The legal framework
Contraception is free in government facilities, with village health teams distributing condoms and pills. National strategies prioritise reducing unmet need among adolescents, which remains high. Access barriers are practical rather than legal: distance, stock-outs, provider attitudes and, for young people, fear of being recognised.
Key points
| Cost | Free or subsidised in public facilities |
|---|---|
| Methods | Condoms, pills, injectables, implants, IUDs and sterilisation |
| Emergency contraception | Available in pharmacies and public facilities |
| Spousal consent | Not legally required, though often requested in practice |
| Adolescents | Entitled to services; national policies increasingly explicit about this |
| Community distribution | Community health workers supply condoms and pills locally |
| Free at public facilities | Under the national family planning programme |
| Village Health Teams | Distribute pills, condoms and injectables at community level |
| Self-injection | Approved and scaled up for the subcutaneous injectable |
In practice
- Ask about long-acting methods — implants and IUDs are the most effective and often the cheapest over time.
- Check contraindications: smoking over 35, migraine with aura and a history of clots rule out combined methods.
- Keep emergency contraception at home; the sooner it is taken, the better it works.
- Only condoms also protect against sexually transmitted infections.
- Ask a Village Health Team member for supplies if the facility is far.
- Request self-injection training at the first visit, then you only return annually.
Cost and coverage
Free or low cost in the public sector; NGO clinics charge modest fees.
Recent changes
Regional partnerships have driven a measurable increase in the use of modern methods, with long-acting implants accounting for much of the growth.
Where to go
- Public health centres and district hospitals.
- National family planning association affiliated to IPPF.
- Community health workers and mobile outreach services.
Worth knowing
If a provider insists on a husband's or parent's consent, that is a local practice rather than a legal rule in almost all of these countries. Asking for the facility in charge, or going to an NGO clinic, usually resolves it. There is no legal spousal consent requirement. Where a facility insists, ask to speak to the in-charge and refer to the national guidelines.
Official sources and links
- World Health Organization — international reference on this topic
- WHO Regional Office for Africa — country data and programmes