My work in Mozambique was marked by World Cup fever. I arrived here a few weeks before the start of the games and soon joined fellow soccer-crazed fans in a crowded street-side café, careening my neck to cheer on the African teams shown on a low-quality projection on the side of a building. For a sports lover like me, it was heaven.
At each commercial break, however -- right through the final match -- Coca-Cola reminded me why I was in Mozambique.
"Whatever it takes to win a FIFA World Cup, we have!" the announcer boomed optimistically to his African target audience, while African players deftly maneuvered through defenders. "But our African teams have something even more powerful on their side ... 1 billion fans!" continued the announcer. And the crowd went wild.
In 1990, Africa was home to around half that many, with 630 million people. Today's actual African population stands at more than 1.1 billion. That's 1.1 billion who are mostly young people who need primary education, safe water and fuel.
They are farmers who need arable land to feed the continent. Young men who need jobs. On a continent that faces abysmal doctor-to-population ratios, all 1.1 billion will, at some point, need health care.
The United Nations estimates that, in 2050, there will be more than twice as many people as there are now. Africa will have to provide for a population of some 2.5 billion. But 2.5 billion people by 2050 is not a foregone conclusion. The continent can take steps to stem the population explosion, which will be required if Africa is to develop solutions in education, infrastructure and jobs. Family planning brings hope.
I am in Mozambique to support a project jointly implemented by Pathfinder International, the Mozambican Association of Obstetricians and Gynecologists, and UC Berkeley's Bixby Center. The project offers the method of contraception most desired by Mozambican women, Depo-Provera, at the community level.
Community health workers are trained to provide the injection, and women are visited in their homes to be given three consecutive doses every three months. The project's goal was to enroll 1,200 women. Within two months, in just two districts of rural Mozambique, we met that target with community health workers reporting that demand continued well past our original goal.
This came as no surprise. Of course women want to plan their families. Of course, if a woman has an option to get the shot of Depo-Provera at home rather than walk 25 kilometers with a baby on her back and wait in line for two hours at the health facility, she will be more likely to use contraception. This is a question of access and we have seen time and time again that when we make it easier for women to use family planning, they use it. Still, we face challenges.
After a recent meeting at a rural clinic with community health workers who are part of the project, I stepped past a long line of women to thank the doctor for his time and involvement. Although he was seeing a patient, he invited me to come in and say goodbye.
I apologized to his patient for the interruption and was struck by her. She had a puny baby at her breast, and she seemed terrified. Her name was Celia. She said she was 15, but looked no more than 12. I asked if her husband had accompanied her to the clinic today, and she replied that she had no husband. I nodded, thanked the doctor, and left.
This brief encounter left me with many questions. If Celia did not want to become pregnant, did she have access to the Depo provided by our community health workers? What misperceptions or ideas do women and providers have that get in the way of access to contraception? Do the providers offer services to young girls? Do they offer services to unmarried women? Do they have opinions about the minimum number of children women should have before they use contraception? Now that Celia has had a baby, will her community health worker offer her the shot, or is there a perception that she is too young?
These questions drive my time in Mozambique and, along with Coca-Cola's African World Cup marketing, remind me of my goals. Africa's 1.1 billion will certainly grow, but the population does not have to double in just 25 years, as the United Nations tells us it may.
We must create access to contraceptive products that women clearly demand. We must create the kinds of programs and policies that enable women and girls like Celia to plan their families, with all of the benefits of improved education, income, resource use and global health that family planning provides.
Cassandra Blazer is a doctoral student in the School of Public Health at UC Berkeley, a doctoral fellow with the Bixby Center, and a University of California Human Rights Fellow, sponsored by the Human Rights Center at the UC Berkeley School of Law.