DOREEN NAWA, Lusaka
SARAH Mutale, 35, is aware of the economic implications of having more children.
The mother of three knows there is a risk of failing to finance the needs of children should they be more, and because of her fears, she and her husband, Francis, have agreed not to go beyond three children.
For Mrs Mutale, a complete stop to having children is the best option for her but she does not know how.
One day she opted to find out on various family planning methods available. At the same time, she fears she might experience complications if she takes options that require a serious operation to prevent an unplanned pregnancy.
This led the couple to the University Teaching Hospital (UTH) to seek advice on the available planning options.
Mr and Mrs Mutale of Lusaka’s Longacres area managed to access the birth control pill.
The pill is a type of birth control that is designed to be taken orally by women to prevent pregnancy.
But three years ago, Mrs Mutale had challenges with adherence to the oral contraceptive pill.
And after she shared her predicament with her workmate, she learnt of the new option which has become popular on the market among women who want to prevent pregnancy.
The Chinese single dose monthly contraceptive pill, also referred to as a once-a-month contraceptive pill, is now becoming common among women.
Asked on the efficiency of the pill, Mrs Mutale says she has had no major side-effects from the time she started taking the drug.
“I like the elasticity, you take it once a month and all I do is indicate on my kitchen calendar right on top of the kitchen unit and this gets me reminded of the next due date,” Mrs Mutale says.
Mrs Mutale is not alone. Limited access to family planning services, fears about side effects, opposition from partners and religious beliefs have led to Zambia having one of the highest unmet needs for contraception in Southern Africa according to United Nations Population Fund (UNFPA) report on access to family planning.
And the report indicates that this unmet need for family planning is highest among illiterate women in rural areas in Zambia.
But with the coming of the Chinese pill on the market, some women have taken up the option.
Another user of the Chinese pill, Precious Kagulula of Lusaka’s Madras area, says she first heard of the Chinese pill in 2015 and a year later, she tried it.
“I have had no side effects and I think it has worked well for me. I have been on it since 2016. I would gladly recommend any woman especially working women to consider being on the Chinese pill,” Mrs Kagulula says.
Although easily purchased in Lusaka at prices varying between K30 to K50 per pill, the purchase goes with no prior medical examination or counselling.
An on-the-spot check at a Chinese clinic in Lusaka in Libala area found the pill going at K30 and easily accessed with no receipts issued for the purchase.
It was the same case at another clinic located in Lusaka’s Northmead area where a pill is sold at K50.
But health authorities in Zambia have maintained that the Chinese contraceptive pills are illegal in Zambia.
Ministry of Health Permanent Secretary Kennedy Malama says women should be cautious when using them because it’s not clear what they contain, and some women have reported serious side-effects, including heavy bleeding.
“It is not recommended to take medication that has no name. People should be worried of such medication and desist from taking it,” Dr Malama says.
At the dispensary section at the Chinese clinic, the attendant said the pills are herbal contraceptives and have no major side-effects.
“We have had no complaints from the time we started dispensing the pill. Actually we have a lot of new clients coming for it on a daily basis. The Chinese pill is a popular option for Zambian women seeking non-hormonal contraceptives,” the attendant said.
But some women who have taken the pill say it causes heavy bleeding.
“I experienced heavy bleeding for the first months but thereafter my body got used and I have had no problem. The only challenge is that the pack for the same pill is written in Chinese language, it would have been helpful if it was done in English. And selling of the pill is strictly one pill a month, so once it is time for that month’s dose, I always go back to the clinic to purchase it,” Jacklyn Choongo, another user of Lusaka’s Thornpark area says.
It’s not clear how the pills get to Zambia, or when they first arrived in the country, but the World Health Organisation notes that Chinese contraceptives flow freely into Southeast Asia.
According to the Zambia Medicines Regulatory Authority guidelines, one of the prerequisites for medicines sold or given to patients in Zambia is that the instructions on the said medicine should be in English.
But for the Chinese pill, the instructions are in Chinese, a language not familiar to Zambians.
ZAMRA public relations officer Ludovic Mwape says the pill is illegal in Zambia and investigations are under way to determine for how long the practice has been going on.
“In the first place, the medicine coming to Zambia must be in English. But for the Chinese, there was an exception that they (Chinese) should bring in medicine in Chinese because it was meant for their people (Chinese speaking). But now that we have Zambians accessing it, it comes to us as a matter that we are handling with the urgency it deserves,” Mr Mwape says.
Further, ZAMRA is carrying out investigations on how the pill has found its way into the country and why Chinese clinics are giving it out to Zambians that do not understand the language of instructions on the pill.
DOREEN NAWA, Lusaka