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Cameroon

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togo-contraceptives

IPPF is awarded USAID-funded ExpandPF

The International Planned Parenthood Federation (IPPF) is pleased to share that last month it was awarded the USAID-funded, five-year, $45 million Expand Family Planning and Sexual and Reproductive Health (ExpandPF) Activity following a competitive process. ExpandPF will scale up evidence-based family planning practices, including postpartum family planning and engaging community health workers, to improve access to and use of voluntary family planning services in poor and underserved urban and peri-urban populations. ExpandPF envisions a local-partner forward strategy and close engagement with young people for implementation in Cameroon, Cote d’Ivoire, Mauritania, and Togo. IPPF brings strong experience improving access to client-centered, quality family planning and sexual and reproductive health care services as allowed under USAID regulations and local law. Its structure is designed to advance locally led development, engaging women and youth while reaching underserved and marginalized communities. Hortense Angoran Benie, MD, MPH will lead ExpandPF and has significant management experience with complex public health programs across West and Central Africa. IPPF’s partners include Options Consultancy Services, Etrilabs, and IPPF member associations in each of the four implementing countries: Association Ivoirienne pour le Bien-Être Familial (AIBEF), Association Togolaise pour le Bien-Être Familial (ATBEF), Association Mauritanienne pour la Promotion de la Famille (AMPF), and Cameroon National Association for Family Welfare (CAMNAFAW). The team also includes Viamo as sub-contractor. Through ExpandPF, the consortium will ultimately assist individuals to make voluntary, informed decisions about family planning with access to contraceptive methods and services. “IPPF is very proud to receive the ExpandPF award,” said Dr. Alvaro Bermejo, IPPF Director General. “It affirms our commitment to West and Central Africa and expanding contraceptive choice to underserved and marginalized populations. IPPF believes that by working with our esteemed partners, we can advance meaningful progress across the region.” "ExpandPF aligns well with IPPF's strategy of prioritizing access to family planning and sexual and reproductive health services for vulnerable women and girls in West and Central Africa,” said Marie-Evelyne Petrus-Barry, IPPF Africa Regional Director. USAID administers the U.S. foreign assistance program providing economic and humanitarian assistance in more than 80 countries worldwide. The Agency is committed to helping countries meet the family planning and reproductive health needs of their people through voluntarism and informed choice.

Healthcare worker with combipack.

In pictures: Innovating during COVID-19

Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

nurse with client - Cameroon
09 July 2019

Providing comprehensive care in Cameroon

Since 1987, the Cameroon National Planning Association for Family Welfare (CAMNAFAW), has been the country’s leading provider of sexual and reproductive healthcare (SRH). CAMNAFAW delivers healthcare including contraceptive, abortion and HIV-related, through a variety of clinics and youth outreach run by full-time staff and supported by over a thousand volunteers.  Yet, healthcare is limited, and women, men and young people are being denied access to crucial healthcare including safe abortion and contraception. Cameroon continues to suffer from high rates of maternal and child mortality, exacerbated by the widespread practice of unsafe abortion. Around 560,000 people (3.7%) of a population of 24 million are HIV positive.   Young women who get pregnant outside marriage face systemic discrimination and will frequently try to end the pregnancy themselves using widely available household products, herbal remedies, or large amounts of alcohol. “They are often refused access to state services and asked if they have no shame about getting pregnant, and (nurses) threaten to tell their parents,” said Aline Mekone Njanjo,  midwife at CAMNAFAW’s SOA clinic, on the outskirts of Yaoundé. Read Urielle's abortion care story Show more + “I heard about the CAMNAFAW clinic from a friend. She said they treat you well here and take care of patients, above all women and children. I came here to find out more. Here things are safe and you’re not at risk. There are doctors and nurses who are professional and know what they are doing. Elsewhere you hear about girls having abortions and it can be risky. You could even die. I am in training to become a customs officer. It’s the only chance I have to get a good job. It’s important because I was a schoolgirl when I had my daughter, and that put the brakes on my development. It stopped me from continuing my studies. I did evening classes and I managed to get my high school diploma. Now my daughter is getting older and she needs so many things. That’s why I was looking for work and doing a lot of entry tests. It’s really tough to have an unintended pregnancy.”   Comprehensive care  Comprehensive abortion care and contraception are key priorities for IPPF and its Member Associations. The Global Comprehensive Abortion Care Initiative (GCACI) supports this work in 16 Member Associations including CAMNAFAW. The overarching goal of GCACI is to improve access to comprehensive quality abortion care (safe abortion and/ or treatment for incomplete abortion depending on local context) and contraceptive care as integral components of sexual and reproductive health. Beyond CAMNAFAW’s clinics, hundreds of peer educators and youth volunteers nationwide manage an outreach programme aimed at busting myths surrounding contraception, sexually transmitted infections and abortion.  Some of these views are entrenched: traditional attitudes to childbearing and the strong influence of Catholic and evangelical churches have contributed to many taboos surrounding contraception and abortion in Cameroon. CAMNAFAW staff,  peer educators and youth volunteers are contributing to a shift in understanding, particularly in urban areas, about the importance of contraception. Read Alvine's story Show more + “I’ve been coming to the clinic for a long time and I came here whenever I was ill with malaria or anything. The last time I came here was, towards the end of last year. I was really happy with the welcome. I am glad I can continue with my studies and get a job. I was really welcome here and was really satisfied. I wasn’t scared to speak out if I had a problem. I have an IUD now.”     Adapting services for young people Over 60% of Cameroon’s population is under the age of 25. CAMNAFAW believes that understanding and use of contraception protects young people’s health and wellbeing. For this reason, CAMNAFAW’s healthcare delivery is adapted to the schedule and lifestyles of young people, to encourage uptake of the clinic's abortion and contraceptive care. CAMNAFAW have also to be mindful with those delivering care to the young people that step through their doors. Having younger staff available makes young people feel more at ease when asking for information or receiving care, and clinics open early to allow them to visit before classes at school or university.   Social media campaigns run by Youth Action Movement (YAM) volunteers engage young people on their phones in an accessible manner, while events organized in educational establishments and on campus bring accurate information about abortion and contraception directly to students. Finally, peer educators target young men at events including football games to encourage close groups of friends to think about contraception. These efforts have contributed to huge drops in the rate of deaths among mothers and children since the 1990s, even if much remains to be done.   Read Daniele's abortion care story Show more + “In March last year I had a scan while four months pregnant, and they told me that my baby wasn’t growing, and I had what is known as a blighted ovum. I needed an abortion. They led me through the whole process and explained everything. If they weren’t here, I don’t know what I would have done. I think I would have panicked and maybe asked older girls what to do. I learned about the clinic through a campaign they did at the university and heard that they could help us with this kind of problem. That’s how I learnt about this place. It would have been dangerous and there might have been a lot of complications if I hadn’t acted then, and if they hadn’t helped me. I would like to have a baby one day and me and my partner are going to keep trying”.    

