Motorcycles began arriving early at Guéyo Health Centre in western Côte d’Ivoire, long before the day’s consultations began. Beneath the veranda, mothers sat quietly waiting for antenatal and postnatal care. Some cradled sleeping babies on their laps, while others lay across the wooden benches, resting as they waited their turn. Inside one consultation room, midwife Kouadio Adjoua Epiphanie prepared for another day of consultations.
But today, one couple stands out.
When Epiphanie first met them, the woman had already given birth to ten children. Yet, her husband wanted more.
“He kept saying they needed another son,” Epiphanie recalls. ” Whenever I talked about family planning, he would tell me I was too young to teach him these things.”
Many health workers might have seen the conversation end there, but Epiphanie saw it as the beginning. Rather than try to persuade the couple in a single visit, she continued the discussion each time they returned for postnatal consultations. She listened carefully to their concerns, answered questions about contraception, and politely challenged the myths that had shaped their decisions for years. Weeks turned into months.
Then one day, the husband returned with his wife and surprised her.
“I’ve understood now,” he said. “I’m tired of the expenses.”
Together, they discussed the available contraceptive options and chose the method that best suited the family’s needs. Today, his wife uses Jadelle, a long-acting contraceptive implant, and the couple continues to visit the health center together.
For Epiphanie, this story is a reminder that a midwife’s role is not to persuade families but to help them make informed decisions together.
“Family planning is a bit like sharing the Gospel,” she says with a smile. “You have to take your time.”
This philosophy has guided her throughout her career.
Each morning, Kouadio Adjoua Epiphanie arrives at Guéyo Health Centre ready for another day of listening, counselling and supporting women and families. Video credit: Ronald Ngeno
Epiphanie’s Career Path
Long before she became a midwife, Epiphanie spent her days selling galettes (a type of cake) while living with her uncle in Cocody, Abidjan. Their home was next to a hospital, where she watched midwives caring for women arriving to give birth. She was fascinated by how women respected midwives and the reassurance midwives brought to families during some of life’s most vulnerable moments.
Later, while speaking with women in her community, she realized how much misinformation surrounded contraception. Many women relied on rumours rather than accurate information and often travelled long distances to access family planning services or advice.
“I enjoyed talking with women,” she says. “I wanted to become someone who could help them.”
That desire eventually led her to study midwifery. When she graduated, however, reality looked different from what she had imagined. Her first posting was Guéyo, a rural community far from the city life she had hoped for.
“Honestly, I didn’t want to come to the village,” she admits. “I thought I would complete my placement and then return to the city.”
Instead, something happened to change her mind. The health center leadership at Guéyo welcomed her warmly, encouraged her to settle into the community and even helped her establish a home where she could eventually bring her family. Neighbours embraced her, including many families originally from Burkina Faso and before long she realised she belonged.
“What encouraged me most was how the community accepted me,” she says. “That made me want to stay.”
Epiphanie believes effective counselling for family planning begins with listening rather than speaking. She avoids pressuring women into choosing a contraceptive method and instead encourages couples to discuss their options together whenever possible.
Midwife Kouadio Adjoua Epiphanie explains the range of contraceptive methods available at Guéyo Health Centre, helping women and couples understand their options before choosing the method that best meets their needs. Photo credit: Ronald Ng’eno
“If you force someone to use a method, it won’t work,” she explains. “Even if a woman receives contraception without her husband’s knowledge, she may feel she has betrayed him. Later, if she experiences side effects, she blames herself. I prefer to move forward patiently.”
Creating Space for Real Conversations
Epiphanie’s patient approach is made possible by reliable access to contraceptives. VillageReach works with Côte d’Ivoire’s Ministry of Health to help ensure that when women and couples decide on a method (whether an implant like Jadelle or another option), it is actually available at facilities like Guéyo. When supplies are consistent, health workers like Epiphanie can focus on what matters most: giving families the time and information they need to choose together.
Reliable supplies matter because these conversations can only lead to informed choices when the chosen method is available. Across VillageReach-supported health facilities, efforts to improve commodity availability, strengthen data use and reinforce supply chain management are helping ensure that women are less likely to encounter stockouts when they seek family planning services.
For Epiphanie, however, success is measured less by numbers than by the moments that happen inside her consultation room. She remembers the husband who once refused to have any conversation about family planning. Today, he accompanies his wife to appointments and supports the choices they make together.
She remembers women who arrived frightened by rumours about the effects of contraception they had heard in their communities and left with confidence because someone had taken the time to answer their questions.
Midwife Kouadio Adjoua Epiphanie shares a smile with a client following a family planning consultation at Guéyo Health Centre. She believes trust is built one conversation at a time, helping women and couples make informed choices about their reproductive health. Photo credit: Ronald Ng’eno
And she remembers why patience matters.
For Epiphanie, each conversation is an opportunity to help women and families understand their options and make informed decisions. Some choose a family planning method immediately, while others need time to ask questions, discuss the decision with their partners and return when they feel ready. Whatever the outcome, she believes the most important decision is one made with understanding and confidence.
As motorcycles continue arriving outside Guéyo Health Centre and more mothers take their seats beneath the veranda, Epiphanie prepares for the next conversation.
She knows it may not change someone’s mind today. But perhaps, after another visit or a few more conversations, it just might.