High rates of population growth are a cause for concern around the world and in Malawi the population is growing by one person every minute. In the 1950s the population of Malawi was about three million. Today it is more than 18 million; that’s a 500% increase. If the UK had increased at the same rate we would have a similar population to the United States of America. UNICEF estimate that the population will grow from 18 to 30 million between now and 2030 – at 4.4 children per family, Malawi’s fertility rate is ninth highest in the world and is putting increasing pressure on the already strained resources in the country. Although provision of contraceptives is free, Malawi has a high unmet need for family planning services and the patriarchal nature of society here also means women are not often given a voice in decisions on family size. Family planning in Africa can be a challenge as there are lots of misconceptions surrounding them.

With all of the projects that Ripple Africa is involved with in Malawi – fish conservation, forest conservation, education or healthcare – the major problems arise because of the rapid population growth. If Malawians can be encouraged to reduce the size of their families, then their natural resources will last a lot longer.

Ripple Africa is piloting a family planning and sexual health project in Malawi to try to address how best to tackle this problem, starting in the area around Kachere Health Centre. During 2018, Khumbolawao Mphande, a nurse midwife, and Watson Chirwa, a health worker, spent time with school and community groups and couples to identify how best to encourage more people to access family planning. Research with these various groups has shown that the problem cannot be solved solely by informing people about family planning methods available.  The project is also encouraging more equal relationships between husband and wife as both need to be involved in decisions to improve their lives and on their family size.

Khumbo and Watson have been talking with couples to understand their current struggles and their aspirations for the future. Typically, in Malawi, women carry out all of the household work including fetching water, collecting wood, washing the clothes, cooking and caring for the children. From September 2019, a number of couples have been challenged to share these job roles, and they all found that by helping one another, they each had more time. Couples were then encouraged to think about what they can do with that extra time. They mentioned setting up small businesses, helping their children with school work and also relaxing with their partner and talking about what they want from their relationship. This included discussing the number of children they wanted and how they could manage their money better. It is these conversations that Ripple Africa believes are the key to couples deciding how to improve their futures, and most of the couples agreed that smaller families would mean that they could have a better quality of life. This naturally leads them to access and use family planning.

In schools, Khumbo and Watson have continued to run and support Life Skills lessons at six primary schools and a secondary school. The teachers have been really keen to involve them in these classes as it gives the students the opportunity to have their questions answered by healthcare professionals. The primary school sessions are with pupils in Standards Five to Eight and with all year groups at secondary level, and each class meets with the team twice a month. In 2019 we worked with 1,048 students.

From initially starting as an opportunity to gather information about the students’ knowledge of sexual health and family planning, etc., the sessions now also include topics on peer pressure, drug and substance abuse, HIV/AIDS and antiretroviral drugs as well as gender, sexuality and child abuse – all of which appear in the Life Skills course.

Simple fun demonstrations highlight the current and future problems arising from having large families and the impact on Malawi, its resources and on individual families. For example, we illustrate the impact of population growth by asking people one by one to stand on a small mat. The mat represents Malawi and each person represents three million people clearly showing how much space there was in Malawi in the 1950s and how little space there is today and will be in the future. These demonstrations are helping to change perception of the ideal family size from five to two children per family.

Khumbo and Watson run sports events and attend Under 5 clinics to reach people who might be reluctant to discuss contraceptives and family planning in a clinical setting.

We are also encouraging husbands and wives to work in partnership to make decisions about family size. Education is clearly key but we are also working in partnership with local government health centres who provide the contraceptive methods to measure the impact of the project.

We are seeking funding to be able to expand this project so that Khumbo and Watson can continue their education programme within schools and with community members.

We are keen to further develop our education programme with parents and the community to highlight the benefits of accessing contraceptives for girls who are already sexually active to reduce teenage pregnancies. In Malawi, when a girl gets pregnant, she has to drop out of school whilst the boy can continue his education. We also hope to encourage more boys to use condoms to avoid the potential spread of HIV and other STIs.

The team will continue to work with couples individually and through community events to encourage more equal partnerships so that both men and women feel that they can discuss family planning and sex openly together.

In order to maximise the potential of this project, we are therefore seeking funding to continue and to expand the team and the area we cover. Read our latest report here.