Finding More Than Food at the Markets in Liberia

MONROVIA, Liberia – Every Thursday, 39-year-old Jartu Kollie walks several kilometres to the market in Pleemu Town, near the Liberian capital Monrovia. But this vibrant local market is not only a place where she can sell her products; it is also where she goes to access the family planning services that have saved her life.

Ms. Kollie gave birth to 13 children, five of whom died at birth because she lacked access to adequate healthcare services.

“I almost lost my right leg and my life during the birth of my last baby. I was in labour for more than one week in the village before I was rushed to the local clinic,” Ms. Kollie recounts. “I am grateful that I am still able to walk to the market, and I am so glad that we can now easily access information on how to prevent pregnancies.”

Bringing family planning to the market

Ten years after the end of a civil war that ravaged the country’s social and economic infrastructures, many Liberian women and girls yearn for access to family planning information and services. With support from UNFPA, the UN Population Fund, the country is introducing innovative ways to provide these services.

Bringing family planning to the marketplace is one such approach. In cooperation with the Planned Parenthood Association of Liberia (PPAL), an affiliate of the International Planned Parenthood Federation, UNFPA runs weekly mobile market clinics offering reproductive health education sessions and family planning services.

“Using a community-based structure like the marketplace to serve as a delivery point for family planning services is proving to be a great approach to breaking some of the barriers to access,” says Ratidzai Ndhlovu, the UNFPA Representative in Liberia. “The strategy has the potential to significantly contribute to the reduction of unwanted pregnancies and ultimately save the lives of women and girls.”

For PPAL Executive Director Miatta K. Kiawu, there is no doubt that offering family planning support at the marketplace facilitates access to those services for women and girls.

“It is a matter of human rights,” says Ms. Kiawu. “The reproductive health needs of women and young people are often neglected. People take advantage of their limited access to financial assets and lack of power and political voice. Ensuring that their reproductive health needs are met would promote our desire for sustainability and development.”

Since 2010, PPAL has also been managing a similar UNFPA-funded project, offering sexual and reproductive health counselling, contraceptives and referrals, to market patrons and host communities in urban areas, too.

Jartu Kollie (right), 39, receives counselling on family planning  at the Pleemu Town market. Photo credit: APANEWS

Making a real difference in local communities

Before this marketplace initiative, most market regulars had little information about family planning.

Jumah Boakai, a busy supervisor at one of the 16 urban market clinics, says the impact that the small clinics have brought to health workers and the local population is undeniable.

“More people are becoming interested in family planning methods. In this market, we receive between 13 and 15 clients per day. Sometimes the number is even higher,” says Ms. Boakai while she keeps an eye on prospective clients milling around her stand at the Waterside Market in Monrovia.

Members of the local community are identified and trained as peer educators, and the services are provided by qualified health professionals.

Deborah Doe, 30, who has been on injectable contraceptives for the past five years, says that access to family planning has given her new options for how to live her life.

“I don’t want to bear a child at the moment, so family planning is my best option,” says the mother of two.

One of Ms. Boakai’s regular male clients, 42-year-old Roland Tuazama, dropped by to pick up condoms.

“I have four children, two of whom are out of high school,” he explains. “I don’t want any more children now, and condoms are the most effective way to be sure. They also protect me from sexually transmissible diseases.”

Promising results

In a country with a high incidence of adolescent pregnancy and one of the highest maternal death rates in Africa – estimated at 770 deaths for every 100,000 live births in 2012 – there is hope that even more Liberians will embrace family planning.

The market clinics have yielded promising results. The number of family planning services that have been provided to beneficiaries increased from 45,663 in 2011 to 104,590 to date. Young people, usually underserved in more traditional settings, represented 40 per cent of the clients, of which 62 per cent were female.

Emboldened by its success, the projects expanded from eight to 16 daily urban market sites in 2014, and UNFPA is continuing to support the Government of Liberia to address the unmet need for family planning throughout the country.

With reporting by APANEWS.