It was only then that her husband realised it was not easy providing for such a big number of children.

Napio and her husband received information on family planning from a staff of Marie Stopes Uganda (MSU) in Kotido town. After counselling, they decided that she undergoes a tubal ligation. She was helped to set up an appointment and later returned to Kotido Health Centre IV where the procedure was carried out.

Napio is now a member of Lomukwa Mothers Club; a group of 10 women who have received long term and permanent family planning methods. These woman are now referred to as "satisfied users". The club is attached to Kotido Health Centre IV in Kotido town. Members move from door to door teaching fellow women in their villages about the benefits of family planning and making referral to those interested to find the services. The women share their testimonies on how using family planning has changed their lives and encourage other women to do the same. Napio says: "Family planning has helped me to rest from giving birth. I wish I had been able to use the services earlier. I now encourage other women to use family planning so that they can have the number of children they can provide for."

Community mobilization strategies such as Mothers Clubs have proved to be an effective tool in demystifying myths associated with family planning that are widely spread in areas like Karamoja. 
15 clubs have been formed in the four project districts of Kotido, Kaabong, Moroto and Katakwi.

"From the time the Clubs became active in April 2013, 176 women have been sensitised and have been able to receive family planning services through the efforts of the Mothers Clubs," says Isaac Ayo, the Karamoja outreach team leader of MSU.

A Mothers Club meeting at Atunga Health Centre II in Kotido district.