Whereas most family planning experts agree that the Rwandan government has done a stellar job in reducing fertility rate, there’s still a long way to go for the country to cut the fertility rate from the current 4.2 children per women to 2.3 by 2050. Several experts argue that family planning is a choice and the practice should be safe and contraceptives available for whoever wants. And for that to be effective, it is important for the government to invest heavily in the health sector to avoid preventable diseases, which lead to high mortality rate, among many developing countries. According to UNICEF, two regions; sub-Sahara Africa and South Asia account for 88 per cent of maternal deaths worldwide. Sub-Saharan Africans suffer from the highest maternal mortality ratio – 546 maternal deaths per 100,000 live births, or 201,000 maternal deaths a year. This is two thirds (66 per cent) of all maternal deaths per year worldwide. South Asia follows, with a maternal mortality ratio of 182, or 66,000 maternal deaths a year, accounting for 22 per cent of the global total Rwanda’s Demographic Health Survey 2015 shows maternal mortality ratio dropped steadily from 476/100,000 live births in 2010 to 210/100,000 live births in 2015. As for some developed countries the numbers are way impressive to emulate if Rwanda is to realize demographic dividends. For instance, in 2015, maternal mortality ratio for China was 27 deaths per 100,000 live births. China’s mortality ratio fell gradually from 68 deaths per 100,000 live births in 1996 to 27 deaths per 100,000 live births in 2015. In 2015, maternal mortality ratio for Germany was 6 deaths per 100,000 live births. South Korea, maternal mortality rate recorded during the same year 2015 was 11 deaths per 100,000 live births, while maternal mortality ratio for Japan was 5 deaths per 100,000 live births. “In many developed countries in Asia, Europe they have made investments into demographic transitions as mortality declines, women do not have to worry that whatever number of children they want to have, some are likely to die from often preventable diseases,” Julia Bunting, the President of Population Council told The New Times on the sidelines of the just concluded International Conference on Family Planning. “Government needs to put in place all measures possible for mothers not to have five children in order to secure at least three who reach adulthood. The faster mortality declines then fertility follows 10 years later and consequently sustainable development,” Bunting added. According to Bunting, everyone has a right to determine how many children they want to have, “but what we see from the evidence is that when people choose to have fewer children and invest in those children, those children are healthier, they are better educated and are less likely to die and are likely to be more productive at a later stage when they are old. Oying Rimon, the Director of the Bill & Melinda Gates Institute for Population and Reproductive Health said that Rwanda has achieved a lot already in terms of family planning, adolescent health and that the country’s geopolitical commitments has been key in reducing maternal mortality and stabilized HIV prevalence rate and bringing child vaccination rate at the highest level in the region. He said that with that kind of political will, the country will be able to bring maternal mortality ratio even lower. “With such open political will; the barriers, the challenges that you are facing with regards to increasing your modern methods of contraceptives and providing family planning services among sexually active young people, I think you will be able to address it.” Rimon said. “I have heard some of the views from Health Minister Diane Gashumba, who told me that Rwanda is willing to learn from the best practices around the world. With that kind of attitude to learn and adopt, I think you will have a positive place in the future”. Nthanda Lizzie Manduwi, 23, an author from Malawi urges parents to be open and speak to their children about sexual and reproductive health, for this will reduce unwanted pregnancies that cost the economy. “Awareness, education and the role of parents are very important. If the young people are sexually active what do you do? One option is to provide them the access to contraceptives and the choice to use them.” He added. According to the 2017 Demographic Dividend study by the National Institute of Statistics, Rwanda’s population more than doubled from 4.8 million people in 1978 to 10.5 million in 2012 and is projected to have reached 16.3 million by 2032. Given that Rwanda is already densely populated and dependent on Agriculture, this growth will have adverse effects on the environment, food security, and general wellbeing of the population. This is why Rwanda needs to invest much in public awareness and educating masses to enhance voluntary decline in birth rates, through ensuring universal access to family planning, keeping girls in school and enhancing female education, and reinforcing efforts in reducing child mortality, Judith Anyona, a Public Health expert from JSI Research and Training Institute told The New Times. This in return, Anyona says, could reduce the child dependency ratio and open the window of opportunity for harnessing the demographic dividend – enable accelerated economic growth through concurrent investments in education, health, and job creation. editorial@newtime.co.rw
