Family planning in rwanda


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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

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Family planning in rwanda

  1. 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. 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. 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. 4. 2. Background Family planning : • Planning of when to have children, • Use of birth control, • Other techniques to implement such plans.
  5. 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. 6. What do you think?
  7. 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. 8. Examples of some traditional methods. • The beads • Cervical mucus
  9. 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. 10. Examples of some modern methods IUDs IMPLANTS
  11. 11. FP methods (Cont’d) 2. IRREVERSIBLE METHODS Tubal ligation Vasectomy
  12. 12. Success rate
  13. 13. 4. Prevalence of FP in Rwanda
  14. 14. Prevalence cont’d
  15. 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.
  17. 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. 18. 5.Advantages&desadvantages How is FP relevant at the community level?
  19. 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. 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. 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. 22. Advantages&desadvantages Cont’d Disadvantages • Far from the community • It is not costeffective • Difficult followup
  23. 23. Acceptance of permanent birth control in Rwanda • Women are more interested than men • Men are not ineterested- they consider vasectomy as castretion
  24. 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. 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. 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. 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. 28. REFERENCES • • Family planning strategic plan 2012-2016 • RHDS2010 report