Mozambique – Overview of Country Activities:
To help improve birth spacing and expand family
planning in Mozambique, the Optimal Birth Spacing
project was implemented in Lioma, Zambezi province.
The purpose of the project, carried out by Advance
Africa, World Vision, the MOH and local NGOs,
was to test the feasibility of increasing knowledge
and intention to space births through networking
and the use of activistas, or community health
workers.
Focus groups and a rapid survey were conducted
in three communities to establish a baseline of
current knowledge and to inform the design of
the intervention. Findings from the focus groups
indicated shifting attitudes towards family planning,
a desire for smaller families and recognition
among many of the importance of birth spacing
to reduce the risks to the mother and child of
closely–spaced pregnancies. Substantial
barriers to family planning use were also found,
including concerns about perceived side effects
of modern contraceptives. Both men and women’s
groups reported preferences for natural methods.
Based on the findings from the focus groups,
a communication strategy including messages about
the benefits of birth spacing was developed to
be communicated through local social networks.
Advance Africa also invited The Institute for
Reproductive Health to participate in the project
and introduce the Standard Days Method (SDM) to
expand the mix of methods and specifically address
the demand for natural methods that was found.
The SDM was viewed as an appropriate option for
women interested in using a natural method to
space births.
The Institute trained Advance Africa staff in
the SDM, and they in turn trained World Vision
staff and local health workers. Advance Africa
translated the SDM training manual into Portugese
and trained activistas, community health workers,
to counsel potential SDM users in the method and
to disseminate birth spacing information.
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The results of the study showed that the knowledge
of optimal birth spacing, the demand for all family
planning methods, particularly the SDM, and the
reported intention to space births all increased
as a result of the intervention. The study also
showed that it was both feasible and acceptable
to introduce the SDM in Mozambique.
Great interest and demand also remained high
as requests for the SDM came in from neighboring
communities. Both men and women reported preference
for natural methods, and the SDM was seen as an
appropriate method for addressing barriers to
birth spacing, such as perceived side effects
of hormonal methods. In the focus group discussions,
SDM was reported to help couples discuss family
planning decisions, and men reported that abstinence
during the fertile days improved their sex life
on the remaining days of the cycle.
Overall, the SDM was found to provide substantial
benefit to the effort to improve birth spacing
because of its simplicity, acceptability, and
ease of use, and to have the potential to contribute
to optimal birth spacing programs both in Mozambique
and other countries in Africa.
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