Uganda’s highway A-109 shoots across the plain from Kampala past the occasional storefront shops and open-air kiosks common to the continent’s roadsides. After rising into the verdant tea plantations of the country’s Western Region, it passes through Fort Portal near the Congolese border. From there, a turn off the main road leaves the reasonably well-maintained tarmac behind in favor of red clay washboard and bone-shaking potholes. Finally, it devolves into a footpath running between a few dozen housing compounds in a village called Kalera.
Though Kalera is poor by western standards, it doesn’t approach the desperation found in many poorer parts of Africa. Flinty, hard-working women tend small plots of bananas, potatoes, maize and soybeans. These plots border larger fields of tea, a cash crop. Goats and chickens roam. The village teems with children. Today, at least, there are no men in sight.
By limiting women’s family planning options in Uganda, “we are likely to get a higher number of abortion cases and more maternal deaths.” Jemiima Mutooro is a village health worker trained by Reproductive Health Uganda (RHU) using U.S. Agency for International Development (USAID) funds provided through the International Family Planning Foundation. She walks through Kalera carrying a black satchel. Inside the satchel is a day planner, pens, bandages, alcohol swabs and, most important, several small tamper-proof foil packages. Sayana Press, the novel, possibly revolutionary, family planning device within those packages is the subject of a pilot program sponsored by an international consortium that, along with RHU, includes the Uganda Ministry of Health and the Bill and Melinda Gates Foundation.
Developed by Pfizer and the Seattle-based non-profit PATH, Sayana Press is as simple in form as it is obvious in function: a…