Cameroon

Hairdressers Spark Rise in Female Condom Sales in Cameroon

Female condom sales have increased in Bamenda, Cameroon, as a local organization recruits and trains hairdressers to sell the product in their salons.

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Hairdressers Spark Rise in Female Condom Sales in Cameroon

Kemende Claris, an apprentice of female condom sales agent Doris Atoh, demonstrates how to insert the condom at Atoh’s salon in Bamenda, Cameroon.

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BAMENDA, CAMEROON – Calendars, posters, an artificial vagina and cartons of female condoms line the walls and tables of the Doris Root Beauty Saloon, one of the most prestigious hair salons in Bamenda, the capital of Cameroon’s Northwest region. The more than 10 hairdressing apprentices in the salon are all wearing aprons that say “Protectiv,” a brand of female condoms.

 

Doris Atoh, a hairdresser and owner of the salon, demonstrates how to use the female condom properly. She removes one from its pack, inspects the wrapping to ensure the product has not expired, and then tears the wrapper open at the dotted line.

 

Using the tips of her fingers, she gently rubs the condom to spread the lubricant evenly. She then holds the bottom ring and squeezes it once into an eight shape while inserting it into the vagina model using two fingers. She pushes the condom down into the artificial vagina with an index finger and then squeezes the bottom ring to open up and take its position inside the vagina.

 

Three salon clients watch the demonstration in silence.

 

Atoh is a certified sale agent of female condoms with Association Camerounaise pour le Marketing Social, a local nonprofit organization. Many women are more comfortable buying female condoms at Atoh’s salon, where they encounter only women, than from drugstores, which are frequented by both sexes, she says.

 

“Women buy the female condom every day,” she says. “The truth is, it is mostly bought by women who have dared to use it.”

 

For customers who are unacquainted with the product, Atoh performs her demonstration. She also promotes the female condoms in markets, at women’s group meetings, on buses and in schools.

 

Atoh sells at least one carton of female condoms every month, she says. One carton contains 40 packets of condoms, and each packet contains three condoms.

 

Sales of female condoms have increased over the past three years in Cameroon. In Bamenda, the rise is partly due to a new marketing strategy as well as government initiatives. Aware that women shy away from buying female condoms from typical vendors, a nonprofit organization recruits and trains hairdressers to sell the product in their salons.

 

About 20 percent of people in Cameroon use contraceptive methods, according to a 2013 U.N. report using 2011 figures. The most popular contraceptive method is male condoms, which are used by 7.6 percent of the population. Other modern methods, such as emergency contraception and female condoms, are the least popular methods; altogether they are used by less than one-tenth of 1 percent of the population.

 

ACMS sold nearly 666,000 female condoms in 2011, compared with 21.3 million male condoms, says Florent Amassoga, the organization’s representative for the Northwest and West regions.

 

But its female condom sales have been improving. The organization sold 59 percent of its stock in 2011, 70 percent in 2012 and 100 percent in 2013, she says.

 

The price cut contributed to the increase in sales, Amassoga says.

 

The price of female condoms in Cameroon went down last year, from 100 francs (20 cents) for one condom to 100 francs for three condoms. Universal Access to Female Condoms Joint Programme – a program run jointly by Oxfam Novib, Rutgers WPF, i+solutions and the Netherlands’ Ministry of Foreign Affairs subsidized their cost because it was hindering access to female condoms, Atoh says. They are now the same price as male condoms.

 

The program funds ACMS to promote female condoms in Cameroon. ACMS started training female condoms sales agents in 2009 after realizing that the products were not selling at vendors that sell male condoms, such as drugstores and supermarkets, says Rita Ngabir, the UAFC Joint Programme animator with ACMS for the Northwest and West regions.

 

Atoh and nine other salon owners were the first to be trained in Bamenda, Ngabir says. In 2009, Atoh was honored as the top sales agent in the town. Thirty Bamenda salon proprietors are now certified sales agents of female condoms. 

 

ACMS drew inspiration for its sales strategy from a similar project in Zimbabwe that had achieved success, Ngabir says. ACMS has implemented the project in five of Cameroon’s 10 regions: Centre, Adamawa, Littoral, Northwest and Southwest.

 

UAFC Joint Programme funds similar projects in Nigeria and Mozambique, Ngabir says. The program’s efforts have increased the popularity of female condoms in these countries too.

 

ACMS pays the salon sales agents a monthly fee for their services, Ngabir says. It also provides each agent with two free cartons of condoms. Because ACMS is a nonprofit organization whose mission is to effect behavioral change, the agents keep the profits from their sales. Agents who sell out their monthly allotments may purchase additional condoms from ACMS. 

 

Besides salon owners, ACMS uses four community-based organizations in Bamenda to sell the condoms. Each community-based organization has 10 peer educators who sell the condoms.

 

But the community-based organizations do not sell as many condoms as the hairdressers do, Ngabir says. That is because women feel more comfortable discussing sexuality in salons than in forums. Also, women visit salons frequently, making salon purchases convenient.

