Building family and community support for women’s health

By Anna-Claire Zanetti, Pacific Women.

Nancy John is a community leader in Papua New Guinea championing women’s sexual and reproductive rights and challenging negative attitudes and behaviours towards women and girls in her community.

She is using the knowledge, skills and confidence gained through the Mamayo Project, a maternal and reproductive health initiative led by CARE International in partnership with the Government of Australia through its Pacific Women and Gender Equality Fund initiatives, and the Government of Papua New Guinea.

A married mother of three children, Nancy lives in Lufa District, Eastern Highlands Province.

As a local leader and Seventh Day Adventist women’s ministry coordinator for the local-level government catchment area, Nancy was nominated by her community to attend the Mamayo Community Workshop Series.

Nancy John. Photo credit: CARE International PNG.

The workshop series helps communities to challenge negative gender norms and behaviours and to encourage equal health treatment for women and men. The training covers health-related modules such as leadership and direct action, and sexual, reproductive and maternal health.

The community leaders explored how some local customs and gender norms can be harmful to women’s health. In Lufa District communities, there have been strong taboos against openly discussing sexual, reproductive and maternal rights and accessing related social and health services.

Nancy and the other leaders participating in the workshops identified norms and practices that were harmful and could be changed within their communities and developed action plans.

Back in the community, Nancy has been putting her plan into action, to increase awareness of family planning services and addressing surrounding taboos. She now speaks with the community about family planning, the issues faced by “second-hand meris” (women who become pregnant outside of marriage), unsafe abortions and accessing the local health facility. Through one-on-one and community discussions, Nancy has identified eleven couples and many young, unmarried women in her community who want access to modern contraceptives.

This builds on previous work conducted by Mamayo to support the Lufa District Health Centre to include family planning as part of their health services outreach patrols. During the patrol, Nancy brought all the young women, their parents and the couples to the health facility to access family planning services. Couples were then asked to decide together if they wish to use family planning. The joint decision making ensures there are no repercussions from the family from women accessing contraceptives. This approach also reflects CARE’s rights-based, “Do No Harm” approach to contraceptive use.


Since the Mamayo project began in 2018, the Lufa District has reported increased support for, and uptake of, modern contraceptives by families and communities, according to Papua New Guinea’s National Health Information Systems. Data indicates Lufa District has a 700 per cent rise in people using family planning services for the first time (from 0.8 per cent of all users in 2018 to 5.6 per cent being first-time users in 2019). The data also show a 40.8 per cent increase in the level of coverage of family planning services (from 296 in 2016 to 417 in 2019).

Through an innovative, rights-based approach, Mamayo uses proven community leadership methodologies that reduce the social and cultural barriers to women’s access to health services. Family business management tools improve shared decision making and distribution of workloads within the family. The project also strengthens relationships between communities and health service providers to improve health services and facilities.


For more information about the Mamayo project and other Pacific Women projects supporting women’s leadership and access to health services in Papua New Guinea, see the Pacific Women Papua New Guinea Annual Performance Report 2019–2020: https://pacificwomen.org/key-pacific-women-resources/pacific-women-papua-new-guinea-performance-report-2019-2020/