Aline a midwife at SOA clinic
09 July 2019

From hostility to understanding: How one midwife in Cameroon is changing minds on abortion care

For the last six years, Aline Mekone Njanjo has slowly built up the trust of the community around the SOA clinic on the outskirts of Cameroon’s capital, Yaoundé. Aline, a nurse by training, oversees services related to the Global Comprehensive Abortion Care Initiative (GCACI), which aims to increase access to comprehensive abortion care and contraceptive services, particularly to poor and marginalized women. She joined the clinic when it opened in 2013, as part of the second phase of GCACI in Cameroon, and has watched attitudes to her presence shift from outright hostility to appreciation from women who lack access to other sources of care.   Working directly with young people “We are located right next to a university, so we work directly with young people, who are our main client base,” she said, taking a short break from seeing clients on a busy weekday morning. “They need help to prevent unintended pregnancy and unsafe abortion, which we see a lot of around here. The students are too scared to go to regular clinics, so will buy drugs from the market for fear of being judged or having to give up their studies.” The drugs young women purchase, which might contain herbal mixtures, cheap whisky or bleach, often lead to incomplete abortion, leaving their lives in danger. The law in Cameroon allows abortion only in the case of rape, incest or to save the mother’s life, and traditional attitudes to childbearing along with hardline religious narratives from some churches confer guilt and suspicion on unmarried, pregnant women. In fact, 77% of all clients seeking abortions were under the age of 25 between January and June 2018 last year, as were a similar proportion of contraceptive clients.   Building relationships Aline emphasizes “the welcome” above all in building a relationship with vulnerable young women, who may have been refused entry to public facilities due to their age or marital status. “We try as hard as we can to help the young people who come to us. If we have a case that isn’t in line with the law, we still try to welcome her and talk about her options,” she explained, struggling to be heard above the sound of children playing in front of the clinic’s gates. “They are often refused access to state services and asked if they have no shame about getting pregnant. [Nurses] often threaten to tell their parents,” she added. Aline has also spearheaded outreach activities in the community to raise awareness of the Cameroon National Planning Association for Family Welfare (CAMNAFAW) clinic, and the varied services it offers.   Outreach work  “A lot has changed since 2013. It was very difficult at the beginning to go into the community and raise awareness, they would call use the “aborters”. We did a lot of outreach work to make people realise that abortion care is not only performing abortions,” she explained. “Today, we have a lot more people coming through every week, with big increases in the number of clients passing through the clinic”.   Aline has sat down with village elders, traditional chiefs, women’s groups and others to patiently explain what the SOA Clinic offers to potential clients, including saving the lives of women and girls. At work in the clinic, she reassures women of the efficacy of contraception and goes over the possible side effects, handing out her number for any follow-ups from nervous first timers. She is determined to travel into villages further away from the Soa Clinic to meet more community representatives, and correct misrepresentations about her work. “We haven’t yet reached everyone and we need to reach further,” she resolved.    

Hervé Tchuigwa Djiya

"I help to raise awareness of why we have to protect ourselves"

“The first time I met Chariette [a peer educator for the Cameroon National Planning Association for Family Welfare] was at Sunday football, around four years ago. She was invited by the organizer to come and talk to us when the match was over. We were all men but she wasn’t intimidated and she handled the stupid jokes well.  We stayed in touch and then one day I realized I had an STI. It’s a little taboo and I didn’t want to talk about it. I bought some drugs at the local market but they didn’t have any effect. I called Chariette and we discussed what had happened. She told me to come to the CAMNAFAW clinic and I did, where I spoke about my problem and they gave me proper drugs to get rid of it. That day, I decided to become a peer educator myself. There are a lot of guys who are suffering but too scared to speak out. Above all, men are scared of talking about STIs.  I now work in schools and youth groups, especially sports teams. They will insist they don’t have anything wrong but every Sunday since then I have gone round the teams and chatted with them.  I speak about pregnancy as well. It’s the guys who push women to have sex without a condom and also to have an abortion afterwards. I help to raise awareness of why we have to protect ourselves. It’s hard to recruit people to become peer educators because we are volunteers. It’s not easy to persuade people to change their ways. The view from a lot of churches is very strict and centers on abstinence. The young men want to be macho.” Hervé Tchuigwa Djiya is a peer educator for the Cameroon National Planning Association for Family Welfare (CAMNAFAW)

Peer educator and English language student Gertrude Zouakeu Noutcha, 29, at Mimboman clinic in Yaounde, Cameroon

"I have brothers and I have helped them to change too. I’ve helped them to adopt a healthier sex life"

“Chariette was my neighbor. We lived next door to each other. She often organized group information sessions in the neighbourhood to talk about sexually transmitted infections (STIs) and early pregnancy, and unintended pregnancies as well.  When I started attending her sessions I was in a bit of unstable relationship. My life was chaotic. My boyfriend didn’t like using protection and we told each other that as we loved each other we weren’t taking any risks. Once I caught something and I was itching a lot. My boyfriend told me that I must have caught it in a public toilet. I trusted him and I didn’t realize I could catch something. When I started listening to Chariette it opened my eyes and I realized I was running big risks. As we aren’t married and we are still studying, we shouldn’t have an unintended pregnancy. What would we do? She told me about sexually transmitted infections as well. I tried to talk to my boyfriend about it but he didn’t want to hear about it, especially about using condoms. I asked for a private session with Chariette for him, and she spoke to us both and he finally understood. Today we have a much more stable sex life and we aren’t running those risks anymore. He learned how to use a condom. After attending her sessions, I was able to save a friend with Chariette’s help. This friend tried to perform an abortion herself and she was bleeding everywhere. I remembered that Chariette told me about the Cameroon National Planning Association for Family Welfare clinic, so I called her and asked how she could be admitted. She was able to receive post-abortion care but if I hadn’t known Chariette I don’t know what would have happened. I have brothers and I have helped them to change too. I’ve helped them to adopt a healthier sex life. There is HIV around and it’s scary.” Gertrude Zouakeu Noutcha, 29, is a student and peer educator for the Cameroon National Planning Association for Family Welfare (CAMNAFAW)

