If you are under 18, the law limits your access to reproductive health services. It is time to change, activists say

The law relating to Human Reproductive Health in Rwanda grants every person the right to medical services and information related to human reproductive health. However, the law limits people under 18 years of age from deciding for themselves on issues regarding reproductive health and offers no clear guidelines on how adolescents can access services related to sexual health and reproduction. In Article 7 of the law, it stipulates that every person who has attained the majority age has the right to decide in relation to human reproductive health issues, the majority age in Rwanda being 18 years of age. By putting the age at 18, younger adolescents are left out and as it turns out, some are already sexually active. In addition, the Law Establishing Medical Professional Liability Insurance specifies that “the health professional who intends to provide healthcare services to a minor or an incapable person must endeavour to inform their parents or their representative or guardian and obtain their prior consent. So far, an under-18 adolescent is considered by the law as a minor and is limited to accessing sexual reproductive health services without parents’ or guardians’ consent. Marie Ange Uwase, Centre for Health and Rights Coordinator at Health Development Initiative explained that the contradiction in the law leads to the widespread impact that affects the life of an adolescent. “Adolescents end up having unprotected sex, most of the time with their agemates and many end up having Sexually Transmitted Infections (STIs), HIV/AIDS and unwanted pregnancies,” she said, adding that given their socio-cultural background, some parents might give their children consent. In the recent Demographic and Health Survey, it was revealed that 65 per cent of married girls and 88 per cent of unmarried sexually active girls aged 15-19 do not use any contraceptives. It was reported that 93 per cent of adolescent girls who are not using contraceptives have never discussed family planning at a health care facility or with a health care worker. Uwase finds the lack of access to services and education about reproductive health has contributed to unwanted pregnancies. “We have seen increasing numbers of teenage pregnancies every year since 2018 not forgetting other consequences such as an increased number of school drop-outs, adolescent engaged in sex work, practising unsafe abortion leading to complications including death, among others,” she said. Contradicting laws encourage negative cultural biases Clementine Nyirarukundo, is a gender activist and Director of Paper Crown Rwanda, a local non-profit organization that works with youth to transform gender norms and create social change. For her, limiting adolescents from accessing reproductive health services and requiring parent’s consent is encouraging negative cultural biases that brand such services as a taboo. “The contradiction is encouraging people to think that reproduction services and topics are taboo among adolescents and that is very limiting for them,” she explained. She added that such limits prohibit adolescents from accessing basic information and end up making uninformed decisions that result in unwanted pregnancies and STIs. The same point was reiterated by Marie Ange Uwase that requiring consent for adolescents to access sexual reproductive health services emboldens stigma.

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If you are under 18, the law limits your access to reproductive health services. It is time to change, activists say