Learning to Love the Female Condom in Uganda

NEBBI, Uganda — Hundreds of women from all walks of life gathered in a school field here recently to celebrate International Women’s Day. As they marched in a parade, carrying placards with messages on the rights of women and girls, many were intrigued by a UNFPA exhibition stall that was distributing both male and female condoms to every adult who asked for them.

As women queued to pick up samples of the female condom, many said they were seeing it for the first time. A UNFPA consultant, Loyce Allen Asire, demonstrated to the curious women and men how to use the device correctly.

One woman had heard about female condoms, but didn’t know how to get them. “I don’t even know where to buy a female condom,” she said. “And if it were for sale, how much it would cost?” she asked, grabbing a pack.

Currently, the female condom (the newest version is known as FC2) is distributed at no cost in selected public and private-not-for profit health facilities in the country. It is also available for sale in some private clinics in the capital city, Kampala, but at a considerably higher price than male condoms.

However, according to a recent report, only one female condom was distributed for every 13 women of reproductive age in sub-Saharan Africa in 2010.

Female condom championed by new Commission

The interest in and questions about the female condom, as well as its scarcity, validate the recent selection of female condoms as one of 12 ‘underutilized’ commodities by the United Nations Commission on Life-saving Commodities for Women and Children.

Working under the auspices of the Secretary-General’s Every Woman Every Child initiative, the Commission will advocate at the highest levels for the increased availability, affordability and accessibility of essential but underutilized commodities for maternal and child health. “This Commission will help ensure access to critical supplies, save lives and improve the health of women,” said UNFPA Executive Director Dr. Babatunde Osotimehin. “This is at the centre of UNFPA’s work, and we are very pleased to be co-leaders in this initiative,” he added.

Priority given to three underutilized contraceptives

In selecting three contraceptives among the 12 lifesaving commodities for special attention, the Commission intends to widen access to family planning methods that are wanted, that show promise for broad public health benefits and that have received inadequate attention from the public and private sectors. The aim is to ensure that women are able to choose and have access to quality and affordable contraceptive methods that fit within their own fertility goals and life circumstances.

Recent experience shows that it is possible to overcome many of the barriers associated with underutilized commodities, even in the most deprived communities. “The Commission will help identify bottlenecks and streamline our work at country level. It will also provide key information to leverage support from donor countries,” said Jagdish Upadhyay, Commodity Security Branch Chief for UNFPA.

“We are hoping that, six months from now, we will be able to state very clearly what we can do to improve the quality and foster the use of these supplies in several countries, and what are the investments needed,” he added.

Female condom offers dual protection

According to the report on underutilized contraceptives, the female condom is a powerful dual protection (from pregnancy and sexually transmitted infections) tool that has been much neglected. Acceptability of the female condom, once consumers are educated about the product and its usage, is not an issue, the report states.

“It is the accessibility, availability and affordability of the female condom that hampers the demand and uptake,” says the report. “Men and women need to be able to make the choice whether they want to use a male or female condom when they are looking for a dual protection method. Currently that choice is rarely an option.”

Giving women more control

One of the women at the stall echoed that idea. “If there were a constant supply of these condoms, we women would be able to take care of our sexuality and do family planning as we wish,” she said. The report points out that while both partners need to collaborate on its use, the female condom may give women a little more power to protect themselves in a sexual relationship.

The report also points to several studies showing that the female condom is not just a substitute for the male condom, but is complementary and contributes to increased use of both types of condoms.

The Nebbi crowd seemed quite pleased to have another contraceptive option available.

“I love the female condom because it has no side effects on me,” said one woman. “It doesn’t cause hormonal imbalances and bleeding. It leaves me as I am.” Fear of side effects of hormonal contraceptives is often cited by African women as a reason for not using them.

Men seemed pleased as well. “I am taking some for my wife,” said one man as he grabbed a pack.

Even after the stock of condoms was cleared, many returned asking for more.

--- Evelyn Kiapi and Allen Asire