A group of peer educators giving a lesson on contraception and sexual health in Cameroon
09 July 2019

In Cameroon the best way to reach young people is through other young people

The best way to reach young people, health workers in Cameroon have found, is through other young people. The under 25s in Cameroon are more likely to require contraception or abortion than any other age group according to the Cameroon National Planning Association for Family Welfare (CAMNAFAW), but are also some of the least informed and most marginalized users of the health system. Between January and June 2018, 83% of clients at CAMNAFAW seeking contraception and 79% seeking abortion were from the under 25 age bracket.   Working with young people in mind To meet this need, young staff and volunteers are recruited with the express aim of making clients close in age more comfortable, and CAMNAFAW’s clinics have extended opening hours to work around apprenticeships and university schedules. Solange Ngo Bikai, a nurse at Mimboman clinic in Yaoundé, started working there aged just 24, and is now 30. She has worked tirelessly to persuade young people in the densely populated suburb to come and talk to her if they face any issues relating to their sexual health. “We do a lot of community outreach. When a young person arrives here, they have so many questions, and there are still many taboos,” she said, as the waiting room slowly filled up on a weekday morning. “Before they arrive, they have a lot of prejudices about contraception, so we talk it through and explain all the different methods. Some of them have been told that taking contraception makes you infertile, so we have a lot of work to do,” she continued.   Debunking myths with information  Debunking myths and informing young people of the merits of the contraception is also the driving force behind the Youth Action Movement (YAM), a group of young volunteers who hold events for students, apprentices and disabled youth in Cameroon. “We hand out condoms and we try to raise awareness about STIs. Then we try to get them on board as members,” laughed Rosa Joyce Ayong Tchonang, a youth representative and advisor to CAMNAFAW’s national board. Rosa spends her evenings doing everything from accompanying teenagers to help tell their parents they are pregnant, to warning footballers against the dangers of counterfeit drugs used to treat sexually transmitted infections.   Unsafe abortion In Cameroon, strong messages about abstaining from sex until marriage are delivered from the pulpit and the family dinner table, while the law restricts abortion in almost all cases. This combination pushes many young women to lie about unintended pregnancies for fear of shaming their families or being forced out of education, and then to attempt unsafe abortion with a cocktail of drugs or household products. “She will try to end the pregnancy herself and end up in the clinic with a lot more complications than would have originally been the case. She will arrive bleeding heavily and in a terrible state,” sighed Salange. Counselling and the offer of contraception with post-abortion care limit the number of return cases, she added.   Social networks & sex education Jacqueline Siego-Foudie, the 22-year-old National President of the YAM, emphasized the need for a 21st-century approach to sex education, relaying her safe sex message through WhatsApp and Facebook as well as through physical meetups. “We make a lot of use of social networks. We have a few different Whatsapp groups, with separate ones in all the different regions of Cameroon where we work, as well as a group of national volunteers,” she explained.   “There is also our Facebook page, where every Wednesday we broadcast a show with a different theme -- last week it was female genital mutilation,” she added. Her crowning achievement was training 30 social influencers to relay messages about safe sex and how to seek help for unwanted pregnancies and infections. In common with many countries, Instagram influencers are the new rock stars in Cameroon, and have a cult following among many young people.  Social networks, Jacqueline added, offered a new and more private way for young people to ask burning questions about sex and their changing bodies, helping to close the information gap that has given Cameroon one of the highest maternal mortality rates in the world, and to tackle stubbornly high rates of HIV infection.

Chariette Socgnia Nguepi, peed educator
09 July 2019

Cameroon: A day in the life of a peer educator

An early start to the day On a typical day in the working week, Chariette Socgnia Nguepi is up before dawn to prepare for the long hours ahead. As a peer educator for CAMNAFAW (Cameroon National Planning Association for Family Welfare), Chariette acts as a spokeswoman for the association and its clinics, and as a conduit for accurate sexual and reproductive health information among all layers of society. She also holds down a full-time job as a phone counsellor for young people, juggling shifts at a call center with organizing sexual health information sessions in her community.   Chariette will hop onto the bus at 6am for the battle through Yaoundé’s gridlocked traffic, before settling in for a long list of calls from young people worried about HIV, pregnancy, and violent partners by 7am. After a quick lunch, she may attend board meetings at CAMNAFAW’s headquarters downtown, or begin setting up an afternoon session in a school or youth center. “We have the task of awareness-raising among the population. Chariette explained. “Most young people, from the age of 12 onwards, are sexually active in Cameroon [so] we have to give them sex education.”   Working to overcome misinformation & confusion Misinformation from community elders, other school students and social networks all contribute to young people’s fear and confusion about sexual matters. It is Chariette’s job to provide them with accurate information, to talk through the different contraceptive methods available, and to refer young people to CAMNAFAW’s two clinics in Yaoundé in the event of early pregnancy, sexually transmitted infections and for contraceptive needs. “We give them statistics and show them real-life cases to help them understand. They can meet young women just like them who have had abortions,” she added, expressing her hope that her work will dispel some of the taboos that cling to sex and abortion care in Cameroon. Gertrude Zouakeu Noutcha, a neighbor, started casually attending Chariette’s information sessions a little more than a year ago, only to be gripped by the realization she was putting herself at risk.   Inspiring others to act “When I started attending her sessions I was in a bit of an unstable relationship. My life was chaotic. My boyfriend didn’t like using protection and we told each other that as we loved each other we weren’t taking any risks,” Gertrude said. She had previously had a sexually transmitted infection and was not entirely sure how, and began turning over in her mind how an unintended pregnancy might force her to give up studying English at university. “I tried to talk to my boyfriend but he didn’t want to hear about it, especially about using condoms. I asked for a private session with Chariette for him, and she spoke to us both and he finally understood,” she recalled. “Today we have a much more stable sex life and we aren’t running those risks anymore. He learned how to use a condom.” The information sessions allowed Gertrude to act fast when a friend attempted an abortion with a cocktail of drugs, putting herself in a life-threatening situation. “She was bleeding everywhere. I remembered that Chariette told me about the CAMNAFAW clinic, so I called her and asked how she could be admitted. She was able to receive post-abortion care quickly, but if I hadn’t known Chariette I don’t know what would have happened.” Reaching men & boys Chariette’s outreach does not only touch women. Hervé Tchuigwa Djiya, a 32-year-old economics student, recalls the first time meeting her in a locker room following a football match, as she attempted to recruit young men to her cause. “We were all men but she wasn’t intimidated and she handled the stupid jokes well,” he recalled. They stayed in and out of touch for a couple of years, until the day he needed her help. “One day I realized I had a sexually transmitted infection. It’s a little taboo and I didn’t want to talk about it. I bought some drugs at the local market but they didn’t have any effect. I called Chariette and we discussed what had happened. She told me to come to the CAMNAFAW clinic and I did, where I spoke about my problem and they gave me proper drugs to get rid of it,” Hervé continued. Remembering the tough time his peer educator had experienced among the football players, and buoyed by his positive experience, he vowed to start educating men himself on the unwanted outcomes of unsafe sex. “That day, I decided to become a peer educator. There are a lot of guys who are suffering but too scared to speak out. Above all, men are scared of talking about STIs,” he noted. Hervé now works in schools and with youth groups, but especially with sports teams. “I speak about pregnancy as well. It’s the guys who push women to have sex without a condom and also to have an abortion afterwards. I help to raise awareness of why we have to protect ourselves.” After changing the attitudes of so many young people, she said, Chariette now wants to target their parents, and encourage more dialogue in Cameroonian homes about sex. “They are the ones who should be talking to their kids!” she said, clearing up condoms and pill packets from the last session of the day, and preparing for the long ride home.  

