Family planning is often seen as a woman’s responsibility, but men have an equally vital role to play in ensuring their families’ well-being. For men like Medgclay, embracing this shared responsibility has been transformative. His journey highlights the importance of informed choices, challenging misconceptions, and fostering open conversations about reproductive health, particularly when it comes to vasectomy—a safe and effective contraceptive method that remains misunderstood by many. A Childhood That Shaped My Perspective on Family Planning My name is Medgclay from Kenya, I have been married for 14 years, and I am a proud father of four children. Growing up in a family of 13 children, I know firsthand the struggles of providing for a large household. Resources were always stretched thin, and even basic needs like food and education were hard to come by. My wife came from a family of seven children, where her parents, as farmers, faced similar challenges. These experiences shaped how we approached family planning when we got married. When we started our lives together, we agreed to have only two children so we could offer them a stable, comfortable life. We hoped for a boy and a girl, and, to our amazement, that dream came true when our first pregnancy brought us twins. We were overjoyed and thought our family was complete. Back then, I viewed family planning as solely a woman’s responsibility, so I encouraged my wife to choose whatever contraceptive method worked best for her. Unfortunately, that wasn’t easy. Every method she tried brought severe side effects, hormonal disruptions, mood swings, weight gain, and allergic reactions. Eventually, she opted for a 5-year hormonal implant, which seemed to work initially. But three years later, while the implant was still active, she unexpectedly became pregnant. We welcomed another child, but it was clear that we needed a more reliable, permanent solution. Exploring Vasectomy: Overcoming Misconceptions and Fears After consulting numerous healthcare providers and exploring our options, a doctor suggested a vasectomy. I hesitated at the idea. Like many men in our society, I was burdened by misconceptions: Would it make me "less of a man"? Was it akin to castration? Would I be seen as weak or "useless"? Despite my education, these myths weighed heavily on me. But love for my wife and a commitment to shared responsibility made me open to exploring various options. After multiple consultations, I learned the truth: vasectomy is a simple, safe procedure with no negative impact on masculinity, sexual performance, or overall health outcome. With newfound understanding and my wife's support, I decided to undergo the procedure in July 2022, when our youngest daughter was six months old. The experience was straightforward, but we made a crucial mistake: we didn’t follow the post-operative guidelines properly. My wife stopped her contraceptives too soon, and by December, we were surprised to learn she was 12 weeks pregnant. This wasn’t a failure of the vasectomy itself; it was our misstep. The procedure was effective, and we learned an important lesson about following medical advice closely. This experience transformed me. I realised how deeply ingrained myths and misconceptions about vasectomy and family planning as a whole hold men back. I decided to take a stand. My wife and I began educating and engaging men in our community about the truth of vasectomy and the importance of shared responsibility in family planning. We’ve spoken to countless men, challenging harmful narratives, and offering accurate and science-based information. My story serves as a reminder that men have a vital role to play in family planning. World Vasectomy Day, observed on 15 November each year, is more than just a date on the calendar; it’s a global movement to empower men, dispel harmful myths, and promote open conversations about contraception. World Vasectomy Day celebrates men who take responsibility for their reproductive choices. I urge men everywhere to join the conversation. Ask questions, challenge harmful traditional values and beliefs, and consider the powerful impact of sharing responsibility in family planning. Together, we can create a world where family planning is recognized as a shared duty empowering couples, supporting communities, and securing a brighter future for all. Debunking Common Vasectomy Myths Here are some common misconceptions I’ve encountered and the truths that dispel them: Myth: Vasectomy reduces masculinity. Truth: It does not impact a man's masculinity or sexual performance.   Myth: It diminishes sexual pleasure. Truth: Vasectomy does not affect sexual sensation or function.   Myth: It’s permanent and irreversible. Truth: While intended to be permanent, vasectomies can sometimes be reversed through surgery.   Myth: It weakens physical strength. Truth: Vasectomy has no impact on physical capabilities.   