Rwanda has for the past 15 years been involved in easing access to contraception services to women and has laid forward strategies and policies in that regard. Contraceptive use increased from 17 per cent to 53 per cent in just ten years; between 2005 and 2015. As a result, fertility rate has reduced from 8.2 children per woman in 1970 to 3.9 children in 2020, according to the National Institute of Statistics of Rwanda. Despite the improvement in access to contraception, there is a prevalent debate on whether young girls and adolescents should be given access to contraception without parental consent, in contrast to the medical liability insurance law that requires prior approval for minors to access health services. Annet Mwizerwa, Adolescent Sexual Reproductive Health and Rights (ASRHR) Program Officer at Health Development Initiative (HDI), urged that requiring adolescents to seek parental consent before they are able to access SRHR services reinforces the gap that is already there in the SRHR information sharing between them and their children. HDI is an NGO that seeks to improve and advocate for public health and human rights in Rwanda. “Although we acknowledge and commend efforts in place to ease access to contraception services and information, such as integrating sexual reproductive health programming in the competence-based curriculum, there is still a long way to go,” she said. “Requiring parents’ approval for adolescents to access contraceptives is contradicting the rights of women and girls to have access to SRHR services. The requirement can also be seen as one of the reasons for the increasing number of unwanted pregnancies among adolescents,” she added. Since 2016, Rwanda has recorded over 78,000 babies born from teen mothers; while just between January and July 2020. Experts say that numbers were probably exacerbated by the Covid-19 pandemic and lockdown that was in place at the beginning of the year. She suggested that youth be sensitized and educated about available options for them. They should also be involved and consulted when it comes to setting policies that affect them. Misinformation as a barrier to contraceptive use Marlene Mporanyi, 22, a medical student Kicukiro District, says that although she considers herself well informed when it comes to using contraception, she knows that some of her peers still struggle with rumors and misinformation that surround the topic. “I can definitely use contraception if I was sexually active. I know options available for me and consider myself informed, partly because I am a medical student, but also because it is a right,” she says. She continued, “Many young people have the wrong information or dont have the full information, which tends to reduce their willingness to use contraceptives. There is still a wrong understanding in the youth where they think that contraceptives are only for married people.” She agrees with Sylvie Giraneza, 25, a resident of Gasabo Distrit, who too says she would consider using emergency or short-term contraceptive methods because she understands that other methods are for couples who are in a long-term commitment or relationship. “I am informed about all the options available, but I wouldn’t choose a long term method until I am in a committed relationship” she said. Dr. Athanase Rukundo, a sexual and reproductive health expert explains that even if people have preferences, all contraception methods are safe for both married and unmarried people; “People need to first consult their healthcare provider in order to be assessed and guided on their methods of choice,” said Rukundo, who is also an advocate for health equity. H urged women and girls to demystify the myths and misconceptions around contraception by getting accurate information from their healthcare providers or other reliable sources. “Power dynamic in a relationship plays a big role in attaining SRHR. Everyone has a role to play. Men need to adhere to contraception methods that are available for them in prevention of unwanted pregnancies.”
