By Sandra Jordan, USAID, and Faustina Fynn-Nyame, Marie Stopes International

Rahinatu is 18 years old and works in one of Accra’s busiest markets. She has travelled down to Accra from Northern Ghana to work as a kayayei (market porter), hoping to save enough money to buy the household goods and utensils she’ll need before she can get married.  She has worked in the markets for six months, but life as a kayayei is desperately hard. Women and girls like Rahinatu sleep rough in market stall doorways or in abandoned boxes, and are highly vulnerable to sexual harassment and rape.

“Living here is difficult,” Rahinatu says. “I am just a kayayei, men sometimes try to rape us. I have no one to look after me, I am on my own.”

Empowering women to take control of their lives and their reproductive health is at the center of USAID’s efforts in family planning, and aligns perfectly with Marie Stopes International’s mission to deliver quality services. It means going the extra mile to ensure that the most marginalized of women are able to access safe sexual and reproductive health services. Rights and protections may be on the statute books, but often women are still unable to access the services they need—like contraception.

Empowerment is a core concept in rights-based reproductive healthcare. FP2020’s Rights & Empowerment Principles for Family Planning defines it this way:

Empowerment:  Individuals are empowered as principle actors and agents to make decisions about their reproductive lives, and can execute these decisions through access to contraceptive information, services and supplies. 

In Ghana, USAID is supporting a unique partnership between Marie Stopes International, HIV charities, the Ministry of Health, the Ministry of Women and Children’s Affairs, and the Police Service to bring empowerment to the most marginalized and vulnerable women. Mobile teams from Marie Stopes go out into the markets every day, bringing family planning information and services to kayayei like Rahinatu.

After her counseling session with the Marie Stopes nurse, Rahinatu decided to get the five-year contraceptive implant so she would be able to keep working and continue to save up. She also learned about other support services, from the police and charity organizations, that can help protect her while she lives and works in the market.

Service to the kayayei is a family planning success story. But that’s just one challenge we face in realizing empowerment for individuals; there are many more.

In Kenya, for example, strongly held conservative cultural beliefs prevent many women in rural areas from using contraception. A critical part of empowering women in these environments is educational work in the community. Marie Stopes International’s outreach teams work with community and religious leaders in these areas, and with the men who control family decision-making, to increase women’s access to much-needed services.

In Zimbabwe, Marie Stopes is sending mobile teams to the most rural areas of the country, bringing modern contraception to women who have never had access to it. In Tanzania, Marie Stopes nurses on auto-rickshaws deliver family planning services to urban slum areas. And in Myanmar, Marie Stopes midwives travel up to 10 hours by boat to reach the most remote communities with lifesaving reproductive healthcare.

In these and many other countries, USAID and Marie Stopes International are collaborating to go the extra mile—and the last mile—to empower women with the information, services, and supplies they need.