Myth: It increases prostate cancer risk. Truth: There is no proven link between vasectomy and prostate cancer.   Myth: It harms future relationships. Truth: Vasectomy does not impact fertility or relationships with new partners.   Myth: It conflicts with religious beliefs. Truth: Views vary, and it’s important to consult religious leaders if needed. Men taking ownership their sexual and reproductive health is a chance to reshape how we think about family planning. Let’s engage men, confront myths, and spread knowledge. Together, we can ensure that every family planning journey is informed, inclusive, and empowering. I stand as a testament to the power of change, and I invite other men to step up and take this journey with me for the good of our families, our communities, and generations to come. By Medgclay

Nairobi, 23 September 2024 – A groundbreaking £75.125 million project has been announced by the International Planned Parenthood Federation (IPPF) and its partners, the International Rescue Committee (IRC), Options, Ipas, and Johns Hopkins University Centre for Communication Programmes, to transform sexual and reproductive health services across East and Southern Africa. This large-scale initiative will benefit seven countries, supporting millions of women, girls, and vulnerable communities in Burundi, Ethiopia, Madagascar, Somalia, South Sudan, Sudan, and Zambia. This programme, known as Women’s Integrated Sexual Health 2 (WISH 2) Lot 2, is funded by the UK Foreign, Commonwealth and Development Office (FCDO). As part of FCDO WISH Dividend, it builds on the successes of FCDO’s £272 million Women’s Integrated Sexual Health (2018-2024) programme, which spanned 27 countries across Africa and Asia. Over its lifespan, the first WISH programme supported over an estimated 16.9 million women and girls, helping them gain access to critical SRHR services. FCDO’s continued partnership with IPPF for this next phase of WISH was unveiled by FCDO's Chris Carter, on behalf of the UK Minister for Africa, Lord Collins, during the United Nations General Assembly (UNGA) side event, “SRHR: Securing reproductive choice for the next generation.” Announcing FCDO’s partnerships with IPPF, MSI Reproductive Choices and the Children's Investment Fund Foundation, Chris Carter noted the new programme will play a critical role in increasing women's voice, choice and control across 13 countries in Africa.” With the goal of delivering over seven million ‘couple years protection,’ the programme will address critical healthcare gaps, promote reproductive choice, and tackle harmful social norms. It will also provide urgent support to improve policies, strengthen health systems, and safeguard the reproductive rights of women and girls, especially in areas affected by conflict and displacement. At the heart of this initiative is a focus on reaching the most marginalised groups, including young women and girls under 20, those living in poverty, people with disabilities, and communities in conflict zones. Importantly, WISH2 will also work to improve access to safe abortion care and counteract the growing threats to women’s and girls' sexual and reproductive health rights. IPPF Director General Dr Alvaro Bermejo emphasised the critical need to protect and expand access to SRHR. “WISH2 will continue our mission of empowering women and girls across Africa to unlock their full potential. We will not only tackle the rollback of SRHR rights but also strengthen disability inclusion while delivering sustainable healthcare solutions,” said Dr Bermejo. “We’re grateful to the UK Government for their unwavering support in this important work.” Elshafie Mohamed Ali, Executive Director of Sudan Family Planning Association (SFPA) said “WISH2 is essential given Sudan’s current circumstances, particularly the ongoing conflict since April 15, 2023. The programme addresses the growing need for sexual and reproductive health services, offering crucial support to vulnerable communities amidst increasing instability and humanitarian challenges.” Chris Carter, Deputy Director, Head of Human Development Department, highlighted the impact of this new initiative: “Access to sexual and reproductive health services saves lives, empowers women and girls, and supports education, transforming lives and entire livelihoods. This project will amplify women’s voice, choice, and control across Africa, and we are proud to partner with IPPF and African organizations in this critical mission.” For media enquiries, please contact [email protected]  