Cameroon Partnering with educational institutions to improve youth access to abortion
05 September 2016

How to improve young people’s access to safe abortion - Cameroon: Partnering with educational institutions

Young people face unique barriers when seeking accurate information about abortion, and in accessing abortion services. This series showcases strategies implemented by IPPF Member Associations that have successfully reduced these barriers and increased young people’s access to abortion information and services. In this short summary from Cameroon, they provide a comprehensive strategy on partnering with educational institutions to provide young people with specifically targeted health education. The strategy, outlines the key steps needed for successful implementation and highlighting key lessons learned to consider in taking this strategy forward. This guide can be used by programme managers and implementers to help design and inform strategies to ensure that young people are enabled to access the necessary support and services they need in the event of an unwanted pregnancy.

Cameroon National Association for Family Welfare

The Cameroon National Planning Association for Family Welfare (CAMNAFAW) was created in 1987 to respond to the needs of women who wanted to plan their families and to enjoy higher standards of living. The organization has rapidly grown into the country’s leading provider of sexual and reproductive health (SRH) services.

The challenges facing the people of Cameroon and the organization are severe. This is a country with very high levels of maternal death and child mortality and an HIV prevalence rate of over 10%. Health provision is limited: CAMNAFAW is working tirelessly to deliver to populations in the greatest and most urgent need of SRH support. 

Through its service points, including dedicated youth sites, run by full-time staff and supported by over a thousand volunteers, CAMNAFAW provides a complete suite of sexual and reproductive health (SRH) services. It offers family planning, vaccination, paediatric care services, antenatal and post-natal care, post-abortion care, the diagnosis and treatment of sexually transmitted and opportunistic infections, screening of cancers of the reproductive system, general laboratory work, voluntary counselling and testing (VCT), home-based care, and education programmes aimed at reducing stigma and discrimination associated with HIV and AIDS.

An estimated 80% of clients are poor, marginalized, socially excluded and/or under-served. These include people living with HIV and AIDS (PLHIV), sex workers, and unmarried men and women. 

CAMNAFAW works in partnership with government and with non-governmental organisations including Care Cameroon, Femmes-Santé-Developpement en Afrique Sub-Saharienne (FESADE), the Youth Development Foundation, OFSAD, Scouts du Cameroun, the Support Centre for New Local Development Alternatives (CANADEL), Service Catholique de la Santé, Service Protestant de la Santé, the Society for Women and AIDS in Africa (SWAA Cameroon), and the Réseau. Camerounais des associations des Personnes vivants avec le VIH (Récap+). CAMNAFAW receives support from the Government of Cameroon, UNFPA, the Government of Japan, the IPPF Japan Trust Fund, Care Cameroun, and CAREF.

togo-contraceptives

IPPF is awarded USAID-funded ExpandPF

The International Planned Parenthood Federation (IPPF) is pleased to share that last month it was awarded the USAID-funded, five-year, $45 million Expand Family Planning and Sexual and Reproductive Health (ExpandPF) Activity following a competitive process. ExpandPF will scale up evidence-based family planning practices, including postpartum family planning and engaging community health workers, to improve access to and use of voluntary family planning services in poor and underserved urban and peri-urban populations. ExpandPF envisions a local-partner forward strategy and close engagement with young people for implementation in Cameroon, Cote d’Ivoire, Mauritania, and Togo. IPPF brings strong experience improving access to client-centered, quality family planning and sexual and reproductive health care services as allowed under USAID regulations and local law. Its structure is designed to advance locally led development, engaging women and youth while reaching underserved and marginalized communities. Hortense Angoran Benie, MD, MPH will lead ExpandPF and has significant management experience with complex public health programs across West and Central Africa. IPPF’s partners include Options Consultancy Services, Etrilabs, and IPPF member associations in each of the four implementing countries: Association Ivoirienne pour le Bien-Être Familial (AIBEF), Association Togolaise pour le Bien-Être Familial (ATBEF), Association Mauritanienne pour la Promotion de la Famille (AMPF), and Cameroon National Association for Family Welfare (CAMNAFAW). The team also includes Viamo as sub-contractor. Through ExpandPF, the consortium will ultimately assist individuals to make voluntary, informed decisions about family planning with access to contraceptive methods and services. “IPPF is very proud to receive the ExpandPF award,” said Dr. Alvaro Bermejo, IPPF Director General. “It affirms our commitment to West and Central Africa and expanding contraceptive choice to underserved and marginalized populations. IPPF believes that by working with our esteemed partners, we can advance meaningful progress across the region.” "ExpandPF aligns well with IPPF's strategy of prioritizing access to family planning and sexual and reproductive health services for vulnerable women and girls in West and Central Africa,” said Marie-Evelyne Petrus-Barry, IPPF Africa Regional Director. USAID administers the U.S. foreign assistance program providing economic and humanitarian assistance in more than 80 countries worldwide. The Agency is committed to helping countries meet the family planning and reproductive health needs of their people through voluntarism and informed choice.

