By: Rati Bishnoi, Special Projects Intern
Despite continued commercial availability for more than 15 years and ongoing efforts to increase global accessibility, a massive unmet demand for female condoms still exists today. High prices—up to 30 times the price of a male condom in some places—and limited or irregular access have kept the only female-initiated contraceptive method out of reach of many women.
In particular, female condoms act as a “barrier” contraceptive, which means they physically prevent sperm from entering the uterus. Unlike other barrier contraceptives, female condoms also protect the inside and outside of the vagina, thus preventing sexually transmitted infections. Greater access to the female condom for both women and men will increase the instances of protected sex and lead to the reduction of unintended pregnancies, maternal deaths caused by unsafe abortions, and help prevent the spread of HIV/AIDS. To help prevent these tragedies, last month on World AIDS Day, the United Kingdom committed 5 million pounds for the distribution of female condoms in Africa.
While this is a positive step, convincing policymakers to establishing sustainable female condom programs to extend this life-saving and life-improving reproductive health commodity to women around the world often proves challenging. In particular, concerns about cost, lack of variety in condom types, and general misconceptions affect the policy discussion. From 1993 to 2005, the only female condom available was the Female Health Company’s FC or FC1. The condom, which was made of polyurethane, is being phased out by FC2, a condom that is made of a less expensive material (nitrile) and is cheaper to manufacture. FC1 and FC2 are the only two female condoms approved by the World Health Organization for purchase by UN agencies, although other types of female condoms are currently under review (updates on the qualification process are available at www.condoms4all.org).
Recognizing these challenges, the Universal Access to Female Condoms (UAFC) Joint Programme has developed an advocacy toolkit to help advocates at any level and across sectors, from civil society to the private sector, to convince policymakers that the availability of female condoms is essential for the health of any community. Launched in 2008, the UFAC Joint Programme is an initiative of Oxfam Novib, Rutgers WPF, i+ solutions, and the Netherlands Ministry of Foreign Affairs committed to making female condoms “accessible, affordable, and available” to all. The programme’s activities include research and development, establishing large-scale female condom country programmes, and conducting international advocacy on the issue. The “Make a Move: Advocating for the Female Condom” toolkit contains information about the efficacy and types of female condoms, and how to perform demonstrations of the contraceptive, design an advocacy strategy, and reach out effectively to the media.
As part of the toolkit, UFAC notes that advocates can use international frameworks and the global development agenda to bring awareness to the need for female condoms. For example, advocates should check if their government has ratified international human rights frameworks like the International Convention on Economic, Social, and Cultural Rights, the Convention on the Elimination of All Forms of Violence Against Women, and the International Conference on Population and Development Programme of Action, among others. Each of these include provisions about the rights of women to sexual and reproductive health, which includes being able to access female condoms. While UFAC notes that there is a “vast gap between the commitment to rights on paper and the implementation of these rights in reality,” advocates can be instrumental in reminding governments of their obligations. In addition, advocates must continue to underscore that Millennium Development Goals related to reducing maternal mortality, HIV/AIDS, and gender inequality will not be achieved without greater access to contraceptives, such as the female condom.
In addition to using international frameworks, the global development agenda, and community concerns to raise awareness about the need for access, UFAC also calls on advocates to better understand and define what policymakers must do to ensure access. For example, female condom programs must include budgets for training of insertion techniques and negotiation skills to ensure that women and couples use female condoms when they are available. To help with the design and implementation process of effective advocacy, the UFAC toolkit outlines 10 necessary steps including (1) defining the issue; (2) setting objectives; (3) defining an audience; (4) building support; (5) developing a message; (6) selecting communication channels; (7) raising funds; (8) developing an implementation plan; (9) collecting data; and (10) monitoring and evaluating progress.
One example of UFAC’s advocacy efforts is the Female Condom Paper Doll campaign, in which a paper doll named Zawadi Smartlove is used to combine awareness raising about female condoms in different countries and at the United Nations. People from around the world write down messages demanding female condoms, and then the paper dolls are collected and made into a long chain representing the worldwide need and desire for the contraceptive.