Citizens based in Nampula province have different opinions on the advantages and disadvantages of using contraceptive methods, resources used by men and women to avoid pregnancy.

The use of contraceptive methods is the only effective way to avoid pregnancy and is therefore fundamental to family planning, according to the World Health Organization

There are different perspectives on this issue in the city of Nampula. Some advocate adoption as suggested by health institutions and the rapid application of contraceptive methods, but others think in the opposite direction.

Some of the girls interviewed by our report consider "The IUD" to be a very efficient, reversible contraceptive method that can be used for a long time, despite the many myths and doubts surrounding this method.

"I've never used any method, but from what I hear from people, I think the IUD is more accessible and efficient for us girls." Said Janete Abacar, a 19-year-old girl.

Catarina Jamo, a 21-year-old university student, focuses her attention on the use of pills, because in her opinion, it's the best method. In fact, these contraceptives are widely used by women not only to prevent pregnancy, but also to control the symptoms of premenstrual tension and cramps.

"I think pills have been the best way to prevent pregnancy, especially the morning-after pill. In fact, the pills are spectacular emergency methods that prevent pregnancy." The source said.

In addition to preventing unwanted pregnancies, it also prevents sexually transmitted diseases (STDs). The female condom is also a very popular contraceptive for women. It is applied by inserting it into the vagina minutes before sexual intercourse to prevent conception.

Social activist Nolete Milato defends the need to improve and disseminate policies linked to the use of contraceptive methods in remote areas, at a time when the birth rate continues to reach alarming proportions.

The "big bang" demographic explosion needs to be curtailed, and the use of contraceptive methods is on the list of the best ways to stop this trend.

"The government must take primary responsibility for rapidly disseminating the application of methods. In rural areas the situation is chaotic and, as a result, basic services are coming under increasing pressure, the population is huge for few resources," he noted.

Last month, the province of Nampula was surprised by an unusual event in which a citizen gave birth to twins at different times and in different health facilities. The first baby, a female, was born in a non-institutionalized delivery, i.e. outside the maternity hospital, in the town of Namuáli, Liúpo district. The second baby, a male, was born 48 hours after the first, at the Central Hospital in Nampula, after doctors in Liúpo found that a fetus had been retained in the parturient woman.

The unusual event involving a 30-year-old woman has caught the attention of the health professionals working in the maternity ward of the Nampula Central Hospital (HCN), who have not hidden their admiration.

In a phone call two weeks after the births, the mother, who goes by the name of Maria Manuel, said she was making her fifth trip to the maternity hospital. She is now the mother of seven children with the arrival of two twins. With this number of children, Maria says she has no choice but to use contraceptive methods, a decision supported by her family. Maria's mother says that she is too young to have seven children.

Traditional factors affect adherence to family planning

The Mozambican Association for the Development of the Family (AMODEFA) in Nampula points out that traditional factors, especially taboos, myths and beliefs in the lives of women in Mozambique's most populous province, continue to condition greater adherence to family planning - which is now available even in peripheral health units.

According to the coordinator of AMODEFA in Nampula, Alizete dos Santos, low participation in the family planning process is still difficult and work needs to be done to overcome the traditional practices that contribute to the misperception of the methods, especially among rural and urban women.

Family planning makes it possible to determine the period and interval between births, and to ensure the health of mother and baby. For women, the lack of time between births entails health risks such as uterine problems. A baby born to a mother with uterine problems runs the risk of absorbing substances from the placenta during childbirth.

The coordinator said that her organization's fight to stop the problem of myths, beliefs and taboos is focused on health units and mobile brigades in the districts of Nampula, Mecubúri and Nacala-porto, in order to encourage women to benefit from family planning.

"At least 863 women have benefited from family planning in the three districts of Nampula, Mecurubi and Nacala-porto and we work with a group of young people who have been spreading messages about family planning in schools and communities, and we also have AMODEFA providers in the health units who give talks to make mothers aware of the need for this phenomenon that safeguards women's lives," he said.

However, to prove AMODEFA's point, we went to the Natikir neighborhood in the city of Nampula and found that many women over the age of 18 know little about family planning methods. For example, 36-year-old Olívia Ernesto, mother of six children, all underage, said that she had never taken up family planning. She didn't explain why.

"I'm a mother of six and my last baby was in May this year. I've never done family planning. I hear from the other women closest to me that family planning is a risk, although this process depends on each woman, because there are others who then have difficulty having children, or can conceive twins, and my fear is greater. I prefer to stick to having children as God allows," she said.

But, as she said, with the greater number of children she has, Olivia Ernesto has been facing difficulties in her life in order to provide for them. However, she still believes that family planning isn't the solution to her problems and that it can guarantee that her needs and those of her children are covered. (Text and photos by José Alberto and Nelsa Momade, in the city of Nampula, for MZNews)