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Africa
Mobile midwives bringing services to their communities
Too many women are still denied their right to determine their own future. MSI Ladies are here to change that.
While more and more women across the world are using modern methods of contraception, many women are still experiencing restrictions that limit their right to decide whether and when to get pregnant. These barriers can be material, such as finding enough money to pay for services or a lack of trained nurses in the area in which they live. But barriers can also consist of intangible obstacles, such as stigma from the community, or religious or cultural restrictions.
MSI is committed to finding new ways of opening up contraceptive access to the 230 million women worldwide that are still experiencing restrictions. One such strategy is MSI Ladies.
What started as a pilot in a handful of countries in 2009, has now developed into a network of more than 700 MSI Ladies across 15 countries. They are qualified midwives and nurses from the local community, or simply committed women from other walks of life, who are trained and supported by MSI to provide contraceptive services and advice to women in their own homes.
United by a strong desire to help the women in their communities to access contraceptive information and services, MSI Ladies provide discreet support to women, and are fully embedded in the communities they serve. They not only establish close relationships with their clients, but tailor their services to the unique needs of the local community. Trusted within their communities, they are particularly effective at reaching young and unmarried women and girls who might not feel confident in using traditional clinics.
MSI Ladies have the ability to work in multiple locations, set a range of prices and work flexible hours, based on the local demand.
The majority of MSI Ladies work from home and visit clients in their homes, or hire a room in a government facility. This flexibility means that they see a high number of clients per day, particularly young girls under 25.
In some of the regions we work in, social stigma around sexual health means women are too afraid to seek out the services we provide, while cultural and religious restrictions forbid women from leaving the house on their own.
In these situations our fixed centres and outreach clinics don't work. By visiting a client discreetly and in her own home instead, she can receive the services she needs and know that her privacy will be protected.
MSI Ladies live in the communities they serve, and have a strong commitment to helping them.
They don’t consider the job done once a visit is over. Instead they build trusting relationships with their clients, providing them with quality follow-up care or ensuring they’re referred to their nearest MSI centre or BlueStar clinic.
Many of our MSI Ladies already have excellent medical and family planning experience, but everyone receives expert training and equipment from us before they go out into the community.
For this reason they enjoy a strong reputation, with over a third of our clients coming to us through word of mouth.
We constantly monitor and assess the quality of what MSI Ladies do, helping them develop their skills. In fact, many MSI Ladies have an entrepreneurial spirit, and the opportunity to develop their business skills is a great benefit to them.
Several generate their own income from this and some even go on to become franchisees for our BlueStar network.
MSI Ladies operate in towns and urban areas, as well as rural under-served communities.
Rural MSI Ladies in particular have had great success with reaching young people under 25. Increased stigma and lack of services in rural areas makes our discreet and flexible service a highly effective way of getting contraception to young girls.
Where income can be generated by MSI Ladies, this offers great return on investment for us and sustainability for our clients.
MSI Madagascar for example has over 170 MSI Ladies, and the channel contributes nearly 25% of its CYPs and at the lowest cost per CYP by channel.
We know that the model works. In 2022, our MSI Ladies delivered services to more than 600,000 women. And not only does the model directly benefit the women and girls receiving the service; the programme also empowers the nurses and midwives themselves to enhance their entrepreneurial skills, setting up micro businesses, learning new business skills and increasing their profile in the community. It's the perfect example of women working together to lift each other up.
That is why we will continue to seek opportunities to expand the model while exploring how we can adjust the existing programmes to make them more sustainable. While some programmes are already self-sustainable by charging affordable fees to clients where possible. However, funding from generous donors are still crucial to ensuring we can continue running the majority of our MSI Ladies programmes – particularly those that reach women living in extreme poverty.