By Marie-Evelyne Petrus-Barry and Mallah Tabot June 24th this year marks the second anniversary of the repeal of Roe v. Wade, a seismic shift in the landscape of reproductive rights that has reverberated far beyond the borders of the United States. In June 2022, the US Supreme Court overturned the landmark 1973 ruling which had established a woman's legal right under the US Constitution to have an abortion. This repeal has had global repercussions, further emboldening anti-abortion movements, and influencing reproductive rights debates, policies, funding, and services. In Africa, not only did it send shockwaves, but has also prompted a reflection and re-evaluation of our role as African stakeholders in shaping the future of reproductive rights everywhere on the continent. In many countries on the continent where access to abortion care is already fraught with challenges, this development serves as a stark reminder of the fragility of reproductive rights. It highlights the danger of complacency and the need for vigilance in protecting and advancing these rights and reminds us that abortion is not a moral issue for debate, it is healthcare, and a fundamental human right. While the repeal has sparked renewed activism and advocacy for rights actors on the continent, it has also further emboldened conservative factions and a growing anti-rights movement to push for more restrictive laws and policies through novel tactics to further their agenda. Under the guise of protecting the family, anti-abortion narratives are used as entry points to infiltrate political, legislative and advocacy spaces to roll back hard-won gains.   Even going as far as setting up alternative research institutions in Africa to generate quasi-scientific evidence to counter reputed research bodies like the Guttmacher Institute. Increasingly, a key tactic is the weaponizing of First Ladies to further the anti-rights agenda. In Kenya, the National Family Protection Policy, drafted by a major anti-rights group, Citizen Go was launched by the First Lady, despite not undergoing public participation and receiving lots of criticism from rights actors. In Uganda, the Geneva Consensus declaration, an anti-abortion joint statement is making inroads in the country through its affiliation with the First Lady, even though the “Consensus” has no legal or policy underpinning. This trajectory underscores a critical reality: Nothing is safe, our continent is a battleground for the ideological struggles taking place elsewhere in the world, sadly, our human rights, including SRHR are at the highest risk. We must forge our own path, grounded in the unique political contexts of our nations through our partnerships with local organizations and governments. As one of the leading voices on SRHR advocacy and services in Africa, IPPF believes now is the time for Africa to assert its leadership in the global fight for reproductive justice. In collaboration with other key actors on the continent and beyond, IPPF is committed to continue playing a pivotal role in the SRHR landscape of Africa. We will continue to expand access to abortion care, especially for the most vulnerable and marginalized, comprehensive sexuality education, contraceptive services and reaching those in humanitarian settings. Despite these efforts, much work remains. The disparities in access and the entrenched stigma surrounding abortion care continue to hinder our progress. One of the key initiatives we are proud to be part of is the CATALYSTS Consortium,  which was born out of this landmark ruling in June 2022. Following the ruling, IPPF Africa Region, Ipas Africa Alliance, Centre for Reproductive Rights Africa, Population Council Kenya and FIGO came together to discuss the ruling’s implications on the continent and consider the case for an abortion consortium that might more effectively protect and promote abortion rights in Africa. Launching on June 27th, the Consortium has set an ambitious and unambiguously comprehensive vision for abortion care for all in Africa. This type of organic consortium on abortion has not yet been attempted. As African thought leaders, field builders and a vehicle for driving accountability, we are a Consortium of the brave with a track record of never backtracking. Our solution is powerful, impactful, and led by those doing the work while building an African critical mass that can effectively open doors, advocate more strongly and underpin bolder action. CATALYSTS is Africa-led, committed to decolonizing, and reframing the discourse around abortion rights in Africa by centring African perspectives, experiences, and voices. But we cannot achieve our goals in isolation. It is imperative that African governments, activists, youth groups and other civil society groups recognize the urgency of prioritizing reproductive rights. Governments must decriminalize abortion, ensure access to contraceptives, and protect the rights of individuals to make informed choices about their reproductive health and rights. Cross-border activist solidarity is imperative if we must move the needle on reproductive justice, and young people should be recognized as not just a passive group with SRHR needs but as critical actors at the centre of the journey towards reproductive justice. IPPF ARO stands ready to champion this charge, but we need the support and