 

Celine Mbolle, a social worker, has been buying female condoms from one of the trained salon agents in Bamenda since 2010.The salon agent convinced Mbolle that the condom would increase pleasure during sex and taught her how to use it, she says.

 

When Mbolle used the female condom for the first time, the result was amazing, she says. The outer ring of the female condom, which lies on the outside of the vagina or on top of the clitoris, increases pleasure during sex.  

 

“Female condom is the best,” she says. “It is far better than the male condom.”

 

Mbolle and her partner prefer female condoms to male condoms, she says. Mbolle’s partner dislikes the male condom, as it grips his penis and makes him uncomfortable.

 

“If it was not for the female condom, I would have had several unplanned pregnancies,” Mbolle says. “This is because my fiancé has never accepted the male condom, and I don’t like using the other artificial family planning methods.”

Some of Atoh’s customers buy the condoms to take to other countries in Africa where the product is still expensive, she says.

 

Damian Adu, a businessman in Bamenda, says his wife introduced the female condom to him eight months ago. When he first saw it, he was hesitant because its shape and size seemed impractical. His wife persuaded him to try it.

 

"I told my wife to extend a big ‘thank you’ to the person who introduced the female condom to her," he says. "It was so sweet."

 

Adu’s wife learned about the female condom from a sales agent who demonstrated its use at a women’s group meeting, he says. The female condom is comfortable, and it does not grab his penis the way a male condom does.

 

"I have settled for the female condom," Adu says. "I don't think I'll ever use the male condom."

 

In a survey of 15 men in Bamenda who had used the female condom, they all said they liked using it and had no complaints.

 

But some women find the female condoms impractical and say they would not buy them, no matter who sells them.

 

Albertine Manka’a, a married mother of four, says the female condom is a production mistake.

 

“What kind of thing did they produce in the name of a female condom!” she exclaims. “Is that thing a condom or a market bag?”

 

Manka’a is ashamed to look at a female condom, let alone use it, she says. She finds its design disgusting.

 

“I have been wondering whether there are really women out there who use the female condom,” Manka’a says.

 

If the female condom were the only contraceptive available, then she would have had countless children, she says.

 

“How do they put that thing in?” she asks, laughing. “Does it really fit?”

 

The female condom must be redesigned if it is to be practical, Manka’a says.

 

Lilian Ayanji, a trained nurse who operates a small drugstore in Bamenda, says she will never use female condoms.

 

She is put off by the fact that it must be worn for an hour before sexual intercourse so it can settle in the vagina, she says.

 

“Myself, I find it really hard to accept the female condom because, to me, it is just boring and impractical,” Ayanji says.

 

Ayanji cannot figure out how to wear the condom.

 

“I tried inserting it once, but I couldn’t do it properly, I guess,” she says. “As a result, I felt pains during intercourse.”

 

Ayanji is sure that the bottom ring that is supposed to lie comfortably on top of the uterus did not find its right place, and the misalignment caused her pain, she says. But she has not heard of any negative side effects of the female condom from a medical standpoint.

 

Women who complain about the female condom have not tried it, Ngabir says.

 

“It is very convenient and easy to use,” she says. “It is safe, as it offers double protection to women; it guards against unplanned pregnancies and sexually transmissible infections.”

 

If girls and women use female condoms, the number of unwanted pregnancies in Cameroon would decline, Ngabir says.

 

“It is not the shape and size of the female condom that matters,” she says. “It is what it offers that is important. The female condom is here to enable women to have control over their sexual lives. It is for this reason that we keep educating women on the importance of it.”

 

Supplying female condoms to the public is one of the government’s main strategies in the fight against HIV and AIDS and unwanted pregnancies, says Dr. Gladys Tayong, the regional chief in charge of prevention of mother-to-child transmission of HIV and reproductive health in the Northwest regional delegation of the Ministry of Public Health.

 

The government has been distributing free female condoms for the past 10 years, financed by the Global Fund. In the past, the supplies expired in the local office of the Ministry of Public Health because women were not aware they were available, Tayong says.

 

But she has seen an increase in the use of female condoms over the past two years, she says. She attributes the increase to the government’s efforts to educate women about the condoms through workshops and seminars and the marketing efforts of ACMS.

 

On four office visits, the government statistician was not available to provide data on the distribution and use of female condoms in the region.

 

The ministry encourages women to use the female condom because it protects them from unwanted pregnancies and sexually transmitted diseases and it rarely bursts, as male condoms sometimes do, Tayong says. Furthermore, women can decide for themselves to use it, while a decision to use a male condom is up to men. She did not list any drawbacks.

 

"The Ministry of Health is encouraging women to take control of their sexuality," she says.

 

Female condoms have become especially popular among sex workers, one of the government’s target populations in HIV prevention, Tayong says. Sex workers now come to her office to request female condoms.

 

The rise in sales of female condoms is a positive turn, Ngabir says.

 

In addition to continuing to change perceptions of female condoms, ACMS plans to start training salon agents in other parts of the Northwest region.