Miriam lives in the west African country of Mali. Like many Malian women she married young. In Mali, 65% of women aged 20–24 were married by the age of 18, and 25% were married by just 15, often for long established cultural reasons.
In many cases, children arrive nine months after the wedding day, and keep on arriving with very little space between them. So mothers don’t have enough time to recover, or enough time and money to devote to their existing children.
Up to a point, this is Miriam’s story too. She became pregnant again less than a year after giving birth to her first child. At the age of 18, she now has two children under the age of three to look after.
However, at this point Miriam’s future took a different turn. One of our team members reached out to her family, and spoke first with her husband about the benefits of birth spacing, advising him that for Miriam and her children to be healthy she should space her births at least two years apart.
Concerned for his wife’s health, Miriam’s husband suggested she visit our centre. Miriam had no knowledge at all about modern family planning methods, so when she came to the centre she spent time with one of our team learning about all the different family planning methods before deciding on an IUD.
Now, six months later, she is still happy with her choice. She says: “My whole family is at peace now. My husband doesn’t have to worry about financing another pregnancy and another child; the children I already have are better cared for; and I can take some time to rest.”
Our programme in Mali serves a large number of young clients. Salimata Maiga, one of our doctors, says: “We see a lot of young women using our services. They come so they can avoid unwanted pregnancy that would conflict with their educational goals.
"Others, like Miriam, have children spaced very close together, and seek services to avoid the occurrence again. We help young people by listening to their individual needs, providing counselling; and offering services at a reduced price.”
In Mali, just over 30% of modern contraceptive users nationally are under 25. Yet 55% of our centre’s clients are under this age, demonstrating the team’s ability to reach this critical under-served group. Across all the countries where we work, we are looking for new and innovative ways to make sure that the young people who want to use our services can do so.
At this time in history, the world is seeing its largest ever cohort of young people, and they are now reaching reproductive age. For these young people to choose what their future will look like, it’s ever more crucial that we can reach more young people who are just becoming sexually active, and more women like Miriam.
That might mean more online real time counselling, mobile phone results services, and opening hours and locations chosen by young people. What it will definitely mean is
young people being able to take charge of their sexual and reproductive health, and deciding for themselves what their future will look like.