Vital Sexual and Reproductive Health Services provided – by you

199 individuals have received vital help through your PopOffsets funding. The latest report from WINGS in Guatemala shows the life-changing benefits have been given by making simple long term contraception freely available where it currently isn’t. A small amount of donated money can change a families future for the better.

These poor families have had no prior access to contraception and so have had large families as a consequence, putting strains on their health and well-being, as well as adding to environmental pressures.

With a grant of only £5000, 199 women have been supplied with long term contraception meaning they can now continue looking after their existing family without the worry of another pregnancy and child.

I. In October 2015, Pop Offsets generously provided WINGS a grant of £5,000 in support of our project Increasing Access to Contraception in Guatemala. The grant has been spent nearly in full, and therefore we are writing to inform you how these funds have allowed WINGS to increase access to contraception in geographically remote areas through the provision of mobile reproductive health services.

II. Project Summary, Activities, and Results
Guatemala is the most populous country in Central America, and also has the highest total fertility rate in the region, 3.8 children per women. Despite expressing the desire to space or limit subsequent births, 27.6% of sexually active Guatemalan women are not using any form of contraception, a clear indication of unmet need for family planning (OHCHR 2011). In indigenous communities, unmet need for family planning reaches nearly 30% and contributes to women having an average of 4.2 children. Limited public expenditure on healthcare, approximately 2.6% of GDP, exacerbates longstanding inequities and results in highly uneven access to social services among the indigenous Maya. In many of the communities in which we work, over 90% of residents cannot reach a health facility within an hour (UNDP 2005).
WINGS operates two mobile medical units which provide long-acting reversible contraception (LARCs), copper intrauterine devices (IUDs) and subdermal hormonal implants (Jadelle), and rapid cervical cancer screening. Staffed by our team of professional nurses, auxiliary nurses, and drivers, our mobile units travel throughout 12 provinces, scheduling on average 12 mobile clinics per month and in addition coordinate voluntary surgical contraception clinics with our network of stationary partner clinics.
Through August 2016, our mobile medical units have reached 1,950 individuals with vital sexual and reproductive health services through 199 mobile clinics. Our medical teams have distributed 537 copper IUDs, which provide up to 10 years protection, and 1,413 Jadelle subdermal implants, which provide up to 5 years protection. Additionally, the team has performed 426 tubal ligations, 79 vasectomies and 3,295 cervical cancer screenings. Thankfully, only 74 women, or less than 2% of cases, have required cryotherapy treatment for precancerous lesions. In total, WINGS’ mobile units have reached 71% of their annual projection for LARCs, as well as 71% of the annual projection for permanent procedures (tubal ligations and vasectomies). We have seen a positive turn regarding use of the IUD, with an increase in usage of 85% in comparison to the same period of time in 2015. This trend reinforces the effectiveness of using the LARCs First Methodology when presenting contraceptive methods to users.
During a recent mobile clinic this August, in the IXIL region of Quiche, we met Petronila. At 24 years old, she has four living children. Weighing only 99 pounds, she presented signs of severe malnutrition, and unfortunately, that means her children are likely malnourished as well. Accompanied by her mother in law, she told WINGS´ nurse Blanca that she came to learn about the screening for cervical cancer, but wasn’t interested in a contraceptive method. However, once inside the examination room, in a whisper, Petronila revealed that in fact she did want a contraceptive method as she didn’t want to have any more children, but her husband does not allow her to use a method, and she was afraid her mother in law would find out and tell her husband. It is quite common in many rural communities where WINGS works to encounter this barrier to access. Men often deny their wives access to contraceptives as it is commonly believed that a large family proves a man’s masculinity, and women use contraception to hide their infidelity or seek revenge on unfaithful spouses.
Blanca explained the various contraceptive methods available to Petronila, and that in cases like hers, the IUD is favorable, as it is undetectable, meaning no one in her family would find out she was using a method. While Petronila thought about her options, she underwent a cervical cancer screening, which unfortunately came out positive for precancerous lesions. She was very scared by the results. It is common for women to think they have cancer and begin to imagine the worst when results are positive. However, Blanca took extra time to sit with Petronila and walk her through the process of treatment with cryotherapy, which can be done on the spot. After roughly an hour, and after recruiting the help of a local health center nurse who committed to following up with Petronila and even to help her speak with her husband, she agreed to undergo cryotherapy treatment and choose the IUD, which will protect her for 10 years against an unintended pregnancy. The community, Santa Avelina Cotzal, where Petronila is from, saw the largest turnout of the three clinics WINGS hosted in the area, with 42 women attending. In Quiché, on average women have 4.1 children, making for the highest departmental fertility rate in Guatemala. WINGS is excited to increase our presence in the department, and make a difference in the lives of women, overcoming the linguistic, cultural, and geographic barriers that exist to accessing services in the area.
Working in close collaboration with our mobile medical units, WINGS network of youth leaders, women and men between ages 14 and 19 trained extensively in sexual and reproductive health information, give
Women from Santa Avelina Cotzal during educational talk.
informal and formal talks to other youth in their communities on various sexual and reproductive health topics, in addition to providing referrals for services from our network of volunteer promoters, mobile medical units, and “youth-friendly” clinic spaces. To date, our network consists of 69 youth leaders who have given 1,043 informal talks, 91 formal, in-school talks, and hosted 26 health fairs reaching 7,196 adolescents. Their hard work translates into 261 new adolescent users opting for a LARC and 416 adolescent users opting for short-acting contraception. We have seen an increase of 68% in use of long-acting reversible contraception among 14 to 19 year olds, in comparison to the same period of time in 2015. Of the individuals attending our mobile clinics, 2 in every 10 is an adolescent.
III. Finances
As of August 2016, WINGS has spent 91% of the grant provided by PopOffsets. The remaining £438.90 will be used to partially fund 1 mobile clinic during the month of September, providing 10 women with Jadelle implants, among other services. The executed funds provided 140 women with Jadelle implants, which translates into the prevention of 60 unintended pregnancies, 13 unsafe abortions, 38 live births, and 532 couple years of protection. In addition, women and their families saved £ 1,246.75 ($1,920) in direct healthcare expenditures.

For more information about WINGS, please visit the WINGS website