collaboration of governments, communities, and international partners. CATALYSTS launches on June 27th after close to two years of consultation, course correction, investment, and realignment. I invite you to join us in bringing this vision to life, which will be marked by the unveiling of the website, Theory of Change, and call to action. It promises to be a celebration of our collective achievements and a testament to the transformative power of collaboration. As we mark the second anniversary of the Roe v. Wade repeal, the stakes could not be higher for African SRHR actors. The urgent need for a unified and proactive approach to safeguard and advance reproductive rights on the continent is imperative as the path forward requires bold action, unwavering commitment, and a collective direction. For us, the lesson is clear: They are coming for us, bolder, stronger, and more organized, and we cannot depend on the legal frameworks or political will of foreign nations to safeguard our reproductive rights. Instead, we must strike back and reclaim our narrative, and enforce our own robust policies that reflect the needs and realities of our people.  

By Mallah Tabot and Sylvia Ekponimo In May 2024, The International Planned Parenthood Federation’s International Medical Advisory Panel (IMAP) released a statement on person-centered care for STIs. The statement  offers the most recent updates on sexually transmitted infections (STIs) and shares practical guidance for IPPF Member Associations (MAs) on “how to develop a comprehensive, person-centered approach for STI care” with emphasis on the importance of integrated services, adherence with guidelines, rights-based care, community involvement, advocacy, and a positive outlook on sexual health and well-being. As with other IMAP statements, this publication is very timely considering the global STI trends which are unfortunately on the rise, with more than 1 million curable STIs acquired every day and many countries continuing to report an increase number of cases. Despite the deployment of interventions for the prevention, treatment, and management of STIs including HIV at global and regional levels, as well as the introduction of biomedical prevention technologies such as vaccines and pre-exposure prophylaxis (PrEP) for HIV prevention, the situation remains bleak. In 2020, global data indicated an estimated 374 million new STI cases per year, with 26% of the new cases coming from Africa. For HIV prevention, PrEP services are expanding significantly in Africa, with 22 countries offering it to adolescent girls and young women, sex workers, gay and other men who have sex with men, transgender individuals, people who inject drugs, and/or prisoners. While its benefits have been widely documented, with the latest research revealing that PrEP reduces the risk of getting HIV from sex by 99%, it however does not prevent against other STIs or pregnancy.     Strategies and planning frameworks for the integration of HIV and other STIs in the face of this global surge exist. However, the elements required for intentional implementation may be missing especially in low resource settings which in turn limits our collective ability to overturn this trend and improve efficiency within our health systems. Currently, most PrEP interventions are implemented within HIV programmes with significant focus on priority population groups. While this is plausible as these populations are at-risk and most-often underserved, pertinent questions however remain, which we must continually reflect upon and consider – Have we fully harnessed valuable opportunities to integrate and link STI service delivery to other services including HIV? How can we ensure that current STI interventions truly contribute to reverse the trends of STI prevalence in Africa? Is the expansion in access to PrEP services in Africa an opportunity to do so? With the rollout of multiple PrEP methods that protect against HIV without condom use, are we fully integrating services?     A systematic review of some studies on STI prevalence amongst PrEP users highlights the need for active integration of HIV and STI services especially for key populations. Therefore, a critical interrogation into current implementation strategies for STI management vis-a-vis PrEP programming is essential. With this in mind, it is of the essence for MAs and other partners to take heed of the robust and actionable recommendations in this IMAP statement, and reevaluate their STI/HIV integration strategies. From standard operating procedures that ensure that clients are systematically offered testing for HIV and STIs, no matter the reason they are attending the clinic, to provider training on integrated services, or checklists to ensure these tests are offered and conducted, we must ensure that strategies are tailored to overturn the current STI prevalence while sustaining efforts in HIV prevention through PrEP.

