title: Lessons from the recent rise in use of female sterilization in Malawi.
abstract: Although female sterilization is the most widely used modern contraceptive method in the world, most family planning programs in Africa have had difficulty providing it. Malawi, however, despite daunting constraints, has made female sterilization widely and equitably accessible, thereby increasing method choice and helping its citizens better meet their reproductive intentions. Ten percent of currently married Malawian women of reproductive age rely on female sterilization for contraceptive protection, compared with less than 2 percent across Africa, and demand to limit births now exceeds demand to space births. Malawi's female sterilization prevalence surpasses that of some high-resource countries. Key service-delivery factors enabling this achievement include supportive policies, strong public-private partnerships, and mobile services delivered at no cost by dedicated providers. Challenges remain, but Malawi's achievement offers lessons for other countries with low availability of female sterilization and similar resource constraints.
authors.affiliation: RESPOND Project, EngenderHealth, New York, NY, USA. rjacobstein@engenderhealth.org
authors.forename: Roy
authors.initials: R
authors.lastname: Jacobstein
mesh_terms: D001721:Birth Intervals / Q000706:statistics & numerical data; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008295:Malawi; D015995:Prevalence; D055818:Public-Private Sector Partnerships / Q000458:organization & administration; D013245:Sterilization, Reproductive / Q000706:statistics & numerical data*