Deliver This: Female Condoms and Maternal Health
By Christine Cupaiuolo — June 22, 2010
by Kiki Kalkstein, Center for Health and Gender Equity (CHANGE)
Earlier this month, I attended the Women Deliver Conference in Washington, D.C ., on behalf of the Center for Health and Gender Equity (CHANGE). After a jam-packed three days of plenary sessions, chairman’s sessions, and more than 100 concurrent sessions, participants left the conference reinvigorated and ready to take action to work toward fulfilling Millennium Development Goal #5: Reduce maternal mortality and achieve universal access to reproductive health.
After speaking with hundreds of participants, one thing was made very clear to me — people not only want female condoms, but they believe that female condoms are a vital tool in decreasing maternal death, improving maternal health, and promoting sexual and reproductive health and rights.
I had countless conversations with participants from all over the world who were thrilled we were there talking about and promoting the female condom. As I shared information about the Prevention Now! Campaign (CHANGE’s initiative to increase access to existing prevention methods, especially female and male condoms), their message came through loud and clear — we want female condoms, and we want them now.
I spoke with men and women of all ages, and again and again they expressed interest in female condoms and inquired about how to increase access in their own countries. A doctor from Kenya said that women who come to his clinic consistently ask for female condoms, and he doesn’t have any to offer. A doctor from Nepal took all the information he could from our booth, and came back with his colleagues to get more. Some participants asked how they could launch a female condom program in their own countries. Female condoms are in demand.
Access to contraception is critical for preventing maternal deaths, but sometimes high-level decision makers do not make that connection. The female condom puts women in control of their own health by enabling women to delay pregnancy and space out births, all of which decrease the risk of maternal death and disability.
Effective family planning programs are not only fundamental to maternal health, they also allow women and families to better manage household and natural resources, secure education for all family members, and address each family member’s healthcare needs. Participants at Women Deliver conference acknowledged the benefits of the female condoms and recognized it as a vital tool for improving maternal health globally.
* Expanding the Female Condom Market
* FC2 Female Condom Available in the U.S.
Kiki Kalkstein is the program assistant at the Center for Health and Gender Equity (CHANGE). She previously designed and implemented public health education programs both domestically and internationally, including a rural community outreach program with the Uganda Village Project focused on increasing awareness around obstetric fistula. She also designed and implemented at the University of California at Berkeley “Sex and Sustainability: Reconnecting Population and Women’s Empowerment,” a campus program designed to increase awareness about unmet family planning needs in developing countries.
In theory this is a great point, and I too after attending a seminar on female condoms left with the same hopeful and urgent attitude. Later I discussed the issue with my boss, who had spent two years in Kenya for the Peace Corp. She was less than optimistic about the panacea potential for female condoms. Her complaint was that they can be quite noisy during intercourse, and partners can feel them. A major obstacle to condom use in Africa and in many places where maternal mortality is a large issue is because women lack the cultural authority to initiate a discussion about birth control, and those that do are deemed promiscuous. For a woman who doesn’t use a condom for this reason, using a female condom could have disastrous results if her partner were to find out that she was “sneaking” in birth control. This discussion happened last year, so hopefully things have changed since then. But unless the female condom is better designed to avoid such incidences from occurring, then its usefulness will be limited.
Yes, you’re right. Female and male condoms need to be both adequately funded and accompanied by education programs, to address supply issues and the cultural barriers that prevent them from being used. Fortunately, there are programs, such as Women’s Action Group in Zimbabwe, that have successfully overcome these obstacles by equipping women with good negotiation skills and by involving men and entire communities in female condom promotion efforts. In addition, the newly FDA-approved FC2 female condom addresses the noise factor–it’s made from a different material specifically to reduce the noise.
Another key thing to consider is that women are demonstrating a demand for female condoms in countries with high maternal mortality rates. As donors, how do we respond? These are the women who can guide us through how to work with men and women to discuss condom negotiation. While not intended to be a panacea, nor “secret” protection (although in some cases like when a man is drunk, it can provide her protection that he doesn’t need to be involved in), female condoms are an option that protect against HIV/AIDS, STIs and can delay pregnancy—and they are being requested by women and reproductive health practitioners in the field. Giving women another tool and the skills to protect themselves is always a good option.
See an example of reintroducing female condoms in Uganda: http://www.rhrealitycheck.org/blog/2009/06/26/uganda-reintroduce-critical-tool-hiv-prevention-female-condoms