In 2015, the United Nations General Assembly resolution (A/RES/69/293) proclaimed 19 June as the International Day for the Elimination of Sexual Violence in Conflict. This annual commemoration raises awareness on the need to end conflict-related sexual violence, honours survivors around the world, and pays tribute to all those who have courageously devoted their lives to the eradication of these crimes. Today and every day, IPPF joins the rest of the world to stand up against these atrocities on the most vulnerable and respond to the Sexual Reproductive Health and Rights (SRHR) needs of those affected. Sexual violence refers to any sexual act or attempt to obtain a sexual act, unwanted sexual comments or acts to traffic, that are directed against a person’s sexuality. This involves using coercion regardless of the relationship to the victim, in any setting, including at home and at work. If there is an already high rate of such violence in normal times, sexual violence is further exacerbated in conflict settings. Sadly, it has been and continues to be used as a weapon of war, and terror, a tactic meant to destabilise opponents. Not too far from war zones, girls and women also continue to be victims of sexual abuse in their homes as they become the sole breadwinners of separated families, hence targeted by perpetrators in their daily livelihood activities. Sexual violence against girls, women, boys and men can lead to a range of adverse physical, mental and psychosocial health outcomes, including negative impacts on sexual and reproductive health such as unintended pregnancies, gynaecological problems and STIs, including HIV. Across a range of countries on the African continent from DRC to South Sudan, and Ethiopia, we have witnessed the scale of these consequences, especially when diplomatic voices get swallowed up by those of armed groups perpetuating and reinforcing acute and protracted conflicts. To respond to the urgent Sexual and Reproductive Health (SRH) needs of affected populations at the onset of a humanitarian crisis, IPPF implements the Minimum Initial Service Package  (MISP) for SRH. The MISP is a series of crucial, lifesaving activities required to mitigate and address any excess SRH-related morbidity and mortality. In acute, more protracted, and post-conflict settings, our network of locally owned Member Associations and Collaborative Partners provide a package of comprehensive sexual and reproductive health and rights services and activities to meet the needs of women, girls, and young people. Working with communities and persons affected by war, we mobilize all actors to prevent and respond to sexual violence in conflicts. This ranges from our community health workers raising awareness on sexual and gender-based violence to our health care providers offering clinical management of rape and other forms of sexual violence. We have also set up strong and effective referral pathways with other actors to ensure the timely provision of psychosocial services and legal support. As much as possible, we support survivors in setting up and managing income-generating activities. We also value the power of collaboration and cooperation in preventing and addressing sexual violence in conflict settings. As such, we make it a priority to participate effectively in relevant cluster and sub-clusters activities in humanitarian responses. This in a bid to ensure that sexual and reproductive health and rights are not overlooked and are sufficiently funded to be able to respond to sexual violence. Our strong advocates do not relent in their drive for regional and national policy changes and implementation to fight against impunity. By working on policy changes, we contribute to ensure that perpetrators are held accountable for their actions. It is imperative that States, UN agencies, civil society