Botswana is among the 10 countries in the East and Southern Africa region to receive support from the United Kingdom (UK) Government under the regional programme on Preventing Maternal Deaths in East and Southern Africa (PreMDESA) to expand contraceptive methods. In preparation for the roll out of the contraceptives, UNFPA supported the Ministry of Health to train 22 health care providers from the Southern region of the country on insertion and removal of contraceptive implant. Manufactured by Bayer, Jadelle Implants are an effective, long-acting (up to 5 years) and reversible contraceptive for women of reproductive age.
Botswana, as an upper middle country, has progressed well in ensuring access to sexual and reproductive health (SRH) services, including family planning. However, key indicators such as teenage pregnancy, unsafe abortions and maternal mortality are high compared to other upper middle income countries. In order to improve these indicators, Botswana has been supported with 2000 Jadelle implants for 2016 as catalytic support to expanding contraceptive method mix. In addition, 450 000 female condoms are being provided - a method that allows women to initiate protection against pregnancy and sexually-transmitted infections, including HIV/AIDS.
Family Planning Methods in Botswana
1. Combined Hormonal Contraceptives
· Combined Oral Contraceptives (LD)
· Combined Vaginal Ring
· Combined Patch
2. Progesterone Only Contraceptives
· Progesterone Only Pill
· Progesterone Only Injectables (Depo)
· Implants (Implanon NXT; Jadelle)
Intra Uterine Contraceptive Device
· Copper T380A
4. Barrier Methods
· Male Condoms
· Female Condoms
5. Voluntary Surgical Methods
· Bilateral Tubiligation
A successful family planning programme depends on the availability of a wide selection of methods that can be safely and affordably offered to clients, and the competency of health care providers is crucial to safely perform insertion and removal procedures of implants and IUDs. As part of the training, health care providers carried out clinical practicals at three selected health facilities in Gaborone. Following the training, facilities with trained health care providers will start offering Jadelle implants as part of the wide range of contraceptive methods available.
a) Maternal mortality: 152/100 000 live births
b) Fertility Rate: 2.9
c) Teenage Pregnancy- 9.7%
d) Unsafe abortion- 21.8% of all maternal deaths in 2014
e) Women currently using modern contraceptives- 52.8%
f) 50% of HIV infected pregnant women report that the pregnancy was unintended, 20.2% seroconverted during pregnancy
Preventing Maternal Deaths in East and Southern Africa
Below: Health care providers learning how to insert and remove Jadelle implants
DFID, the UK Government Department for International Development, is supporting UNFPA East and Southern Africa to improve maternal health through two-year programme funding support of US$28 million. The programme meets critical family planning commodity gaps in 10 countries. It also supports the development of longer term capacity to increase the volume of robust evidence and proven innovative approaches available, which will increase the awareness and future uptake of sexual and reproductive health (SRH) services by adolescents, young people and people with disabilities.
The expected impact of the intervention for Botswana include:
6178 unintended pregnancies averted
2 maternal deaths averted
9421 family planning users
784 unsafe abortions averted