Every three months Felistus has to set off on a four hour walk across two mountains to get to her closest family planning services.

Felistus’ husband, Peter, said: “Family planning helps us to enjoy our marriage without fear of unwanted pregnancies. Children grow healthier and we can have not have more than we can afford.”

She has no alternative unless she wants to risk an unwanted pregnancy but the trips creates problems with her husband because the household tasks don’t get done and their five children are left unattended while she is away.

In such remote locations the choice is a long walk to a service post or to use a Community Based Distributor (CBD) but there are some problems with the CBDs. They are not trained to administer long acting reversible contraceptives which means they are often only able to distribute condoms.

One of the CBDs in Zambia, Kabungo, said:

“When the people heard the Government is planning to introduce CBD to attend to their family planning needs they thought that all family planning methods would be available but since many CBDs are not trained to offer anything apart from condoms it is not possible to offer other methods. It discourages people because they expect the CBD to provide all family planning methods.”

Prisca Simbeya, who’s a family planning champion in Zambia, said she thought it was time for the Government of Zambia to explore the underlying potential of the CBDs to reach out to the most underprivileged populations. She said they needed to build the capacity of the community based distributors so they could administer the injectable method of contraception which, she said, could be a good starting point for long last reversible methods of contraception. 

She added that they needed to cement the intervention to ensure that services were available as close to people as possible. Ms Simbeya said she thought that the Government also needed to be mindful of time since Zambia as a country made these commitments at the family planning summit in London three years ago. She said that if they didn’t act sooner rather than later it would be difficult to meet Zambia’s target which was a major factor in addressing high fertility rates.