organisations, the media and communities continue to engage in preventing conflicts and crisis, be they man-made or natural, caused by climate changes, and raise awareness on the fight against sexual violence. IPPF will continue to stand up against and condemn all forms of sexual violence as a tactic of war and strengthen our service delivery to mitigate risks but also respond to the dire SRHR needs of women, girls and young people in all their diversity in conflict settings. By  Helene Stephanie Mekinda Ndongo IPPF Africa Region Specialist Gender, Inclusion and Humanitarian Response

The project objective is to improve access to Abortion Self Care (ASC), youth empowerment, and strengthening the use of digital interventions. Budget:  1,500,000 USD Donor: The David & Lucile Packard Foundation Timeline: 2 Years ( January 2021 -  December 2022 ) Project implementation areas: Cameroon, Ghana, Cambodia, and India Partners: CAMNAFAW, PPAG,RHAC, FPAI, Ipas, Y-Labs, and IBIS Key achievements to date: Youth engagement in SRHR advocacy ASC as an option for all clients Digital/m health to increase access to SRHR and CSE Influence national guidelines and policies Review of IPPF IMAP- integrating ASC Generating leanings & sharing Building capacities of start-ups ( YSVF) Virtual immersion program Innovative approaches: Access to SRHR and CSE through digital/m health YSVF -  working with young entrepreneurs to accelerate & enhance existing SRHR solutions Lessons learned: Aggregating client data in DHI, DHIs works best in hybrid models compared to stand-alone models, multi-language engagement

  Stand Up for SRHR (Stand Up) is a 6.5-year multi-stakeholder, multi-country initiative that contributes to the increased enjoyment of sexual and reproductive health and rights (SRHR) by adolescent girls and young women (10-29 years), other women of reproductive age (30+ years), and men and boys, in strategically selected Mozambican and Ugandan districts. IPPF Africa Region and its Member Associations - Reproductive Health Uganda (RHU) and Associação Moçambicana para Desenvolvimento da Família (AMODEFA) are responsible for the component of the project which aims to strengthen knowledge and capacity of service providers and healthcare facilities to improve the provision of comprehensive sexual reproductive health (SRH) information and services. Donor: Global Affairs Canada Partners: OXFAM – Consortium Lead, The Guttmacher Institute (SRHR research and Policy), Action Canada (SRHT public engagement in Canada) Implementing MAs: Uganda (RHU), Mozambique (AMODEFA) Duration: 3 December 2021 – 31 October 2027 (6 years) Total IPPF Budget: CAD $5,867,063 IPPF Implementation Location: Uganda - West Nile Northern districts (Nebbi, Terego, Madi-Okollo, and Arua) and Eastern Uganda districts (Mayuge and Namayingo). Mozambique - Northern coastal province of Nampula: Nampula City, Nacala, and Mecuburi. Key achievements to date: Agreement signed with Oxfam Canada in December 2021 Project Implementation Plan finalized in May 2022 Established 6 (Mozambique-4; Uganda-2) service provision clusters (local groupings of health service delivery points) to ensure availability of coordinated, comprehensive services Trained 318 (Mozambique-64; Uganda-254) health service providers to provide contraceptives to young people including provision of Long-Acting Reversible Contraceptives (LARCs). Sensitized 250 (Mozambique-18; Uganda-232) ​health workers including service providers and community health workers (CHWs) on delivery of youth-friendly, non-discriminatory services. Trained 158 (Mozambique-20; Uganda-138) health professionals trained on sexual and gender-based violence (SGBV) and safeguarding practices and policies. Reached 7,098 adolescent girls and young women (AGYW) reached Sexual and Reproductive Health and Rights (SRHR) trainings and awareness activities.

