The National Union of Disability Organizations in Rwanda (NUDOR) has praised a new bill proposing the provision of reproductive health services, including contraception, to teenagers aged 15 and above.

Louise Manirakiza, a healthcare professional and communication officer at NUDOR, emphasised that the bill is particularly timely given the heightened vulnerability of girls with disabilities to defilement and rape.

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The bill, presented to parliament on November 5, seeks to regulate healthcare services and includes provisions for teens aged 15 and older to access reproductive health services.

This move is in response to the growing issue of teenage pregnancies in Rwanda, which was highlighted by Minister of Health Dr. Sabin Nsanzimana, who introduced the bill to lawmakers.

The explanatory note for the bill argues that adolescents are being discriminated against by current laws, which deny them the right to make decisions about their reproductive health.

Under the current law, the age of majority in Rwanda is 18, limiting access to reproductive services for those under that age.

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"Sexual and reproductive healthcare services should be affordable and accessible for girls with disabilities. We need quality services. Girls under 18 should be allowed access to contraception as it is their right," said Manirakiza.

"We know that a recent law allowed 18-year-old girls to marry, and contraception should also be accessible to girls under 18, especially with the rise in teenage pregnancies."

She added that the services should be inclusive to ensure quality care for individuals with disabilities. Manirakiza pointed out the challenges faced by adolescents with disabilities when seeking healthcare, particularly in accessing services at health centres where staff may lack the necessary skills to assist those with hearing or speech impairments. Additionally, long distances to health centres remain a barrier for many people with disabilities.

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"Girls with disabilities are more vulnerable to defilement and rape than others," she said. Youth centres and services should cater to the needs of adolescents with disabilities."

The Government of Rwanda has made significant strides in improving sexual and reproductive health (SRH) services for adolescents and youth. This includes the establishment of youth-friendly health services at health centres.

However, challenges persist, including early sexual activity, teenage pregnancies, unsafe abortions, and low contraceptive use.

Adolescents, particularly those with disabilities, often face social stigma and cultural barriers that limit their access to sexual and reproductive health education and services.

Manirakiza stressed the need for community health workers to be better equipped to address the specific needs of adolescents, as many currently only provide basic services like condoms.

"Community health workers should offer comprehensive sexual and reproductive health services, not just condoms," she said. "Safe spaces are critical for enhancing access to these services."

Safe spaces—programmes designed to support vulnerable adolescent girls and young women—can help create an environment of trust and confidence, promoting better sexual and reproductive health outcomes.

"Safe spaces build confidence among adolescents to address sexual and reproductive health concerns," Manirakiza explained.

Globally, access to adolescent sexual and reproductive health (ASRH) services for young people with disabilities remains limited.

Adolescents, particularly girls and those living with disabilities, are especially vulnerable to sexual abuse, unintended pregnancies, and gender-based violence (GBV).

Manirakiza called for increased investment in both government and non-government institutions to address these issues.

She also highlighted the success of the Make Way program in Rwanda, which focuses on creating safe spaces for vulnerable youth, including those with disabilities, teenage mothers, young people in isolated areas, sex workers, and people living with HIV.

She recommended that this model be expanded and replicated across the country.