Healthcare worker with combipack.

In pictures: Innovating during COVID-19

Women around the world have faced multiple barriers to accessing safe abortion care during the COVID-19 pandemic including the de-prioritization of sexual and reproductive healthcare, overwhelmed health systems and restrictions on movement. The COVID-19 crisis has sparked innovation among IPPF Member Associations who responded swiftly by developing new approaches to reach women with safe abortion care including telemedicine and home-based provision of medical abortion. Strong evidence generated from this work supports the continuation and strengthening of these approaches beyond the end of the pandemic. Cameroon Cameroon National Planning Association for Family Welfare (CAMNAFAW) To ensure that quality abortion care can be provided to women during travel restrictions, CAMNAFAW’s service providers travel to partner clinics in underserved areas and to clients’ homes to provide medical and surgical abortion care. This model of taking safe abortion care closer to women will continue even with easing of travel restrictions, as this has been found to be an effective and acceptable approach to increasing access.Photo: IPPF/Xaume Olleros/Cameroon Share on Twitter Share on Facebook Share via WhatsApp Share via Email Guinea Association Guinéenne pour le Bien-Etre Familial (AGBEF) Building on lessons learned during the Ebola crisis in Guinea, AGBEF quickly took measures to prevent infection in its clinics to continue providing sexual and reproductive healthcare, including surgical and medical abortion, in a safe environment. AGBEF donated protective materials to communities, including hand-washing stations, face masks and antibacterial gel, alongside messaging on infection prevention. This community visibility reassures clients they can safely attend AGBEF clinics for abortion and contraceptive care.Photo: AGBEF/Guinea Share on Twitter Share on Facebook Share via WhatsApp Share via Email India Family Planning Association of India (FPA India) FPA India and partners advocated to have sexual and reproductive healthcare, including abortion, recognized as essential by the government, which meant FPA India could continue healthcare delivery during the national lockdown. To reduce in-person clinic visits, FPA India established teleconsultation and counselling for abortion care, and is continuing to provide in-clinic care for both medical and surgical abortion. Photo: IPPF/Alison Joyce/India Share on Twitter Share on Facebook Share via WhatsApp Share via Email Nepal Family Planning Association of Nepal (FPAN) FPAN and partners advocated for interim approval of home provision of medical abortion and telemedicine for abortion counselling during COVID-19. FPAN is now implementing these approaches, ensuring continued access to abortion care in Nepal, where many people live in remote locations with limited mobility, which has been further restricted by COVID-19 lockdowns. Photo: FPAN/Nepal Share on Twitter Share on Facebook Share via WhatsApp Share via Email Pakistan Rahnuma – Family Planning Association of Pakistan (Rahnuma-FPAP) Rahnuma-FPAP and partners successfully advocated for the government to class sexual and reproductive healthcare as ‘essential’, which enabled the team to continue providing post-abortion care during the pandemic. Rahnuma-FPAP expanded its telemedicine and home-based provision for menstrual regulation counselling and post-abortion care. These new approaches have ensured continued access to services for clients unable to reach clinics.Photo: Rahnuma-FPAP/Pakistan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Palestine Palestinian Family Planning and Protection Association (PFPPA) In response to the government-mandated closure of its clinics, PFPPA quickly established a toll-free call centre which provides consultations, counselling, referrals and follow-up, including consultation for abortion care through a harm reduction approach, ensuring that women are provided with accurate information. Due to its success, PFPPA is exploring options for continuing this healthcare delivery model beyond the pandemic, with the aim of keeping it free of charge for users.Photo: SAAF/Samar Hazboun/Palestine Share on Twitter Share on Facebook Share via WhatsApp Share via Email Sudan Sudan Family Planning Association (SFPA) Following a nation-wide shutdown in April, SFPA  established  a call centre to increase access to healthcare, including abortion and contraceptive counselling and referrals.  An unexpected outcome of the new call centre is that it has reached an increased number of young women who regularly call to discuss their reproductive health and rights. SFPA  is working  towards institutionalizing this model for continuation beyond the pandemic.Photo: SFPA/Sudan Share on Twitter Share on Facebook Share via WhatsApp Share via Email Togo Association Togolaise pour le Bien-Etre Familial (ATBEF) ATBEF adapted its mobile application ‘Infos Ado Jeunes’, adding a toll-free teleconsultation service for young clients to use to access abortion consultations and pre- and post-abortion counselling. This app has given young clients ongoing access to care when they face challenges travelling to clinics. It has also eased overall client flow in clinics at a time when social distancing is being implemented.Photo: ATBEF/Togo Share on Twitter Share on Facebook Share via WhatsApp Share via Email