Numbers don’t lie: Between 2015 and 2019, on average, 73.3 million induced (safe and unsafe) abortions occurred worldwide each year. Every year, between 4.7% – 13.2% of maternal deaths can be attributed to unsafe abortion. The World Health Organization (WHO) defines unsafe abortion as a procedure for terminating an unwanted pregnancy either by persons lacking the necessary skills or in an environment lacking minimal medical standards or both. Unsafe abortions result in the deaths of 47,000 women every year and leaves millions temporarily or permanently disabled[1]. In Africa, nearly half of all abortions happen in the least safe circumstances. Moreover, mortality from unsafe abortion disproportionately affects women in Africa. While the continent accounts for 29% of all unsafe abortions, it sees 62% of unsafe abortion-related deaths (WHO). An estimated 93% of women of reproductive age in Africa live in countries with restrictive abortion laws. This means that the country’s laws only permit abortion in certain cases, often only if there is risk to the woman’s life, her health, the pregnancy is the result of rape, or there is evidence of foetal impairment. The costs of treating medical complications from unsafe abortion constitute a significant financial burden for developing countries’ public health care systems. Further, the more restrictive the legal setting, the higher the proportion of unsafe abortions. Statistics from unsafe abortions give us a glimpse into the suffering women must endure to end an unwanted pregnancy. We must challenge, re-evaluate different countries’ positions on the provision of life-saving safe-abortion care. We must advocate for changes in laws and policies and push-for the uptake of targeted and budgeted approaches that reach women and girls with safe abortion and contraception services wherever they are. IPPF and other key stakeholders are working towards ensuring that in the next five years, more women and girls will access abortion services differently, as the solutions to terminate a pregnancy will be more easily understood and available through self-managed medical abortion. This new approach promises to radically transform how health care is perceived and accessed by firmly placing women and girls at the centre of the abortion process; shifting the power dynamic from a medicalized and provider-led/decided approach to one that is person-centred and guarantees bodily autonomy. Where women can take control of their bodies and decide when and if to have children; whilst being supported by the healthcare system if needed. Also Read: Safe abortion in the context of COVID-19: partnership, dialogue and digital innovation This approach has been endorsed by WHO and is detailed within the newly released self-care guidelines. Several studies  have confirmed that self-managed abortion is safe, effective, and not inferior to those performed in clinical settings. A recent WHO review revealed that 94–96% of self-managed abortions had similar success rates to those conducted in clinic-based settings. In fact, 90% of clients confirmed they would recommend self-managed medical abortion. As local and global actors working for women’s health, rights and bodily autonomy, we must champion and roll out such new models and approaches that uphold, protect and champion women’s health, sexual rights and reproductive justice. Last July, IPPF joined global actors at the Generation Equality Forum to define and announce ambitious investments and policies for women and girls worldwide. Among our bold commitments, was a resolve to “expand and improve the provision of abortion care through 102 Member Associations, including quality medical and surgical abortion, person-centered abortion self-care support, and abortion care beyond 12 weeks of gestation through a simplified outpatient model using task-shifting to mid-level providers, including self-managed medical abortion.” This is a bold pledge that cannot depend on IPPF alone. It is critical if we are to reach the target of making the self-management of abortion a reality by 2026. Among others, IPPF calls upon the global ecosystem; feminist movements and civil-society organisations to continue to counter the multiple barriers i.e., legal, cultural, social and religious, that impede women from accessing safe abortion freely. Also Read: Abortion Quality of Care from the Client Perspective: a Qualitative Study in India and Kenya IPPF also calls upon policy and decision-makers to uphold their sexual reproductive health and rights (SRHR) commitments and repeal laws and policies that prevent safe abortion. We ask donors to invest in commodities and essential supplies, service delivery partners and prioritize research that promotes this approach. We also urge local and national stakeholders and service providers to embrace this new approach by encouraging, providing and supporting the integration of new models of abortion service delivery within existing clinic-based services. Self-care is not a magic bullet, and neither will this radical change happen by chance. It takes all of us to make it happen. This is not just a question of access. It is a fundamental question of freedom, empowerment, and bodily autonomy. Read more about The Global Comprehensive Abortion Care Initiative (GCACI). By Marie-Evelyne Petrus-Barry, Regional Director, International Planned Parenthood Federation, Africa Region (IPPFAR). Marie-Evelyne Petrus-Barry is the Regional Director of the International Planned Parenthood Federation, Africa Region (IPPFAR). The International Planned Parenthood Federation Africa Region (IPPFAR) is one of the leading providers of quality sexual and reproductive health (SRH) services in Africa and a leading sexual and reproductive health and rights (SRHR) advocacy voice in the region.   For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.

