South African reproductive health experts say that it is concerning that young girls and women continue to carry the sole responsibility of ensuring contraceptive use.

In South Africa, contraceptives are legally available to anyone over 12. But Dr Kim Jonas, a specialist scientist at the Health Systems unit of the South African Medical Research Council(SAMRC), says historical cultures and gender norms have long made women solely responsible for family planning.

Who is responsible contraceptives?

As the country marks Reproductive Health month, aimed at raising awareness about many crucially important reproductive health issues, we spoke to a few South Africans for their views.

Faith Mulaudzi, 36, from Mpheni Village, outside Louis Trichard, says she has been using contraceptives regularly for about 15 years. “I started using injectable contraceptives when I was 21 years old. I was introduced to this form of contraceptive quickly after giving birth to my son. And I was told I would have to go to the local clinic after every three months to get a shot,” explains Mulaudzi.

The mother of four says that she has never experienced any side effects from the injectable Depo-Provera, a form of progesterone injected into the upper thigh or arm.

“I like this form of contraceptive because it has never given me any challenges. Sometimes when I go to the clinic its out of stock, and I must return some other time. Also, when I want to fall pregnant, I know I can just stop taking it for two or three months, and then I will be ready to conceive again,” says Mulaudzi.

She says she has never heard of male contraceptives.“I only know of the condom, which most men do not like using. It means that not enough awareness is being raised, especially within rural communities like ours”.

32-years old Richard Mudau* from Waterfall in Limpopo believes women and girls should be responsible for contraceptives because most men do not care whether they will impregnate them.

“They know they can always shy away from taking responsibility. And in that case, a woman is the one who will be left to fend for the child. So, I feel that though it is wrong for women to be always the ones taking contraceptives, sometimes it helps to protect them from unnecessary headaches,” says Mudau*.

He adds, “Many men, including myself, even if male contraceptives were to be made available to most of us, we are still not going to take them. Just look how easy it is to access condoms, but we continue to sleep around without condomising”.

30-year-old Patrick Ndou* from Maniini village, outside Thohoyandou, says the only form of male contraceptive he uses are condoms. 

“I will never consider using any other form of male contraceptives besides a condom. But also, I do not pressure any woman I date to use other contraceptives as I know I will always use a condom as I care about my health and future,” says Ndou*.

Everyone has sexual and reproductive rights

The World Health Organisation says reproductive health means people can have a satisfying and safe sex life and the freedom to decide if, when and how often to do so. 

But Jonas says SA is a traditional country to some extent, and less is expected of a man regarding contraceptives and preventing unwanted pregnancies.

“We first need to address the gender norms. We need to educate men/boys about contraceptives and address the myths around contraceptive use,” says Jonas.

Jonas also says contraception counselling should be provided to men and boys at health facilities when they visit for any sexual reproductive health(SRH) related service. Boys also need to be educated about contraceptives in schools. 

“Just like for women, interventions to dismiss community- and gender- norms are urgently needed to improve contraceptive uptake. Provision of educational pamphlets/leaflets in the community, as well as community awareness campaigns, are the most critical approaches to address these societal norms, which hurt contraceptive uptake,” says Jonas.

Mentality shift needed

Nelisiwe Hlophe, Senior Manager: Programmes at Soul City Institute, says men must be equal partners so that reproductive health and contraceptives are not a woman’s sole responsibility.

Hlophe says the shortage of contraceptives is worrying.  “Last year, for example, there was a shortage of injectable (injections), and only oral contraceptives were available. Access from public health centres is limited due to lack and shortage of contraceptives, which leaves youth the burden of buying, which is a huge problem,” says Hlophe. 

Hlophe says change can be affected by encouraging dual protection and highlighting the importance of roles played by both parties – Health-e News.

*Names have been changed