nurse with client - Cameroon
09 July 2019

Providing comprehensive care in Cameroon

Since 1987, the Cameroon National Planning Association for Family Welfare (CAMNAFAW), has been the country’s leading provider of sexual and reproductive healthcare (SRH). CAMNAFAW delivers healthcare including contraceptive, abortion and HIV-related, through a variety of clinics and youth outreach run by full-time staff and supported by over a thousand volunteers.  Yet, healthcare is limited, and women, men and young people are being denied access to crucial healthcare including safe abortion and contraception. Cameroon continues to suffer from high rates of maternal and child mortality, exacerbated by the widespread practice of unsafe abortion. Around 560,000 people (3.7%) of a population of 24 million are HIV positive.   Young women who get pregnant outside marriage face systemic discrimination and will frequently try to end the pregnancy themselves using widely available household products, herbal remedies, or large amounts of alcohol. “They are often refused access to state services and asked if they have no shame about getting pregnant, and (nurses) threaten to tell their parents,” said Aline Mekone Njanjo,  midwife at CAMNAFAW’s SOA clinic, on the outskirts of Yaoundé. Read Urielle's abortion care story Show more + “I heard about the CAMNAFAW clinic from a friend. She said they treat you well here and take care of patients, above all women and children. I came here to find out more. Here things are safe and you’re not at risk. There are doctors and nurses who are professional and know what they are doing. Elsewhere you hear about girls having abortions and it can be risky. You could even die. I am in training to become a customs officer. It’s the only chance I have to get a good job. It’s important because I was a schoolgirl when I had my daughter, and that put the brakes on my development. It stopped me from continuing my studies. I did evening classes and I managed to get my high school diploma. Now my daughter is getting older and she needs so many things. That’s why I was looking for work and doing a lot of entry tests. It’s really tough to have an unintended pregnancy.”   Comprehensive care  Comprehensive abortion care and contraception are key priorities for IPPF and its Member Associations. The Global Comprehensive Abortion Care Initiative (GCACI) supports this work in 16 Member Associations including CAMNAFAW. The overarching goal of GCACI is to improve access to comprehensive quality abortion care (safe abortion and/ or treatment for incomplete abortion depending on local context) and contraceptive care as integral components of sexual and reproductive health. Beyond CAMNAFAW’s clinics, hundreds of peer educators and youth volunteers nationwide manage an outreach programme aimed at busting myths surrounding contraception, sexually transmitted infections and abortion.  Some of these views are entrenched: traditional attitudes to childbearing and the strong influence of Catholic and evangelical churches have contributed to many taboos surrounding contraception and abortion in Cameroon. CAMNAFAW staff,  peer educators and youth volunteers are contributing to a shift in understanding, particularly in urban areas, about the importance of contraception. Read Alvine's story Show more + “I’ve been coming to the clinic for a long time and I came here whenever I was ill with malaria or anything. The last time I came here was, towards the end of last year. I was really happy with the welcome. I am glad I can continue with my studies and get a job. I was really welcome here and was really satisfied. I wasn’t scared to speak out if I had a problem. I have an IUD now.”     Adapting services for young people Over 60% of Cameroon’s population is under the age of 25. CAMNAFAW believes that understanding and use of contraception protects young people’s health and wellbeing. For this reason, CAMNAFAW’s healthcare delivery is adapted to the schedule and lifestyles of young people, to encourage uptake of the clinic's abortion and contraceptive care. CAMNAFAW have also to be mindful with those delivering care to the young people that step through their doors. Having younger staff available makes young people feel more at ease when asking for information or receiving care, and clinics open early to allow them to visit before classes at school or university.   Social media campaigns run by Youth Action Movement (YAM) volunteers engage young people on their phones in an accessible manner, while events organized in educational establishments and on campus bring accurate information about abortion and contraception directly to students. Finally, peer educators target young men at events including football games to encourage close groups of friends to think about contraception. These efforts have contributed to huge drops in the rate of deaths among mothers and children since the 1990s, even if much remains to be done.   Read Daniele's abortion care story Show more + “In March last year I had a scan while four months pregnant, and they told me that my baby wasn’t growing, and I had what is known as a blighted ovum. I needed an abortion. They led me through the whole process and explained everything. If they weren’t here, I don’t know what I would have done. I think I would have panicked and maybe asked older girls what to do. I learned about the clinic through a campaign they did at the university and heard that they could help us with this kind of problem. That’s how I learnt about this place. It would have been dangerous and there might have been a lot of complications if I hadn’t acted then, and if they hadn’t helped me. I would like to have a baby one day and me and my partner are going to keep trying”.    

Aline a midwife at SOA clinic
09 July 2019

From hostility to understanding: How one midwife in Cameroon is changing minds on abortion care

For the last six years, Aline Mekone Njanjo has slowly built up the trust of the community around the SOA clinic on the outskirts of Cameroon’s capital, Yaoundé. Aline, a nurse by training, oversees services related to the Global Comprehensive Abortion Care Initiative (GCACI), which aims to increase access to comprehensive abortion care and contraceptive services, particularly to poor and marginalized women. She joined the clinic when it opened in 2013, as part of the second phase of GCACI in Cameroon, and has watched attitudes to her presence shift from outright hostility to appreciation from women who lack access to other sources of care.   Working directly with young people “We are located right next to a university, so we work directly with young people, who are our main client base,” she said, taking a short break from seeing clients on a busy weekday morning. “They need help to prevent unintended pregnancy and unsafe abortion, which we see a lot of around here. The students are too scared to go to regular clinics, so will buy drugs from the market for fear of being judged or having to give up their studies.” The drugs young women purchase, which might contain herbal mixtures, cheap whisky or bleach, often lead to incomplete abortion, leaving their lives in danger. The law in Cameroon allows abortion only in the case of rape, incest or to save the mother’s life, and traditional attitudes to childbearing along with hardline religious narratives from some churches confer guilt and suspicion on unmarried, pregnant women. In fact, 77% of all clients seeking abortions were under the age of 25 between January and June 2018 last year, as were a similar proportion of contraceptive clients.   Building relationships Aline emphasizes “the welcome” above all in building a relationship with vulnerable young women, who may have been refused entry to public facilities due to their age or marital status. “We try as hard as we can to help the young people who come to us. If we have a case that isn’t in line with the law, we still try to welcome her and talk about her options,” she explained, struggling to be heard above the sound of children playing in front of the clinic’s gates. “They are often refused access to state services and asked if they have no shame about getting pregnant. [Nurses] often threaten to tell their parents,” she added. Aline has also spearheaded outreach activities in the community to raise awareness of the Cameroon National Planning Association for Family Welfare (CAMNAFAW) clinic, and the varied services it offers.   Outreach work  “A lot has changed since 2013. It was very difficult at the beginning to go into the community and raise awareness, they would call use the “aborters”. We did a lot of outreach work to make people realise that abortion care is not only performing abortions,” she explained. “Today, we have a lot more people coming through every week, with big increases in the number of clients passing through the clinic”.   Aline has sat down with village elders, traditional chiefs, women’s groups and others to patiently explain what the SOA Clinic offers to potential clients, including saving the lives of women and girls. At work in the clinic, she reassures women of the efficacy of contraception and goes over the possible side effects, handing out her number for any follow-ups from nervous first timers. She is determined to travel into villages further away from the Soa Clinic to meet more community representatives, and correct misrepresentations about her work. “We haven’t yet reached everyone and we need to reach further,” she resolved.    

