Overheard at Women Deliver: The Need for Comprehensive Reproductive Health Care and Female Condoms

By Annie Fedorowicz, Center for Health and Gender Equity (CHANGE)

“Reducing maternal mortality”, “investing in women and girls”, “collaboration of AIDS, maternal and child health (MCH) and sexual and reproductive health and rights (SRHR) advocates”–these were all empowering statements echoing through the Washington, D.C., Convention Center during the Women Deliver 2010 Conference. More than 3,000 advocates from around the globe migrated to Washington to declare their dedication to fulfilling Millennium Development Goal 5 (MDG5), reducing maternal mortality by three quarters by 2015.

I tabled with the Center for Health and Gender Equity (CHANGE) for most of the three-day conference. The Expo Hall was lively; filled with people in colorful clothing from around the world. CHANGE had two campaigns they were promoting at the conference. The first was a “take action” postcard being delivered to Ambassador Eric Goosby, the U.S. Global AIDS Coordinator. The postcard urged Ambassador Goosby to:

• Ensure that every PEPFAR program meets the needs of women and youth—no more stand-alone abstinence and faithfulness programs;
• Guarantee that PEPFAR activities address HIV and reproductive health with integrated, woman-centered programming;
• Promote access to rights-based prevention programs, especially for sex workers by addressing the negative impact of the anti-prostitution loyalty oath (APLO).

This action generated great conversation about the necessity of integrating all sexual and reproductive health services. A physician from Nepal commented on the importance of integration and referral systems to ensure that his clients receive the care they need. He recalled a woman living with HIV, pregnant with her eighth child, coming to his clinic for prenatal and HIV-related services. She wanted to discuss the option of not having any more children. His clinic only had male condoms, and was not equipped with additional family planning (FP) services or trained staff to discuss woman-initiated contraceptive options. She left the clinic with a bag of male condoms. He reflected that her husband probably refused to wear the condoms and that she would be visiting his clinic shortly with her ninth pregnancy. It is stories like this that shed light on the importance of integrated services, trained community health workers, and multi-sectoral supply distribution.

CHANGE also had Prevention Now! campaign materials and samples of the latest FDA-approved female condom (FC2). Prevention Now! promotes the distribution of female condoms through U.S. foreign policy initiatives. Conference attendees where extremely excited about the campaign. A Nigerian doctor said that his clinic distributed female condoms. Women had entered the clinic asking FP nurses for condoms, and when given male condoms, they refused them and explicitly asked for female condoms. A Kenyan attendee laughed as he told me in broken English that female condoms were noisy. He explained that he liked the idea of a woman-initiated barrier method, but that seemingly small issues like noise can be the determining factor in women’s decisions to use the method. I told him about the new material of the FC2 condom and he was happy to hear that many reviews of the new FC2 state that the new material makes the product less noisy. While seemingly silly details, it is stories from the people working with women on the ground that alert us to importance of promoting FP and STI/HIV barrier methods that women WANT to use. If there is no demand for the product, the intervention is useless.

As a young woman from Minnesota, the Women Deliver 2010 Conference was my first exposure to the international community in action. This is a community dedicated to improving the quality of life for women and girls, regardless of cultural and geographic differences. A community composed of several women’s and development organizations, working towards a common goal that will ultimately improve the social health and development of all communities.