For Nora Nwachukwu, a Lagos – based lawyer, female condom is a new phenomenon and one she had never been aware of.
Expressing surprise, she said enough awareness has not been created enough for it. “Am even surprised that it exists, she says. If they advertise it like they do male condoms, everyone, including me would have been aware. Instead, they are doing it hush, hush.”
Unlike Nzeribe though, Linda Nwadioha says she is aware that female condom does exists. A banker, she disclosed that she got enlightened through the help of health officials whom the bank management usually engage to educate the staff.
In 2005, United Nations Fund for Population Activities (UNFPA) launched the Female Condom Initiative in 24 countries to ensure that female condom programming was integral to national AIDS policies and reproductive health programmes.
According to a report by the organisation, in a number of countries, governments were applying highly creative approaches to educating the public about condoms and to overcome the stigma and taboos associated with it.
“In the process, they are discovering that the female condom is a tool for women’s empowerment, enabling women and adolescent girls to take the initiative to protect their own and their partners’ health,” the report said.
The female condom is a 17cm-long polyurethane sheath with a flexible ring at each end. It provides about the same protection from sexually transmitted infections – including HIV – and unwanted pregnancy as the male condom, but unlike the male condom, can be used with oil- and water-based lubricants without the risk of breakage.
The UNFPA also stated that female condoms which were once rejected are now gradually gaining acceptance.
The executive director, UNFPA, Dr Babatunde Osotimehin was quoted in the report, saying, “For the fourth consecutive year, access to female condoms has increased dramatically, reaching a record number of 50 million in 2009,”
He called for the courage and political will to protect and empower girls and women who have remained vulnerable to HIV.
“We have to invest in practical tools that women can use to protect themselves, such as the female condom,” he added.
Few years ago, the Society for Family Health (SFH) launched the Universal Access to female condoms (UAFC) Programme and unveiled the Elegance brand Condom which is funded by Oxfam Novib.
The Universal Access to Female Condom programme (UAFC) seeks to reposition the female condom to prevent STIs including HIV and as a contraceptive of choice among couples and women of reproductive age.
SFH commenced implementation of the UAFC programme in Nigeria in 2008, and has sold over 300,000 female condoms over the past two years.
According to the deputy director, Partnership and Programme Management, SFH, Mr Ifeanyi Okekearu, SFH and her partners decided to launch the Universal Access to Female Condoms (UAFC) programme to formerly introduce the programme at national level. While female condoms programming has been on in Nigeria for some time by the UNFPA through FMoH, UAFC was to complement these efforts as well as sustain ongoing female condoms programming.
He said the project was intended to create awareness and increase demand for female condom, to integrate female condom into existing reproductive health programmes, making female condom more acceptable and also creating an enabling environment for female condom programming. It was to be implemented in three states, Lagos, Delta and Edo and its for two years. The target groups are men and women of reproductive age.
But in the views of the president, Association for Reproductive and Family Health (ARFH) Prof Oladapo A. Ladipo, the contraceptive use rate is very low in Nigeria.
He stated, “It’s barely 10 per cent which is very low. We find that the unmet need for contraception is about 20 per cent of women who want to delay conception or who want to stop producing babies don’t have access to it and we are aware of the importance of family planning in reducing maternal and child mortality. We are also aware of the importance of family planning method in particular; barrier methods from preventing sexually transmitted infections with inflammatory diseases. Recently, of course, the barrier methods have dual protection of prevention of unwanted pregnancies and prevention of infections, particularly, HIV/AIDS.”
On what is responsible for low condom use in the country, Ladipo said, “ there are many people who still use barrier method of contraception who are not using the condom. Partly because as they often say, it reduces sensitivity, but I believe its because they are not sufficiently motivated. Such people take risks and the ultimate effect of that is that they are the ones who will fall victim to HIV/AIDS infection. Certainly, one would encourage every male or female to have one on one sexual relationship, or if they are young or are not in marriage to abstain from illicit sexual activities but if they cannot restrain themselves, one would encourage them to use the barrier method of contraception using male or female condom.
Random check on some pharmacists in Lagos, revealed that the female condoms were much in stock even though there were variations in the cost price. While some pharmacists sell the pack of two for N250, some sell as low as N160. It’s only in government hospitals that they are given out free of charge.
However, a sales girl at Amen Green pharmacist and Stores, Gwarinpa, disclosed that the volume of sale was very low especially when compared to the male condoms. She observed that women were buying them in trickles as stock could last for long on the counters before they are disposed of”
The reason for this is not farfetched. The president, Association for Reproductive and Family Health (ARFH), Prof Oladapo A. Ladipo, says there is need to give more publicity to family planning method; particularly the condoms. “There is not enough notice spot showing the importance of these methods. There are not enough television or radio announcements. My position always is that we must evangelize family planning to show that it’s not just for prevention of unplanned or unwanted pregnancies but there are other health benefits from the use of family planning.”
On what should be done in the issue of cultural barrier to family planning, he said, “One of the reasons adduced for the low contraceptive use has been our inability to break through the cultural barriers. We believe that the evidence that we are having now shows that there is considerable improvement, change of attitude and behaviours of Nigerians, especially the young ones. People are better informed now than ever before. We have 20 per cent unmet needs as an example; if only government can make provision to have commodities to meet the need of those 20 per cent, we would have achieved a great deal.”
According to him, “Access to methods is a major issue of concern; availability of commodities too is another major concern.
The federal government, until recently, had no budget for commodity purchase. We relied solely on the donors especially UNFPA and some other organisations like US government and DFID. So government needs to ensure contraceptives security in Nigeria to meet the needs of those who need it because it makes sense. If you plan your family, you will be successful in anything that you want to do. A nation that does not plan will plan to fail. There’s wisdom in moderating our population growth. The quality of life is more important than quantity. It’s better to have highly educated, healthy population that will be very productive than to have a very large population where the masses are in abject poverty and cannot contribute much to national development. To compound that of course, is the potential risk of threats to security when you have large population of disgruntled, unemployed individuals.”
According to a report published in Momentum, a UNFPA in-house publication, currently, there are 33.3 million people living with HIV and for every two receiving treatment, five are newly infected.
“The widening scope of the epidemic, which is affecting more and more women, calls for an urgent increase in combination HIV prevention strategies, of which condom are an essential part,” Purnima Mane, UNFPA deputy executive director programme said in the report.
According to reports, in Zimbabwe, billboards, radio spots and TV adverts helped boost female condom distribution by the public sector from about 400,000 in 2005 to more than two million in 2008, while the sales of female condoms went up from 900,000 in 2005 to more than three million in 2008.
In Zimbabwe, Guyana and Malawi, hairdressers were used to market the female condom, which proved highly successful while in Ethiopia, coffee ceremonies, an age-old social custom were used to reach married women because condoms – perceived to be used by promiscuous people and sex workers – are highly stigmatised in Ethiopian society.
Based on the SFH report, findings have shown that a lot of misconceptions exist on the female condom and it recommended among others that there was need to increase demand for the female condom, as this is currently not a well known product, with only 13% of persons having heard of the female condom, and much fewer having ever used one.