Last week over two days I helped counsel fifty women on family planning through part of a Ministry of Health campaign offering free condoms, IUDs and contraceptive implants to all who came to the Danfili integrated health center. This campaign was co-sponsored by a couple of NGOs present in the Adamawa. In Cameroon, according to the Population Reference Bureau, about 77% of contraceptives available in Cameroon are offered by the private sector. During the campaign, the health staff inserted 28 IUDs and 22 contraceptive implants, while I helped collect demographic information, vitals, and used my broken Fulfulde to help counsel clients on the different methods. At the end of the two days, we were tired and triumphant by the successfulness of this campaign.
In the days leading up to our campaign, the chief hired members of the men’s group (les Hommes Dynamiques) and women’s group (les Meres Liders) I work with to inform the community. They did an outstanding job, referring all of the clients who came in during the campaign. During the previous year the CSI received a total of 95 clients seek family planning which proves the success of their campaigning.
During the campaign, the average age of our clients was 26 years old and all had had at least one pregnancy already. 70 percent of the clients never attended school, and 84% were muslim. The average weight was 51kg, or 112lbs.
According to a United Nations Population Division update, the unmet contraceptive need in Cameroon is 23% and about 14% of women use modern contraception. Unmet need for family planning is defined as the percentage of women of reproductive age who want to stop or delay childbearing but are not using any method of contraception.
When I spoke about this with the campaigners they brought up that some of the women they campaigned are tired of having babies and have been interested in seeking family planning but did not have the money to come to the health center. BOOYAH. By having a campaign for free contraceptives, we are reducing the barriers associated with unmet need.
The organization I interned for last year, DKT International, is a results-driven social marketing organization committed to reducing unmet need worldwide through increasing access to and affordability of contraceptives. Throughout the year, country directors send reports on activities conducted in the field (including events like the campaign we just had) and I synthesized the data in terms of results—How many condoms were sold in Brazil? How many IUDs did our providers in India insert? By the metrics DKT and other contraceptive social marketing organizations use, 100 condoms are presumed sufficient to prevent pregnancy for one couple for one year, generating one CYP (couple year of protection). If a country program sells 50,000 condoms in the year, the program can claim to have aided 500 couples in preventing unplanned pregnancy for the year. Additionally, if a program sells 50 contraceptive implants, and each implant can provide 3 years of pregnancy prevention, the program can claim to have provided 150 years of unplanned pregnancy. CYPs are a helpful metric to show the impact DKT has on reducing unmet contraceptive needs worldwide.
When updates from the different DKT programs worldwide came in, seeing these numbers was motivating. I was proud to be associated with an organization that empowers women and families in such a way, but felt too far removed from the reality of these results. I tried to imagine the impact of all these “CYPs,” but sitting comfortably at my desk in Washington, DC, many of my questions were unanswerable. Who are the people who use or receive these contraceptives? What is their understanding of contraceptives and family planning, and who teaches them? How do providers find clients? What training do they receive?
Reflecting on these questions confirmed my interest in joining the Peace Corps by concluding that the only way I could answer these questions was to go into the field and see for myself. Now that I am here, I am happy to say that I better understand the realities of these numbers, and also appreciate the importance of monitoring and evaluation.
In M&E, it is important to differentiate between outputs and outcomes. For example, an output from our campaign in Danfili resulted in 50 women receiving long-term contraceptives to prevent unwanted pregnancy. If my math is right, we provided 181 CYPs.
The outcomes of these CYPs will be a little more difficult to quantify, but through providing free contraceptives to fifty women, they will have more control over other aspects of their life, such as feeding, clothing, and educating their children, seeking health care for themselves and their children, and reduce the incidence of child and maternal mortality. Through part of the visit we collected the women’s phone numbers, and I am planning a way to use their numbers, to either send health updates through sms, or to canvas for interest in a women’s health class at the health center. Updates to come!