as a PHE community of practice, we need to be making clear asks to the various stakeholders who we wish to be part of the engagement. We need to be doing a better job of measuring and reporting the impacts of the cross-sectoral integration. I always notice that the burden of proof is upon the cross-sectoral integrated practitioners, though I feel that the burden of proof should be from those implementing vertical or siloed interventions. We are the ones who have to convince the policy makers, the decision makers, that integration makes sense, when it could be the other way around. Why are standalone programs encouraged when you’re dealing with integrated challenges at the individual, the community, and the national level? This is something that we need to be prepared for and to make sure that we have the right tools, whether they are related to policy, advocacy, doing good research, using greater approaches like knowledge management to bring all the pieces together. There is so much knowledge out there, but organizing it and putting it in formats that can be used by the various stakeholders is so critical.
Babafunke Fagbemi, Executive Director, Centre for Communication and Social Impact
Abuja, Nigeria
In Nigeria, a lot of women are disadvantaged. And the fact that you’re educated doesn’t even give you that edge. So for women who don’t have the money, who don’t have the knowledge, who can’t even make that choice, they don’t have the social support, they’re confused about if their religious leaders approve or not – they’re in such a dilemma. So it brings me so much joy when the projects that we work on, actually interact with these women and you see the expression of hope in their eyes. First there is confusion – “I’m not sure I can do this.” Then there is doubt – “I’m not sure it’s good for me.” Then there is hope – “I can talk to my husband. I can talk to my friends. I can talk to a religious leader.” And they actually take that step. So that brings me a lot of joy. It’s not easy. At times you don’t get the results quickly, but eventually we get there.
Dr. Simon Peter Kibira, Lecturer, Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University
PMA2020 Co-Principal Investigator
Uganda
Since I started working with the Uganda Demographic and Health Surveys (UDHS) in 2006, one thing I’ve been trying to track is contraceptive prevalence rate (CPR), and there’s been a bit of a rise. I think it was at 24% when I started working in 2006 and now we’re getting into 40%. We’ve set the targets and we may not achieve them, but we should keep raising the bar. I think the trends show that we are moving in the right direction. For me it’s those trends that show that we need to do a lot. One thing I see is from the data is the role of side effects in preventing use of family planning methods or even leading to discontinuation of family planning methods. Side effects are difficult. It’s something we shouldn’t ignore. You can provide access, but then they don’t use it because these side effects are real.
Knowledge about contraception is high, almost 100 percent. Everyone is aware of a method, but I think comprehensive knowledge is also an issue. What is interesting is, in the UDHS from 2006 and 11, about 30 percent of women who were using a rhythm method actually did not know when is the likely fertility period. They had completely wrong answers. Someone said at the beginning of the cycle, someone said at the end of the cycle. But if we ask which method they’re using, [they say, “‘I’m using the rhythm method.” So when you tick the boxes of contraceptive use, “check.” Are they using the method right? No. Are they going to get pregnant? Yes. So this also doesn’t mean we should celebrate for all who say they are using a method, because they may be using it but they don’t have the comprehensive knowledge.
Reverend Moses Ssemugooma, Mityana Diocese Headquarters, Church of Uganda
Uganda
What is important now to the outside community is supporting the church to build capacity. If the religious leader’s capacity is built, they are able to address these issues. People who are trained and equipped with this information are able to use Bible verses to advance family planning and health in totality. I believe in the Bible where Jesus himself says, He came that I may have life and have it in abundance. It is John 10:10. But people cannot have life in abundance unless we do something to advance family planning.
