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Long-acting Contraception Changes a Woman’s Life

Thirty-nine-year-old Rosentina lives in a remote village in Timor-Leste’s Covalima Municipality, where she spends her days caring for her seven young children, keeping her house in order, taking care of the family’s animals, and working in their nearby fields.

Despite not having much time for rest, Rosentina is fit and happy, with a supportive husband and fulfilling time with her children. However, one year ago, Rosentina suffered a miscarriage during the third month of her eighth pregnancy. Although she lost a lot of blood, Rosentina was treated successfully at the Fatumea Health Center.

Vitorina de Jesus Cardoso, the midwife who took care of Rosentina, changed Rosentina’s views about her health and wellbeing. Vitorina is used to seeing women like Rosentina, who work tirelessly day after day to ensure their children thrive, eat well, and attend school.

Recently, with support from JSI’s USAID-funded Reinforce project, which, among other things, works to improve the quality of family planning services in Covalima, Vitorina attended a family planning training given by the National Institute of Health. At the training, Vitorina learned about the benefits of spacing children: more rest for the mother who can fully recover from the pregnancy and delivery, more attention for the baby and siblings, and more time for sharing remunerative tasks with husbands. The training also taught Vitorina how to counsel women to space their children and choose the right contraception for spacing.


With training made possible by JSI, Fatumea Health Center Midwife Vitorina provides family planning counseling for a mother in Covalima Municipality.
While Rosentina was recovering from her miscarriage, Vitorina counseled Rosentina and her husband about the benefits of birth spacing. Without hesitation, the couple decided they should not risk getting pregnant too soon after the miscarriage. “I was lucky to survive after the loss of my baby, but my children and my husband need me more than ever right now and I have to be healthy for them,” said Rosentina.

After further family planning counseling from Vitorina, Rosentina decided the contraceptive injection was the method for her and soon went home to her family. From that day on, she fully enjoyed her life without worrying about being pregnant again.

But Rosentina’s village is a long walk from the health center and after returning two times for subsequent injections, which need to be repeated every three months, Vitorina happily informed Rosentina that she was now certified to provide long-acting contraceptive methods. These methods, which include contraceptive implants and intrauterine devices (IUDs), would free Rosentina from having to come back to the health center every three months. After further counseling from Vitorina, Rosentina chose the IUD, which lasts for five years.

Vitorina was certified to provide long-acting methods of contraception by the National Institute of Health in February 2017 thanks to repetitive practice sessions supported by the Reinforce project. Vitorina is now able to counsel mothers on the full range of family planning methods. “Every woman has different needs and lives in a different situation depending on her age, the number of children she has, where she lives, and her health condition,” said Vitorina.

This is why the Reinforce project supports the National Institute of Health to build the capacity of Covalima Municipality’s midwives to address every woman’s family planning needs. Since 2016, the Reinforce project has supported the National Health Institute to train 48 service providers in family planning. These newly-trained service providers work in 24 of Covalima’s 25 health facilities, a coverage rate of almost 100 percent.