Paulina Marko Dahai

Paulina lives in Hanang, a Tanzanian village where we work on an outreach basis through the Dawar dispensary. It’s a service that’s helping many local women and their husbands find out about the different contraception options available to them.

Paulina and her husband have been married for 16 years. They live on a small plot with their children, aged 15, 14, 13, 11, 10 and 4. Paulina began using the DEPO method – a contraceptive injection given every 12 weeks – after having her third child.

“I first heard about family planning in 2006 when I already had three of my children. I came to the Dawar dispensary to find out what I could do, as the spacing of my first three kids was too close.”

When Paulina felt ready to have another child, she stopped having the injections and went on to have another three children. In 2012, she returned to the dispensary to find out what her options were for a more long-term solution.

One of the choices discussed with Paulina was a tubectomy, known as a BTL. “At first I wanted to have the BTL, but then I thought, wait, I’m still young, let me wait for a few more years. I had a three-year implant instead, which I then had removed in 2014, and continued to use DEPO given to me by the local dispensary. Now I’ve decided to have a five-year implant. After that, we will think again about the best method.”

Changing attitudes to family planning

In places like Hanang, where MSI Reproductive Choices provides regular outreach services, family planning is becoming part of everyday life. There’s less stigma associated with it and, by offering services to couples, rather than just women, whole communities are learning the importance and value of contraception.

Paulina’s husband has been supportive of her choices and about family planning in general. “It was actually him who thought I should go back to using a family planning method again. He even suggested the BTL but it was me who hesitated to have it.”

Many of the men in Paulina’s village have attended the clinic. “The husbands go with the wives when they are pregnant. There, they learn about family planning methods, so they can understand too.”

The positive effect of acceptance

Among the younger generation in Paulina’s village, there’s already plenty of awareness about family planning. And the more acceptable it becomes, the more likely mothers are to educate their daughters about it themselves.

“I think I will be ok to talk to my child about family planning when she is grown up enough. Here in this village, the youth are using family planning methods already. It is very secretive and they don’t tell anyone because the elders are not comfortable with it. But they still use it.”

Paulina recognises that effective family planning can mean the difference between completing and dropping out of education. “My daughters must study. Education is the most important thing. I want them to go further than I did – this is my dream.”