Community-based Distribution of Injectable Contraceptives in Rwanda: An Intervention to Reverse Rural Disadvantage
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Family planning preferences and fertility patterns in Rwanda are similar to those observed in much of the sub-Saharan region. They are typical of countries at similar levels of socioeconomic development and female education. However, in Rwanda, these patterns and preferences are changing rapidly. In 2000, six years after the genocide of 1994, demand for and use of family planning was extremely low; only 4 percent of married women of reproductive age were using modern contraceptive methods. By 2005, modern contraceptive prevalence grew to 10 percent. Between 2005 and 2007, contraceptive prevalence nearly tripled, with the contraceptive prevalence rate for modern methods at 27 percent. The unmet need for family planning also increased during this period, suggesting that supply failed to meet the increased demand. In 2005, the met need for spacing and limiting was much lower for rural women than for their urban counterparts. Because much of the population resides in rural areas and because the effect of population density is most acutely felt in rural areas, a particular concern is the widening urban-rural disparity in fertility outcomes. To accommodate changes in preference and to address the disparities in outcomes, the government of Rwanda and the Department of Maternal and Child Health initiated a public sector program for the community-based distribution (CBD) of modern methods of family planning, in particular, injectable contraceptives.
This report presents findings on the international and local evidence for making contraceptives, injectable contraceptives in particular, widely available through a CBD approach. During 2009, the USAID | Health Policy Initiative, Task Order 1, completed a literature review, conducted stakeholder interviews, and developed guidelines and a costed implementation plan to support the Rwanda Ministry of Health's (MOH) 2008 and 2009 decisions to allow specially trained community health workers (CHWs) to provide injectable contraceptives.
|Document Type:||Technical Reports: Global|
|No. of Pages:||44|
|Keywords:||FP/RH, Unmet Need, Strategic Planning, CBD|