Rwanda will join the rest of the world on September 26 to celebrate World Contraception Day (WCD). The annual worldwide campaign focuses on a vision where ‘every pregnancy is wanted’. Launched in 2007, WCD’s mission is to improve awareness of contraception and enable young people to make informed choices on their sexual and reproductive health. This year, Eagle Research Centre LTD (ERC), in partnership with University of Rwanda, has organised a contraception week in honour of WCD. The WCD celebrations in Rwanda will feature community outreach programmes, mass media education, and social media campaigns. According to organisers, all activities will be conducted in three districts, Huye, Nyarugenge and Rwamagana. A secondary student addresses her peers on reproductive health. /Courtesy ABOUT THE DAY World Contraception Day is devoted to raising awareness of contraception and improving education on sexual and reproductive health, with a vision to promote family planning. Contraception provides prevention of unplanned pregnancy, and so different key players in the field use WCD as a time to reflect on new strategies to implement, and tackle underlying issues. According to experts, there is need to educate the population on long term contraception; adding that Rwanda has made tremendous progress in family planning, however, a lot is yet to be done. WHY MORE EFFORT IS NEEDED Kenneth Ruzindana, a gynaecologist and obstetrician at University Teaching Hospital Kigali (CHUK), says most of the countries with the lowest rates of contraceptive use, highest maternal, infant, and child mortality rates, and highest fertility rates are in Africa, Rwanda being one of them. He says that only about 30 per cent of women use birth control, although over half of all African women would like to use birth control if it was available. He notes that the main problems that prevent access to and use of birth control are unavailability, poor health care services, spousal disapproval, religious concerns, and misinformation about the effects of birth control. He adds that the most available type of birth control is condoms. A rapidly growing population coupled with an increase in preventable diseases means countries in Sub-Saharan Africa face an increasingly younger population. In Rwanda, however, the National Institute of Statistics (NIS) reported that 10 years from now, the Rwandan population will be twice the current population. Only 36 per cent of women who are sexually active use contraception methods. Therefore, according to NIS, there is a special need for the youth to be educated as well. The Rwanda Demographic health reported that in five young people below the age of 18, one is sexually active. 19 per cent of women in Rwanda have unmet needs for family planning. While 21 per cent of women in the reproductive stage have incorrect knowledge regarding family planning. ONGOING ACTIVITIES The organisers say prior to the main day of celebration, there are already ongoing activities in Huye, Rwamagana and Nyarugenge, all of which are contraception related education. The activities aim at raising awareness and family planning, and contraception promotion. According to Ruzindana, some of the objectives of the outreach programme are to raise awareness on contraception to the general community, and clear myths and misconceptions of the general population on contraception. Also, he adds that they are sensitising the youth on family planning/contraception use by forming a youth club/ youth advocates on contraception, as well as providing free contraception methods for women, men and young people who would voluntary need the service. Dr Diomedes Ntasumbumuyange, the head of the obstetrics/gynaecology department at University of Rwanda’s College of Medicine, says a team of trained medical students and residents are educating the youth about the existing methods of contraception, and safe and planned sex. He says that the youth will also be sensitised on talking freely about sexual reproductive health. “The training tackles misconception on family planning. Youth are encouraged to form groups of advocates and champions of family planning,” he says. A contraception booth is also up for the whole week where trained midwives, medical students are informing the general population about contraception methods, side effects, myths and misconceptions. Ntasumbumuyange says that because the social media audience is growing day-by-day and many young people use Facebook and Twitter on a daily basis to deliver messages, they are targeting this to reach out to more youth. “We will run a social media campaign, using the hashtag #Twcd2018, we will have a speaker address the community on contraception and they will be able to ask questions,” he says. WHY EMBRACING CONTRACEPTION IS VITAL People need to have children, but not every pregnancy is wanted, and when you want to have it, there is the need to plan for it. Dr Theodomir Sebazungu, a gynaecologist at CHUK, says the aim of contraception is birth control, which involves preventing pregnancy. He says that every woman should be able to control birth; this means that they shouldn’t get pregnant unintentionally. “Instead, they should be able to plan the number of children they want, and how to space them, thus making contraception important,” he says. He explains that the purpose is to prevent pregnancy but also, there are other benefits that come from using contraception. For instance, he says, contraception reduces mobility and mortality. He also says that it has been shown in many studies that the bigger the family, the more difficult it is to take care of it, financially. But with proper planning, Sebazungu says the woman is able to build her career, and take care of her family without difficulty. Ruzindana says it’s even more important in Rwanda because many studies show that the country has a high population density. This means that the burden is high. “The fertility rate for Rwandan women is now at 4.5 per cent, meaning that every woman in their lifetime has about four to five children. This needs to be reduced to about 2.5 (number of children) so that the economy of the country can grow steadily,” he says. He says that the only way this can be achieved is by embracing contraception methods. AVAILABLE METHODS Dr John Muganda, a gynaecologist at Harmony Clinic, says one of the common family planning methods is the implant. This, he says, is placed by a doctor under the skin high up in your inner arm. The progestin thickens cervical mucus, making it tougher for sperm to reach an egg, that is if one is released. Progestin can also halt eggs from leaving the ovaries to begin with. He adds that there is also the hormonal IUD, which is a t-shaped device placed in the uterus that can last from three to six years. Copper IUD is another common method of family planning, Ruzindana says. He says like hormonal IUDs, the copper device is also placed in the uterus and left alone, for up to 10 years. The difference, he says, is that the copper version doesn’t contain any hormones. It’s the metal itself that prevents pregnancy by making the uterus inhospitable to sperm. He adds that there are many more methods around and that methods work best for different individuals, and that when a problem is detected, seeking professional help is vital. Experts share their views Couples should work together to ensure that they have all the information regarding family planning. Talking to teens on reproductive health is also vital. Dr Emmanuel Ssemwaga, Gynaecologist ****************************************** People should take advantage of such campaigns on contraception, just to get the right information concerning the methods. There are many myths on family planning methods which need to be set straight. Aline Gihoza, Nurse ***************************************** Encouraging women to go with their partners for family planning sensitisation is ideal. This will ensure joint counselling as well as decision-making and ensure support as a couple. Dr Jean Marie Nsabimana, General practitioner **************************************** There should be open discussions among couples, especially regarding family planning methods and sexually transmitted diseases. Also, providing accurate information as far as contraception is concerned is ideal. Dr Iba Mayale, Gynaecologist editorial@newtimes.co.rw