Hervé Tchuigwa Djiya

"I help to raise awareness of why we have to protect ourselves"

“The first time I met Chariette [a peer educator for the Cameroon National Planning Association for Family Welfare] was at Sunday football, around four years ago. She was invited by the organizer to come and talk to us when the match was over. We were all men but she wasn’t intimidated and she handled the stupid jokes well.  We stayed in touch and then one day I realized I had an STI. It’s a little taboo and I didn’t want to talk about it. I bought some drugs at the local market but they didn’t have any effect. I called Chariette and we discussed what had happened. She told me to come to the CAMNAFAW clinic and I did, where I spoke about my problem and they gave me proper drugs to get rid of it. That day, I decided to become a peer educator myself. There are a lot of guys who are suffering but too scared to speak out. Above all, men are scared of talking about STIs.  I now work in schools and youth groups, especially sports teams. They will insist they don’t have anything wrong but every Sunday since then I have gone round the teams and chatted with them.  I speak about pregnancy as well. It’s the guys who push women to have sex without a condom and also to have an abortion afterwards. I help to raise awareness of why we have to protect ourselves. It’s hard to recruit people to become peer educators because we are volunteers. It’s not easy to persuade people to change their ways. The view from a lot of churches is very strict and centers on abstinence. The young men want to be macho.” Hervé Tchuigwa Djiya is a peer educator for the Cameroon National Planning Association for Family Welfare (CAMNAFAW)

Peer educator and English language student Gertrude Zouakeu Noutcha, 29, at Mimboman clinic in Yaounde, Cameroon

"I have brothers and I have helped them to change too. I’ve helped them to adopt a healthier sex life"

“Chariette was my neighbor. We lived next door to each other. She often organized group information sessions in the neighbourhood to talk about sexually transmitted infections (STIs) and early pregnancy, and unintended pregnancies as well.  When I started attending her sessions I was in a bit of unstable relationship. My life was chaotic. My boyfriend didn’t like using protection and we told each other that as we loved each other we weren’t taking any risks. Once I caught something and I was itching a lot. My boyfriend told me that I must have caught it in a public toilet. I trusted him and I didn’t realize I could catch something. When I started listening to Chariette it opened my eyes and I realized I was running big risks. As we aren’t married and we are still studying, we shouldn’t have an unintended pregnancy. What would we do? She told me about sexually transmitted infections as well. I tried to talk to my boyfriend about it but he didn’t want to hear about it, especially about using condoms. I asked for a private session with Chariette for him, and she spoke to us both and he finally understood. Today we have a much more stable sex life and we aren’t running those risks anymore. He learned how to use a condom. After attending her sessions, I was able to save a friend with Chariette’s help. This friend tried to perform an abortion herself and she was bleeding everywhere. I remembered that Chariette told me about the Cameroon National Planning Association for Family Welfare clinic, so I called her and asked how she could be admitted. She was able to receive post-abortion care but if I hadn’t known Chariette I don’t know what would have happened. I have brothers and I have helped them to change too. I’ve helped them to adopt a healthier sex life. There is HIV around and it’s scary.” Gertrude Zouakeu Noutcha, 29, is a student and peer educator for the Cameroon National Planning Association for Family Welfare (CAMNAFAW)

A group of peer educators giving a lesson on contraception and sexual health in Cameroon
09 July 2019

In Cameroon the best way to reach young people is through other young people

The best way to reach young people, health workers in Cameroon have found, is through other young people. The under 25s in Cameroon are more likely to require contraception or abortion than any other age group according to the Cameroon National Planning Association for Family Welfare (CAMNAFAW), but are also some of the least informed and most marginalized users of the health system. Between January and June 2018, 83% of clients at CAMNAFAW seeking contraception and 79% seeking abortion were from the under 25 age bracket.   Working with young people in mind To meet this need, young staff and volunteers are recruited with the express aim of making clients close in age more comfortable, and CAMNAFAW’s clinics have extended opening hours to work around apprenticeships and university schedules. Solange Ngo Bikai, a nurse at Mimboman clinic in Yaoundé, started working there aged just 24, and is now 30. She has worked tirelessly to persuade young people in the densely populated suburb to come and talk to her if they face any issues relating to their sexual health. “We do a lot of community outreach. When a young person arrives here, they have so many questions, and there are still many taboos,” she said, as the waiting room slowly filled up on a weekday morning. “Before they arrive, they have a lot of prejudices about contraception, so we talk it through and explain all the different methods. Some of them have been told that taking contraception makes you infertile, so we have a lot of work to do,” she continued.   Debunking myths with information  Debunking myths and informing young people of the merits of the contraception is also the driving force behind the Youth Action Movement (YAM), a group of young volunteers who hold events for students, apprentices and disabled youth in Cameroon. “We hand out condoms and we try to raise awareness about STIs. Then we try to get them on board as members,” laughed Rosa Joyce Ayong Tchonang, a youth representative and advisor to CAMNAFAW’s national board. Rosa spends her evenings doing everything from accompanying teenagers to help tell their parents they are pregnant, to warning footballers against the dangers of counterfeit drugs used to treat sexually transmitted infections.   Unsafe abortion In Cameroon, strong messages about abstaining from sex until marriage are delivered from the pulpit and the family dinner table, while the law restricts abortion in almost all cases. This combination pushes many young women to lie about unintended pregnancies for fear of shaming their families or being forced out of education, and then to attempt unsafe abortion with a cocktail of drugs or household products. “She will try to end the pregnancy herself and end up in the clinic with a lot more complications than would have originally been the case. She will arrive bleeding heavily and in a terrible state,” sighed Salange. Counselling and the offer of contraception with post-abortion care limit the number of return cases, she added.   Social networks & sex education Jacqueline Siego-Foudie, the 22-year-old National President of the YAM, emphasized the need for a 21st-century approach to sex education, relaying her safe sex message through WhatsApp and Facebook as well as through physical meetups. “We make a lot of use of social networks. We have a few different Whatsapp groups, with separate ones in all the different regions of Cameroon where we work, as well as a group of national volunteers,” she explained.   “There is also our Facebook page, where every Wednesday we broadcast a show with a different theme -- last week it was female genital mutilation,” she added. Her crowning achievement was training 30 social influencers to relay messages about safe sex and how to seek help for unwanted pregnancies and infections. In common with many countries, Instagram influencers are the new rock stars in Cameroon, and have a cult following among many young people.  Social networks, Jacqueline added, offered a new and more private way for young people to ask burning questions about sex and their changing bodies, helping to close the information gap that has given Cameroon one of the highest maternal mortality rates in the world, and to tackle stubbornly high rates of HIV infection.

