When Blanca started as a volunteer, she committed to her new role with enthusiasm, thinking about how the women of La Loma village would benefit from being able to access contraceptive methods close to home. “Many women walk up to an hour and a half from the villages of the Guazapa hill, to receive family planning services or to receive counseling,” Blanca Edith Mendoza Ramos, 61, says proudly. Her house is a cozy and special place for the clients. “I have been a Pro-Familia volunteer for 29 years, when I started, I had already had my five children, I was busy at home, but when the Pro-Familia staff explained to me about working in my community, I trusted It was important to support women. I have learned a lot and I continue to do so, I have received training that helps me to be a better person, to have knowledge and to give good advice; I have received many people from Pro-Familia in these years, and always with great responsibility”, she says. To ensure her clients’ confidentiality, Blanca has created a private room with a sofa where she provides counseling and administers injectable contraceptive methods. By creating a private space, Blanca has built up trust in the community and women prefer to go to her for contraception and advice. “I am proud to help in my community, I visit clients to see if they have any side effects when they do not come to receive their method, or to know if they are well or to recruit new clients who are encouraged to use a family planning method because their families are already very large”, comments Blanqui, as she is known in her community. The public health facility provides free healthcare, however, women from other local communities prefer to see Blanca because she is closer and offers confidential personalized care. “The Health Unit is not close, so women prefer to plan with me, they come with confidence to apply their method. On their first visit, I ask them a few questions about their health, and if everything is okay, they plan with me. I think that family planning is important for the spacing of the children and that it is not only the use of methods but also communication with the couple”, reflects Blanca. The poverty and patriarchy in these communities present many challenges, including domestic violence, multiple partners, and miscarriage that require a sensitive approach to provision of healthcare and information. Volunteers like Blanca are supported to deal with these challenges through training provided by the Community-Based Program staff. Volunteers develop skills to use referral systems, coordinate with local institutions, such as the Ministry of Public Health, other NGOs, such as the Feminist Women's Collective, the Institute for Research, Training, and Development of Women (IMU), which provide support for cases of violence or care in cases of miscarriage. This approach is integral to the provision of healthcare and support in the communities. The team of volunteers helps to reduce violence and femicides in order to improve the quality of life for women and families. “People in the community tell me that they are grateful for the care I give them, and I will continue to change what I can to improve people's lives. I will continue to make home visits, give counseling because it is a need, women need someone that understands them and helps them. Pro-Familia is part of my life, being a volunteer is something special, I have learned a lot, and the most important thing is that I can help others”, says Blanca. Respect and comfort Blanca is often recommended by her clients. María Ofelia, or Felita, as she likes to be called, comments that “a friend from the community recommended that I visit the Blanqui, I already had two children, one 4-years-old and another 11-year-old. I still remember with deep sadness the moment I looked for her, it was my last pregnancy, and I lost my daughter. Blanqui received me with affection, respect, and comfort, she understood what I was going through, she guided me, and I made the decision to plan until now. I’ve been using the two-month injection for 4 years." María Ofelia says that although she can go to the social security check-up, she prefers to go to Blanca because of the confidence she gives her, “she always takes care of me, and the prices are low, I can pay it, because in other places the methods (contraceptives) are more expensive.”

Dr. Stewart McKoy has dedicated his life to ensuring the needs of both men and women are equally represented in the provision of healthcare at the Jamaica Family Planning Association (JFPA). When Dr. McKoy returned to Jamaica from overseas medical studies in the 1980s, the frustration at the failure of many Jamaican males to use contraception was a continuing concern. This led to him making a strong case for vasectomies to be offered as part of JFPA’s contraceptive options. Whilst the initial response from local males was disheartening, Dr. McKoy took the grassroots approach to get the buy-in of males to consider contraception use. Getting men on board “Someone once said it’s only by varied reiteration that unfamiliar truths can be introduced to reluctant minds. We used to go out into the countryside and give talks. In those times, I came down heavily on men. I remember after one talk, when I was finished, the driver of the JFPA van said they [men] didn’t like what I was saying. I saw a bar outside and went, carried them in, and said drinks on me. By the second round they opened up and were receptive,” he said. The reception would form the catalyst he needed to ensure that men, too, benefitted from sexual and reproductive healthcare. Men were choosing vasectomies if they already had children and didn’t plan to have any more. In addition, Dr. McKoy was an instrumental voice in the Men’s Clinic that was formerly operated by JFPA and also encouraged the inclusion of women at the meetings, in order to increase male participation and uptake of healthcare. “When we as men get sick with our prostate it is women who are going to look after us. But we have to put interest in our own self to offset it before it puts us in that situation where we can’t help yourself. It came down to that and the males eventually started coming. The health education got out and men started confiding more in health services,” he said.   It could be a matter of life or death McKoy said it is important that women use contraception and take their sexual and reproductive health seriously. If neglected, Dr McKoy said it could be a matter of life or death. He refers to a case of a young mother who was complacent towards having pap smears and ended up dying a preventable death as a result of cervical cancer. “Over the years I saw the opportunity to do pap smears out of the clinic. The mobile unit gave us access to so many patients. We had persons who neglected to do it. One patient in particular - she was not yet 30 years old. She had three children and after every delivery, she was told by the hospital to do a pap smear. She didn’t do it and eventually got cervical cancer. When she was to do the pap smear, she didn’t come. One morning they brought her and had to lift her up out of the car. At that time doctors said they couldn’t do anything for her,” Dr. McKoy said while fighting back tears. “It wasn’t necessary. We had to go out more to meet people, educate them teach them the importance of sexual and reproductive health.” That experience was his driving force to continue the work in sexual and reproductive healthcare. Dr. McKoy said the message about family planning, sexual and reproductive health must be continued through education in community outreach projects.