Although Rwanda saw an 11 percent improvement in family planning method uptake between 2015 and 2020, a number of challenges continue to hamper its plans to ensure that services are available to all who need them. need and timely.
Commenting on World Contraception Day, Joel Serucaca, reproductive health manager at Rwanda Biomedical Center (RBC), said the increase in uptake of family planning programs increased from 53 percent in 2014/2015 to 64% in 2019/2020.
However, he explained that this number includes those who also use natural methods like exclusive breastfeeding and safe day counting.
He recalled that the country’s goal is to increase the number of people using modern and reliable contraceptive methods from 48% to 60% between 2018 and 2024.
RBC says that in 2019/2020, at least 14% had unmet family planning needs.
So what challenges continue to hamper the use of these services?
1- mentality issues
Serucaca said that some people’s views on using modern family methods triggered by cultural beliefs and poverty continue to be a challenge.
Serucaca told the New Times that there are still a number of people who believe they can have as many children as possible because they will be taken care of by the government.
“Ignorance coupled with poverty means that the thinking process of some of these people requires a lot of resources in terms of time and information to change their mindset. We are continuing to work on this, but it will certainly take time, ”he said.
2- Lack of sufficient facilities offering these services
Serucaca also explained that there is always a human resource challenge when health facility staff are overwhelmed and in doing so prioritizes what he sees as more pressing issues than family planning. Ultimately, this also affects the quality of service provided.
He also pointed out that health posts that were stationed near faith-based hospitals are understaffed, meaning services could be available at least once a week, discouraging those who have to make long trips to pick them up.
“The majority of hospitals in the country are denominational. This means that they do not offer modern methods of family planning which they believe are contrary to their beliefs. However, even the health posts that we set up near these hospitals to provide these services are also understaffed, ”he said.
3- Difficulties in accessing medication
UNFPA Reproductive Health Program Analyst Marie Claire Iryanyawera says that for family planning services to work well, there must be a supply of the required drugs and equipment on time and in sufficient quantity.
However, she recalled that there was a challenge prior to the importation of such products, which was compounded by the outbreak of the Covid-19 pandemic.
“We already have and continue to face challenges where we run out of stock of certain drugs and equipment such as the contraceptive implant commonly known as Implanon NXT which is over 99% effective in preventing pregnancy and can last up to at 3 years old, ”she said. noted.
However, she recalled that new stocks will arrive in October, but called on stakeholders to start thinking about alternatives, including finding local solutions to produce these products locally.
4- Insufficient data
Iryanyawera also raised the issue of insufficient data which she believes can be a barrier to timely planning and budgeting.
She called on service providers in health facilities and those who report on drug distribution to these facilities to focus on using the systems in place so that accurate figures that will inform decisions are available. .
“Data is very crucial. It gives us an idea of what needs exist and how they can be met. If it is drugs or equipment, we want to be sure that there is enough of it in stock so that we do not face a demand challenge that we cannot meet, ”he said. .
5- Challenges within the law
The national coordinator of the organization IMRO-Ihorere Munyarwanda Aimable Mwananawe said there were still challenges in laws on access to contraceptive services where young adults under 18 must be accompanied by a parent. / tutor to access the services.
IMRO-Ihorere is a local non-governmental organization working on human rights, HIV / AIDS prevention program, health promotion and poverty reduction.
He said this provision means more sexually active young people continue to shy away from using these services.
In 2018, while responding to questions raised by the Senate on teenage pregnancies and prohibitive laws, Prime Minister Eduoard Ngirente said the government is aware of the limits that current law places on teenage girls, some of whom could be blamed. for the increase in the number of teenage pregnancies in the country.
At the time, he said the government was revising a law that will make it easier for adolescents to access family planning methods.
“Yes, young adults under 18 are required to accompany their parents to access contraceptives, but they are the most vulnerable when it comes to unwanted pregnancies. I would like to tell you that we are changing this because we found it inconvenient, ”he said.
He also informed the senators that in addition to the recognized flaws, a number of young people had petitioned several institutions pushing for change.
Ngirente also acknowledged that it does not make sense to ask teachers to educate young adults about reproductive health and safe sex methods when these methods are inaccessible.
Speaking on behalf of the Rwanda Interfaith Council for Health (RIC), Sheikh Suleiman Mbarushimana said there was still a need to tackle misconceptions among followers of all faiths.
“We have three categories of believers. Those who believe in family planning, those who have the potential to believe in it, and those who still believe that using these methods is tantamount to terminating a pregnancy. ” he said.
To solve this problem, he asked for informational manuals that link what religious books say to the value and meaning of planned parenthood.