Chariette Socgnia Nguepi, peed educator
09 July 2019

Cameroon: A day in the life of a peer educator

An early start to the day On a typical day in the working week, Chariette Socgnia Nguepi is up before dawn to prepare for the long hours ahead. As a peer educator for CAMNAFAW (Cameroon National Planning Association for Family Welfare), Chariette acts as a spokeswoman for the association and its clinics, and as a conduit for accurate sexual and reproductive health information among all layers of society. She also holds down a full-time job as a phone counsellor for young people, juggling shifts at a call center with organizing sexual health information sessions in her community.   Chariette will hop onto the bus at 6am for the battle through Yaoundé’s gridlocked traffic, before settling in for a long list of calls from young people worried about HIV, pregnancy, and violent partners by 7am. After a quick lunch, she may attend board meetings at CAMNAFAW’s headquarters downtown, or begin setting up an afternoon session in a school or youth center. “We have the task of awareness-raising among the population. Chariette explained. “Most young people, from the age of 12 onwards, are sexually active in Cameroon [so] we have to give them sex education.”   Working to overcome misinformation & confusion Misinformation from community elders, other school students and social networks all contribute to young people’s fear and confusion about sexual matters. It is Chariette’s job to provide them with accurate information, to talk through the different contraceptive methods available, and to refer young people to CAMNAFAW’s two clinics in Yaoundé in the event of early pregnancy, sexually transmitted infections and for contraceptive needs. “We give them statistics and show them real-life cases to help them understand. They can meet young women just like them who have had abortions,” she added, expressing her hope that her work will dispel some of the taboos that cling to sex and abortion care in Cameroon. Gertrude Zouakeu Noutcha, a neighbor, started casually attending Chariette’s information sessions a little more than a year ago, only to be gripped by the realization she was putting herself at risk.   Inspiring others to act “When I started attending her sessions I was in a bit of an unstable relationship. My life was chaotic. My boyfriend didn’t like using protection and we told each other that as we loved each other we weren’t taking any risks,” Gertrude said. She had previously had a sexually transmitted infection and was not entirely sure how, and began turning over in her mind how an unintended pregnancy might force her to give up studying English at university. “I tried to talk to my boyfriend but he didn’t want to hear about it, especially about using condoms. I asked for a private session with Chariette for him, and she spoke to us both and he finally understood,” she recalled. “Today we have a much more stable sex life and we aren’t running those risks anymore. He learned how to use a condom.” The information sessions allowed Gertrude to act fast when a friend attempted an abortion with a cocktail of drugs, putting herself in a life-threatening situation. “She was bleeding everywhere. I remembered that Chariette told me about the CAMNAFAW clinic, so I called her and asked how she could be admitted. She was able to receive post-abortion care quickly, but if I hadn’t known Chariette I don’t know what would have happened.” Reaching men & boys Chariette’s outreach does not only touch women. Hervé Tchuigwa Djiya, a 32-year-old economics student, recalls the first time meeting her in a locker room following a football match, as she attempted to recruit young men to her cause. “We were all men but she wasn’t intimidated and she handled the stupid jokes well,” he recalled. They stayed in and out of touch for a couple of years, until the day he needed her help. “One day I realized I had a sexually transmitted infection. It’s a little taboo and I didn’t want to talk about it. I bought some drugs at the local market but they didn’t have any effect. I called Chariette and we discussed what had happened. She told me to come to the CAMNAFAW clinic and I did, where I spoke about my problem and they gave me proper drugs to get rid of it,” Hervé continued. Remembering the tough time his peer educator had experienced among the football players, and buoyed by his positive experience, he vowed to start educating men himself on the unwanted outcomes of unsafe sex. “That day, I decided to become a peer educator. There are a lot of guys who are suffering but too scared to speak out. Above all, men are scared of talking about STIs,” he noted. Hervé now works in schools and with youth groups, but especially with sports teams. “I speak about pregnancy as well. It’s the guys who push women to have sex without a condom and also to have an abortion afterwards. I help to raise awareness of why we have to protect ourselves.” After changing the attitudes of so many young people, she said, Chariette now wants to target their parents, and encourage more dialogue in Cameroonian homes about sex. “They are the ones who should be talking to their kids!” she said, clearing up condoms and pill packets from the last session of the day, and preparing for the long ride home.  

Cameroon Partnering with educational institutions to improve youth access to abortion
05 September 2016

How to improve young people’s access to safe abortion - Cameroon: Partnering with educational institutions

Young people face unique barriers when seeking accurate information about abortion, and in accessing abortion services. This series showcases strategies implemented by IPPF Member Associations that have successfully reduced these barriers and increased young people’s access to abortion information and services. In this short summary from Cameroon, they provide a comprehensive strategy on partnering with educational institutions to provide young people with specifically targeted health education. The strategy, outlines the key steps needed for successful implementation and highlighting key lessons learned to consider in taking this strategy forward. This guide can be used by programme managers and implementers to help design and inform strategies to ensure that young people are enabled to access the necessary support and services they need in the event of an unwanted pregnancy.

Cameroon National Association for Family Welfare

The Cameroon National Planning Association for Family Welfare (CAMNAFAW) was created in 1987 to respond to the needs of women who wanted to plan their families and to enjoy higher standards of living. The organization has rapidly grown into the country’s leading provider of sexual and reproductive health (SRH) services.

The challenges facing the people of Cameroon and the organization are severe. This is a country with very high levels of maternal death and child mortality and an HIV prevalence rate of over 10%. Health provision is limited: CAMNAFAW is working tirelessly to deliver to populations in the greatest and most urgent need of SRH support. 

Through its service points, including dedicated youth sites, run by full-time staff and supported by over a thousand volunteers, CAMNAFAW provides a complete suite of sexual and reproductive health (SRH) services. It offers family planning, vaccination, paediatric care services, antenatal and post-natal care, post-abortion care, the diagnosis and treatment of sexually transmitted and opportunistic infections, screening of cancers of the reproductive system, general laboratory work, voluntary counselling and testing (VCT), home-based care, and education programmes aimed at reducing stigma and discrimination associated with HIV and AIDS.

An estimated 80% of clients are poor, marginalized, socially excluded and/or under-served. These include people living with HIV and AIDS (PLHIV), sex workers, and unmarried men and women. 

CAMNAFAW works in partnership with government and with non-governmental organisations including Care Cameroon, Femmes-Santé-Developpement en Afrique Sub-Saharienne (FESADE), the Youth Development Foundation, OFSAD, Scouts du Cameroun, the Support Centre for New Local Development Alternatives (CANADEL), Service Catholique de la Santé, Service Protestant de la Santé, the Society for Women and AIDS in Africa (SWAA Cameroon), and the Réseau. Camerounais des associations des Personnes vivants avec le VIH (Récap+). CAMNAFAW receives support from the Government of Cameroon, UNFPA, the Government of Japan, the IPPF Japan Trust Fund, Care Cameroun, and CAREF.