Online Program

Local understandings of reproductive health and family planning in Rwanda's southern kayonza district

Tuesday, November 5, 2013 : 10:30 a.m. - 10:45 a.m.

Didi Bertrand Farmer, MA, Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
Fidele Ngabo, Ministry of Health of Rwanda, Kigali, Rwanda
Paulin Basinga, MD, PhD, National University of Rwanda School of Public Health, Kigali, Rwanda
Grace Ryan, BA, Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
Francois Kamali, Nurse, Rwinkwavu District Hospital, Rwanda
Elias Ngizwenayo, Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
Jacklyn St. Fleur, MD, Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
Leslie Berman, MPH, Partners In Health-Inshuti Mu Buzima, Kigali, Rwanda
Paul Farmer, MD, PhD, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA
Michael L. Rich, MPH, MD, Partners In Health, Harvard Medical School, Brigham and Women's Hospital, Boston, MA
Background: Rwanda remains one of the most densely populated countries in Africa, with a population growth rate of 2.7%. Rwanda's Vision 2020 outlines a framework for increasing family planning uptake to curb population growth, while improving population welfare. In order to increase uptake and retention in family planning programs, it is critical to understand cultural norms surrounding birth, fertility, and family composition.

Methods: We conducted semi-structured interviews with 162 male and female community members, community health workers, and health care providers. Interviews took place in Rwanda's southern Kayonza district, which is supported through a Partners In Health and Ministry of Health partnership. Participants were asked to reflect on family planning, sexuality, and reproductive health.

Results: During interviews, study participants shared information they received about family planning through national broadcasts and community meetings. Interviewees spoke of family planning as an opportunity to contribute to Rwanda's development, reflecting themes from public service announcements and health education campaigns. However, many individuals also shared experiences cycling in and out of the family planning program according to their changing fertility needs. Participants shared their efforts to reconcile desires for large families, influenced by recent memories of conflict and insecurity, with messages from the national family planning program that emphasize the benefits of reduced family size.

Conclusions: These narratives highlight the importance of understanding local, and constantly evolving, belief systems in order to develop public policies that encourage uptake and retention in family planning programs.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Social and behavioral sciences

Learning Objectives:
Describe local understandings of reproductive health in Rwanda's southern Kayonza district Describe components of Rwanda's national family planning program

Keyword(s): International Reproductive Health, International Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a medical anthropologist who has been working for the last 15 years as a community organizer, activist for the rights of women and girls, and researcher in Paris, Haiti and Rwanda. Since 2006 I have served as Director of the Community Health Program for Partners In Health Rwanda-Inshuti Mu Buzima, where I am the principal investigator on several cross-site studies focusing on community health, reproductive health, and traditional healing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.