"It is better to have just one child than many, so you can give your child the support he needs and the best education you can offer", shares Farzana during her visit at the family planning center in Herat city. However, her case was different. She is now 37 years-old and a mother of five. She got married when she was only 16 and one year later she had her first child. She doesn't read or write and she wants a different future for her children.
Her eldest child, a girl, is studying 11th grade in high school. "I hope that my daughter will make the right choices and become a mother later, when she is at least 22 years old. By then she will have finished her university studies", says Farzana. "I hope that all my children will be able to get an education." Farzana represents the average woman in Afghanistan: married young and mother of five. The country has one of the world's highest fertility rates. In 2003, only a tenth of Afghans used modern methods of family planning. Today, in a little over a decade, usage has almost doubled. This figure is at odds with the awareness about contraceptives in Afghan society, where 90 percent of couples know at least one method of contraception.
"This is because of lack of comprehensive information, inadequate counseling skills among health service providers, limited access to contraception, fear of side effects among users and misinterpretation of religious doctrine regarding family planning. Also some cultural factors play a crucial role such as son preference and tendency of having large family", explains Dr Abdul Malik Faize, Reproductive Health Officer at UNFPA Afghanistan.
At the clinic, Farzana explains that most of the women she knows use either injection methods or contraceptive pills. "I know only few couples that use other methods. Even me, I use the injection."
Injectables are the most popular method of contraception in Afghanistan. According to the Afghanistan Multiple Indicator Cluster Survey 2012, ten percent of married women choose this contraceptive. Other commonly used methods are the pill (6 percent) and male condoms (1 percent).
According to the midwives at the clinic, most women in Minarha district opt for pills as a first choice followed by injections and condoms. "We also recommend implants", explains Nargis, a midwife in Ingil district. That's a small contraceptive tube that is placed under the skin and prevents conceiving for three years. "People are afraid of using those and husbands don't allow them out of the false fear that their wife will not be able to have children again."
Sahra is another mother who is visiting the clinic for family planning services. She is 22 and has two children. She was married when she was only 14 and mother of a baby by 15. Her husband owns a rickshaw which is the only family income.
Like Farzana, Sahra also hopes that her daughter will not get married until she is 20. "We only get enough to survive. If I send my son to school we will need more money for his school uniform, books, notebooks and everything else. We can't afford that", said Sahra. "I want to wait at least 5 more years again to have my next child."
UNFPA supports the Ministry of Public Health ensuring reliable supply of contraceptives to government health facilities which are not otherwise supported by donors, training service providers, and an enabling environment in which there is a strong demand for family planning services.