Rwanda on right track, removing barriers to family planning access

Today is the 22nd annual World Population Day, and this year’s theme is ‘Universal Access to Reproductive Health Services’. The theme is also in line with the Millennium Development Goal 5 (MDG5), which is to ‘Achieve Universal Access to Reproductive Health by 2015.’Extensive sensitisation on family planning by several health organisations and actors in Rwanda has gradually broken barriers hindering the usage of modern contraceptives. Women between the ages of 15 to 49 years are the most affected when they have no access to reproductive health services.Among the country’s family planning barriers are; religious influence, cultural mindsets and limited information regarding the access and use of contraceptives. Rwanda is among the countries celebrating the World Population Day, which aims at promoting access to reproductive health services. The day also aims at recognising the people who make the progress possible—those who help to increase access to sexual and reproductive health and reproductive rights.Rwanda was ranked the top East African country with the highest rate of contraceptive use among women. The country stands at 52 per cent according to the State of East African Report, 2012 published by Society For International Development and TradeMark East Africa.In an Interview with The New Times, Arthur Asiimwe, the Head of Division, Rwanda Biomedical Centre/Health Communication Centre, explained how educational campaigns on contraceptive use is breaking the barriers. “Family planning methods and programmes have been decentralised down to the grass root level. This has helped in breaking several barriers. Community Health workers have helped women understand the importance of family planning,” Asiimwe said. He further said that Community Health Workers have played a major role in helping women to make informed decisions on which type of contraceptives to use. “As people continue to look at the value of family planning, they continue to take up the several methods available. Vasectomy is also being practiced by men especially those with many children. Collectively/ family planning services at health centres are also offered at no cost,” Asiimwe explained. Reproductive health problems remain the leading cause of ill health and death for women of childbearing age worldwide. According to the State of the World Population Report (SWOP 2011), major problems related to women’s reproductive life include; unplanned pregnancies, maternal deaths, unsafe abortions, disabilities, Sexually Transmitted Infections (including HIV) and Gender-based violence, among others.Victoria Akyeampong, Resident Representative UNFPA, said there is more need for creating awareness, change of behaviour and information for women to make informed decision on which contraceptives they should use. “UNFPA works with the Ministry of Heath at various levels as far as unmet needs are concerned, there are a number of development partners who support the Government of Rwanda to have enough family planning methods available for the population,” said Akyeampong.She emphasised that several development partners and the Government are working hard to close the gaps that exist in Family planning, especially at community level. “This is done through the community based provision, where Community Health Workers are involved in ensuring that family planning methods are available. There is still need for women to make choices and informed decision regarding family planning,” Akyeampong explained.Universal access to voluntary family planning services involves the access of pre-and antenatal care; skilled attendance at all births as well as timely emergency obstetric care when complications arise to prevent maternal deaths and greatly reduce injuries related to childbearing. It also involves providing affordable, effective medicines and health supplies to women and young people who need medication the most.According to DHS 2010, 52 per cent of women in Rwanda use contraceptives; 45 and six per cent use modern and traditional methods, respectively. According to Dr Anicet Nzabonimpa, MCH/FP/HIV Integration Coordinator, culture is still a major barrier to accessing reproductive health services in Rwanda.“Some people still think that it’s not normal to discuss Reproductive Health issues publicly; there are even some who don’t allow closed discussions in their households,” Dr Nzabonimpa said adding that, “it is also common for adolescents, particularly the youth, to think that Reproductive Health services are for only married people.” He explained that among the challenges met while implementing reproductive health programmes are, “limited health professionals at health facilities and some negative behaviour such as cross generational sex: sugar-mummy and sugar-daddy relationships.” Nevertheless, as reflected in the latest 2010 DHS, Rwanda made commendable progress towards achieving key health indicators of the MDG5. Maternal health has considerably improved with the percentage of mothers giving birth assisted by skilled providers increasing from 39 per cent in 2005 to 69 per cent in 2010. As a result, maternal mortality rate decreased from 750/100,000 live births in 2006 to 487/100,000 live births in 2010/2011.

Insight

Rwanda on right track, removing barriers to family planning access