MALAWI: High hopes for female condom

BLANTYRE, 29 July 2008 (IRIN) - Malawian women have little say when it comes to condom use, but the government hopes that the recent launch of the female condom in the country could go some way in solving this age-old dilemma.

Sandra Mapemba, national condom programme coordinator at the Reproductive Health Unit (RHU) in the Ministry of Health, believes the female condom will empower women to have more control in their sexual relationships, help them protect themselves from sexually transmitted infections (STIs) and HIV, as well as unwanted pregnancies.

The female condom was first piloted in Malawi in 2000, with funding from the United Nations Population Fund (UNFPA), but failed to catch on.

"What led to this was lack of proper information on the condom. The product was just dumped in clinics and most service providers lacked basic knowledge," said Mapemba. "This resulted in people getting wrong information about the product, hence the low acceptance."

The pilot was repeated four years later in 22 areas across the country and subsequent studies found that it had gained greater acceptability.

Public health workers thought the introduction of the female condom in the late 1990s would give women in developing countries more power to protect themselves against HIV infection.

But the prohibitive cost of the product, lack of political will and stigma surrounding its use, have kept it out of reach to the many women who need it.

Distribution of the product

The health department will be distributing a new and improved version of the female condom, which is easier to insert than the original version. "They are neither noisy [previously a main complaint] nor uncomfortable, as some people have alleged," said Mapemba.

Government clinics will distribute them to clients at no charge, but they will also be for sale at a price of K35 (US$0.25) for a pack of two. Population Services International (PSI) Malawi, an international non-profit social marketing organisation, is already distributing female condoms throughout the country.

Drawing on the organisation's global experience, PSI Malawi is using a network of hairdressers to distribute the condoms because the salons are able to provide their clients with consistent support and information. Pamela Msukwa of PSI Malawi said it was too early to gauge the success of the initiative, but so far the response had been encouraging.

Public response

A quick survey by IRIN/PlusNews found a mixed reaction to the female condom. Magdalene Philipo, a receptionist and mother of three, was doubtful about the extent to which they would help women protect themselves from HIV and unplanned pregnancies. "I don't think it will change anything," Philipo told IRIN/PlusNews. "Men will continue to dominate in these issues and the status quo remains just that."

Fatsani Nanjaikho, a mother of two, agreed. "Experience has shown that women have very little say on matters related to sex," she said, adding that whether the condom was male or female, men would continue to have the final say about its use.

She also felt that the government and NGOs needed to step up campaigns to educate people about female condoms. "At the moment we hear very little about [them]," she said. "I have never heard any advertisement on radio or on television about it, and I am sure many others are in the dark about how to use it."

But beautician Martha Banda, 22, felt that the female condom had the potential to help women have more control over their sexual health. "In the past it was men who could direct things and at the expense of women's health. I am glad that women have a choice to protect themselves against STIs and unwanted pregnancies using this new condom," she said.

Bartholomew Boaz, a journalist, said commercial sex workers would probably benefit most because they tended to be in a stronger position to negotiate condom use than other women.

"But I expect problems in families, because most women lack the courage to stand up and say 'no' to any form of abuse, including sexual harassment," he said. "It has been our tradition that men should be the ones to lead, even in dictating who should and should not wear a condom."