Overburdened Mother Gains Access to Family Planning

Kadia Bagayogo is a 39 year-old woman who lives in the working class neighborhood of Bamako, in Mali. She was married to Seyba Fane when she was only 14 years old. Since then, Kadia has been pregnant 11 times, with two sets of twins and one miscarriage. The couple rents a room where they live with their surviving nine children. Seyba works as a chauffeur but is currently unemployed. Kadia, in addition to her role as a housewife, sells charcoal to earn extra money. The children are unable to attend school because the family cannot afford it. Even though Kadia lives in an urban area with access to medical clinics, she rarely seeks prenatal care when she is pregnant. Her children are vaccinated just as rarely - only during mass vaccination campaigns when healthcare providers go door to door.

Kadia's reproductive years have been difficult: She has had three infant deaths and one miscarriage that were due in part to poorly spaced births. When the burden of a growing family and limited financial resources seemed too much, the couple discussed turning to contraception. After approaching a nurse in the neighborhood for advice, they learned about a family planning program at the nearby Community Health Center funded by USAID and the Dutch Government through Population Services International (PSI).

Kadia and her husband visited the health center and were able to attend a group presentation on family planning allowing them to learn about their options, ranging from oral contraceptives, injectables, Cycle Beads, condoms, spermicides and intrauterine devices to implants. After discussing their options with a nurse, both agreed on the implant for its long-term efficacy and low cost. Since then, Kadia has been using the implant while also receiving counseling from the midwife. Kadia's life has changed. ''Without this program, I would never have used this method of family planning because the cost reported to me meant a fortune for us. I want to thank Mrs. Kouma, the midwife, for setting up our initial meeting and following up with us afterwards," said Kadia.

Through this type of program, thousands of women like Kadi are now able to access health services allowing better care for themselves and their families.