Story by Maryanne W. Waweru l Photos by Moctar Menta Mwangi Peter, 38, is a cobbler in Kiandutu slum, Thika, Kiambu County, in Central Kenya. On a bright Tuesday September morning, we meet him meticulously repairing a pair of beige-colored ‘Safari Boots’—a favorite shoe brand for men in that part of the country. With his hands, he carefully weaves the nylon thread in and out of the boots’ worn-out soles. It’s a job he has been doing for many years. He is Kiandutu’s ‘shoe fixer’. Mwangi is one of the estimated 2.2% of Kenyans living with a form of disability, according to an analysis of the 2019 census report released by the Kenya National Bureau of Statistics (KNBS). With a physical impairment, he walks with an artificial leg, which he says is long overdue for replacement because he has never gotten funds to do so. “It costs so much money to replace it, and despite working hard for over two decades, I have never been able to save enough,” says Mwangi, who dropped out of school in Grade three as his parents were unable to cover the school fees. It would cost Mwangi about 70,000 shillings ($634) to replace his artificial leg.   Senior Bachelor But that’s not the only thing that Mwangi has been unable to do because of lack of funds. “I’m in my late thirties yet I don’t have a family of my own. People say that I should be married with big children. However, marrying a wife and raising children costs money, which I don’t have. I will marry when I become rich,” he says. Mwangi once had a ‘pregnancy scare’ when one of the women he was in a relationship with told him she was pregnant. “She however told me she would not go ahead to have my baby because she didn’t want her child to be born into poverty like me. So she procured an abortion. No woman agrees to marry me or have my baby because they say I’m poor,” he says, a forlorn look on his face. Multiple Relationships Mwangi has an interesting, active dating life. “I don’t have one particular girlfriend, but I have different women that I see. They come to my place and spend the night, then leave in the morning.” Even though he is aware of the risks associated with unprotected sex such as sexually transmitted infections (STIs) including HIV, as well as unplanned pregnancies, Mwangi does not always use protection with his different women. “I know about condoms because they discuss them on radio and television. I even learn more about them when I go for my HIV tests every two years at the local health center, but I don’t use them all the time as is required,” he admits.   Condoms or a Basic Meal? Mwangi says that on the few occasions he uses condoms, he purchases them from a nearby kiosk at 30 shillings ($0.27) for a pack of three, an amount he can’t always afford. While Mwangi knows he can get condoms for free at the local government health facility, he cites time limitations. “For me to walk to the health center, I would have to close my business. That is money that I cannot recover. I wouldn’t have enough for my meal that day if I lost those hours,” says Mwangi, who makes an average of 300 shillings ($2.7) a day from his business. Bringing Services Closer to the Community Thankfully, there are community health workers and mobilizers who regularly distribute condoms in the neighbourhood. One of them is Stanley Ngara, popularly known as ‘condom king’. “Stanley passes by here often and leaves me with some condoms. I get very happy when he does so,” Mwangi says, as he clutches the glittering, red-packed condoms he has just received from the condom king. “I will try use a condom with the next woman I’ll have sex with. But I would also urge health workers to be more considerate to people like me who face various challenges when it comes to our sexual health. Condoms should be distributed more frequently in the community for free. They should also go around doing HIV tests regularly without us having to leave our jobs for the hospital to get tested. Bringing the services where we are is more practical and convenient for us,” he says. On this World Contraception Day, it is important to remember the plight of persons living with disability (PLWD) such as Mwangi, who often live below the poverty line. Approximately 67% of PLWD in Kenya live impoverished lives. Their quality of life is poorer, with lower educational achievements which contributes to fewer economic opportunities. They also suffer poorer health, including their difficult access to sexual and reproductive health services. This is a challenge that IPPF, through its Member Associations, continually tries to address through its various programmes across sub-Saharan Africa, such as WISH2ACTION, BMZ and COVID-19 innovative response projects. For more updates on our work, follow IPPF Africa Region on Facebook, Twitter, Instagram and You Tube.