Four Women, One Life-Changing Intervention

As a mother to a toddler son, I’m often asked if my husband and I want to give him a sibling. What’s implied in that question is that we have the ability to plan for that someday. But what if you could not control when you have children, or how many children you have? What toll would it take on your life, your health, your dreams, and that of your children?

More than 214 million women around the world are facing this very challenge: They want to avoid or delay pregnancy but are not using modern forms of contraception. That means almost a quarter of a billion women lack the basic human right to plan for their family and future ― a right that I’ve always unquestionably had. When women who want to use contraception are informed and empowered to use a safe, effective and affordable contraceptive method of their choice, they are in control of their lives. This one life-changing intervention allows girls and women to stay in school, pursue jobs and have children if and when they are ready. It improves maternal and child health, decreases unintended pregnancies, lowers HIV infection rates, and is considered one of the greatest antipoverty innovations in history.

Contraception allowed me, Jackqueline, Rafaela, and Sherley – four women from four different corners of the world – to take control of our futures and pursue our dreams.

Meet Jackqueline, Busia, Uganda

“Family planning helps us to plan for the children, to have a number that we can feed, a number that we can clothe, a number that we can comfort well.”

Jackqueline Bwire Nabwire experienced what many young girls do while growing up in rural Uganda: Money was scarce in her large family, and priority was given to the boys when it came to education.

With little education and few career prospects in her community, Jackqueline went on to marry and have seven children. As her family grew larger, Jackqueline worried about providing food and education for her children.

“I saw that the children were becoming more, and I could not afford to take care of them,” she said. This was when she decided to begin using contraception.

Jackqueline was so moved by how contraception helped her take control of her life that she decided to become trained as a community health worker in her village. She trained through a U.S. government funded NGO, FHI360, and now distributes a whole range of contraceptive options from pills to three-month injections to women in her village.

“I really feel it in my heart I should work for this community,” said Jackqueline. “When I am talking to the fellow women, I am moved to serve them, and that’s why I decided to do this kind of work.”

Meet Rafaela, Chichicastenango, Guatemala

“Without family planning I would have five children by now, and I may be a failure because perhaps we would have to face malnutrition because we wouldn’t have enough money.”

Rafaela Panjoj Sente lives in a village on the outskirts of Chichicastenango, Guatemala, with her husband and two children. When she first became pregnant at age 16, Rafaela was surprised: “Before I got pregnant, I never got any information regarding pregnancy,” she explained.

Rafaela now uses a five-year contraceptive implant, which she learned about through REDMISAR, a local NGO that receives U.S. aid to promote and monitor reproductive health, nutrition, and education in Guatemala. Using contraception allows Rafaela to invest in her children’s education, health, and nutrition – especially critical in a country where 50 percent of children suffer from malnutrition. Where Rafaela lives, that statistic is even grimmer: 70 percent of children under age 5 suffer from malnutrition.

“When we have a large family, we cannot provide for them and sometimes we might fall into chronic malnutrition or severe malnutrition,” Rafaela said.

Like Jackqueline in Uganda, Rafaela felt so strongly about the impact of access to contraception that she became a REDMISAR trainer herself and now shares information on contraception and reproductive health with hundreds of other women in her community.

Meet Sherley, Port-Au-Prince, Haiti

“I plan to become a big entrepreneur from Haiti, but to do it, I must do family planning.”

Sherley Philistin owns and operates a successful catering company in Port-au-Prince, Haiti, where she lives with her young son.

Although pursuing school as a girl in Haiti was challenging, Sherley graduated not only from high school, but from the well-known hotel management school, Ecole Hoteliere d’Haiti. She was also one of 27 women selected to participate in a 22-day training course in hotel management at the Arizona School of Management.

“I began with $500 and three people,” said Shirley of her business. “Now I have more than 10 people, I organize ceremonies with more than 400 people, and I have my Facebook page. I organized the opening of the [Cine] Triomphe [the first cinema to open in Haiti in five years].”

Sherley believes that none of her successes would have been possible without access to contraception – she chose a three-year contraceptive implant as her method of family planning, to help her pursue the big entrepreneurial plans she has for the future. She does not plan to have more children.

“Life in Haiti is very difficult,” she added. “But when you have one child, you can do something; you can work. … I want to give the possibility to my son to have a better education. When I use family planning, it’s the right path to educate my son.”


Jackqueline, Rafaela, Sherley, and I may live in very different circumstances; but we all share in wanting to be able to plan our lives and do what’s best for our families through the life-changing intervention of contraception.

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