Sensitisation on contraceptive use to curb Rwanda’s high abortion rate

Every year, about 60,000 pregnancies are prematurely terminated in Rwanda. As a result, more sensitisation on contraceptive use has been beefed up in order to curb the dangers resulting from abortions.A study jointly conducted by the Ministry of Health, the National University of Rwanda’s School of Public Health and the U.S.-based Guttmacher Institute, indicated that the national abortion rate is 25 abortions per 1,000 females aged between 15 and 44.The study also showed that traditional healers without professional expertise carry out most abortions. One of the reasons given by women who sought traditional healers for abortion was that abortion is illegal in the Rwandan law.Globally, over 30 percent of maternal and child deaths are a result of abortion. In an interview with The New Times, Dr. Thomas Nsengiyumva, a family planning expert in the Ministry of Health, said that more women use modern family planning methods than natural ones.“For modern methods, the contraception rate of family planning in 2010 was 45 percent. The percentage of women using natural methods, such as the calendar, Cycle beads (moon beads) and breastfeeding was six percent,” Dr. Nsengiyumva explains. Some of the modern methods of family planning include; birth control pills, barrier methods like condom use and the long-term methods such as the contraceptive injection, vaginal ring, implantable rod and intrauterine device.The birth control pill is a type of oral contraceptive that women must take daily however, this method is challenging because women sometimes forget to take the pill. Solange (name withheld) a mother of three, claims that when she conceived her third child, it came as a surprise because she was on the pill. She had been using the pills for a year but she was shocked to discover that she was pregnant. She later went to the health centre to find out what went wrong. She said that the information she attained has helped her to become more careful while taking the pill. One of the challenges that revolve around the use of contraceptives is that several women ignorantly use them without acquiring the necessary precautions from their physicians. According to Dr Alphose Butoyi, a Gynaecologist at Kibagabaga Hospital, the use of hormonal contraceptives without the directive of a doctor could lead to severe side effects. “I usually receive young mothers in need of contraceptives after they have just given birth. Because women are scared of opening up about their sexual health and the use of contraceptives— as a result of taboos and cultural beliefs—they end up using anything without consulting doctors,” Dr. Butoyi explained. He further said that contraceptives such as birth control pills, if misused without the doctor’s prescription, could lead to side effects such as cardiac arrest, liver problems and many other complications. “It’s important that couples visit a doctor and collectively decide on which contraceptive will be convenient for both of them,” Dr. Butoyi emphasised. Chantal Umuhoza, Coordinator of the Safe Abortion Action Fund at ARBEF (Association Rwandaise pour le Bien-Etre Familial’s) explained how knowledge of the available family planning services can change the family planning perception of Rwandans in both urban and rural areas. “We have four clinics that mainly offer family planning services such as contraceptives. The clinics are in Kigali, Huye, Rusizi and Musanze district. At these clinics women are counselled and advised on which contraceptives work best for them, after different tests are carried out by the doctors,” says Umuhoza. She further said that the communities, which reside around the clinics greatly benefit from the different family planning programmes. “For instance the services offered at the clinics are pocket friendly. Emergency contraception is also offered at these clinics and these are mostly used by young people,” Umuhoza said. Emergency contraception or emergency postcoital contraception, are birth control measures that may prevent pregnancy if taken after sexual intercourse. “The prices of contraceptives vary depending on location; contraceptives in rural areas are cheaper than those sold in urban areas. For example, birth control pills cost Rwf100 and Rwf300 in rural and urban areas respectively,” she stated.Additionally, emergency contraception pills cost Rwf1000 to Rwf5000 and spermicides (contraceptive that eradicates sperm and is inserted through the vagina prior to intercourse) cost Rwf2000Rwf. ARBEF, which was, established in 1986 offers sexual and reproductive health (SRH) services in different parts of the country especially in rural areas and their main target group, are the youth.

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Sensitisation on contraceptive use to curb Rwanda’s high abortion rate