By Numfor Alenwi
When one hears that only 37% of demands for family planning in Cameroon are met, he may be tempted to think the determinants are the availability and affordability of modern options as is the case with many developing nations. Contrary to this, the need for comprehensive education seems to be the key demand for young girls in Bamenda as the fear of body deformation; sterility and cancer increasingly block usage.
Social enterprises and charity organizations in the last five years have greatly increased the availability of modern contraceptives in the Cameroonian city, Bamenda. Beside the female and male condoms which can be found in stores around town, IUDs, Jadelle, Depo-Provera and Nouvelle-Duo can be accessed from a majority of the health centers within the town. Despite this availability, 14 in every 100 girls aged 15-24 have conceived a baby with less than 5% of the pregnant adolescents (married or not) desiring a pregnancy. (UPSB 2011). What then are the key obstacles that make young people uncomfortable about accessing or using contraception?
‘I fear the side effects like weight increase, cancer, and sterility’ says Stephanie Nchum. ‘Condoms are very unreliable and the long term methods would destroy my sexy shape. I don’t want an ugly weight’ says Ruth Lum. All 20 young women (15 -24 years) recently interviewed by Cameroon Agenda for Sustainable Development (CASD) in Bamenda, identified with Stephanie and Ruth on the fear of increase in weight if they take pills, inserted or injected contraceptives. The fear of sterility and cervical cancer also came up several times.
Mr. Ngang Peter, head of Family Planning Services at ACMS Bamenda also confirmed these allegations as the key obstacles to the use of contraception by young people in Bamenda. However, he makes it clear that sterility and cancer are only myths but weight increase is likely for the hormonal methods. ‘None of the family planning options causes sterility or cancer but the hormonal methods can likely cause weight increase for some people, the reason we often insist on counseling before choice’ says Ngang.
Strangely, the girls who fear weight gain consider every other contraceptive apart from condoms as hormonal. Even the Copper T 380 intra-uterine device (IUD) which is the most promoted in Cameroon is also dreaded for the same reason. Ngang Peter thinks the problem is not the weight issue but lack of information. ‘The choices are many. Through counseling, providers help clients make and carry out their own choices about contraception. There are eligibility criteria for all the family planning methods. Most people who don’t feel comfortable relying on the condoms are often advised to consider IUDs if no contraindications are found’ Ngang.
Truly, these girls spend a lot of resources to maintain what they call ‘sexy looks’. They are also aware that pregnancies make weight control more difficult. Thus, in as much as they prefer to protect beauty over contraception, they need contraception to maintain beauty. Presumably, young women want to know if there are possibilities of rendering the hormonal contraceptive to have local instead of systematic effects. Dr. Ngalla Elvis, a medical researcher and family planning expert with Cameroon Agenda for Sustainable Development (CASD) attempts an answer. ‘It’s possible to localize drug administration with nano technology but that is not a priority for contraception’. He continues ‘the challenge with young people and contraception use is not the hormonal effects. It is a lack of comprehensive education. Young people need to be informed that the IUDs which last longer than some hormonal methods are mechanical and cannot cause changes in body mass. They also need to know that the female condom is to give young women enough control before a sexual encounter. They also need to know that keeping fit during and after pregnancy is 4 times costly than making an informed choice on contraception ’’.
We need to make informed choices.
Numfor Alenwi is the Executive Director of Cameroon Agenda for Social Development. You can connect with him his blog and via email at firstname.lastname@example.org.