This document provide an information on Types of FP methods used in Rwanda, Their prevalence, advantages and disadvantages of of their usage at health centers&DH, barriers or challenges of using FP at different health levels and Responses to those barriers

1. Presenter: NZAYIRATA Lucien
Medical student at University of Rwanda
SUPERVISORS: Prof. Calvin Wilson M.D. University of Colorado
Henry Nieder M.D. Martha’s Vineyard Hospital
Family planning
in rwanda

2. Content
1. Case presentation
2. Back ground
3. Types of FP methods
4. Prevalence of FP in Rwanda
5. Advantages and disadvantages of FP
methods at health centers,DH
6. The barriers or challenges of FP
7. Responses to those barriers

3. 1. Case presentation
A 3 Y.O male patient presented to the hospital for severe
malnutrition on background of failure to thrive Whose
physical examination reveals the generalized body
swelling.
The mother reported that he has 12 children and the previous
child is having 3 years and 11 months.
WHAT WILL YOU ADVISE THE MOTHER BEFORE
SHE LEAVES THE HOSPITAL?

4. 2. Background
Family planning :
• Planning of when to have children,
• Use of birth control,
• Other techniques to implement such
plans.

5. Background(ctd’)
Family planning is most usually applied
to a female-male couple who wish to
limit the number of children they have
and/or to control the timing of pregnancy
(also known as spacing children)

6. What do you think?

7. 3.FP methods
1. REVERSIBLE METHODS
A. Traditional method
• Withdrawal (coitus interruptus)
• Fertility awareness methods
-Calendar-based methods
KUBARA+URUNIGI(cyclebeads)
-symptom-based methods
cervical mucus and body temperature

8. Examples of some traditional methods.
• The beads • Cervical mucus

9. FP methods (Cont’d)
B. Modern method
B1.Long acting reversible
contraception(LARC)
• IUDS:<1%
• IMPLANTS:6%
• INJECTABLES:26%
B2. Short acting
contraceptives
• PILLS:7%
• CONDOMS:3%

10. Examples of some modern methods
IUDs IMPLANTS

11. FP methods (Cont’d)
2. IRREVERSIBLE METHODS
Tubal ligation Vasectomy

12. Success rate

13. 4. Prevalence of FP in Rwanda

14. Prevalence cont’d

15. According to RDHS 2010:
URBAN Vs RURAL AREAS
• The urban area uses FP at 47%
• The rural area uses FP at 45%
The use of contraception increases with
increasing education:
• 60% of women with at least some secondary
education use a contraceptive method
• in contrast to 43 %of women with no education.

16. CURRENT SITUATION IN RWANDA
CONCERNING NON REVERSIBLE CONTROL

17. Current situation in rwanda concerning
non reversible control Cont’d
 Vasectomy 2010 → 0.0 case
According to DHS 2010
 Between Feb/2010 – Dec/2012
→2,523 vasectomies delivered.
 Tubal ligation at 0.8% according to DHS 2010

18. 5.Advantages&desadvantages
How is FP relevant at
the community level?

19. Advantages&desadvantages Cnt’d
1.Community Health center
advantages:
• It is the nearest place
• Counselling gets easier because they are in
the same community
• It is costeffective
• Reduces malnutrition in the community
• Reducing adolescent pregnancies in the
community
• Easy follow up

20. Advantages&desadvantages Cont’d
• Disadvantages
• Low number of technicians(nurses,trained
health workers)
• Capacity building of the personel
• Limited ability to control complications and
side effects
• Innaccessibility of some methods and
contraceptive drugs.
• Family Conflicts due to inadequate methods

21. Advantages&desadvantages Cont’d
• 2. District hospital
Advantages
• High capacity built of the personnel
• Ability to handle the complications and side
effects
• Availability of most of the contraceptive
methods

22. Advantages&desadvantages Cont’d
Disadvantages
• Far from the community
• It is not costeffective
• Difficult followup

23. Acceptance of permanent birth control in
Rwanda
• Women are more interested than men
• Men are not ineterested- they consider
vasectomy as castretion

24. 6. Challenges or Barriers
• Mindset:
-men equate vasectomy with castration
- fear of the death of the children
• Rwandan culture-consider children as
power and blessing.
• Spiritual believes

25. Challenges cont’d
• Insufficient information
• Insufficient health professionals on family
planning
• inadequate counseling
• Ignorance
• Long distance
• Lack of decision-making power of a single
partner

26. 7.Response to those barriers
• Enhance education on FP
• Improve trainings to the health providers
• Promote campaigns and
decentralization of FP services
• Increase the availability of family
planning methods

27. Key message
FP is the key to the answer of problems such
as :
Poverty
Malnutrition
Child death during delivery
Everyone is an ambassador of the
community!!!!

28. REFERENCES
• www.moh.gov.rw
• Family planning strategic plan 2012-2016
• RHDS2010 report