This article analyzes the status and future prospects of family planning in Rwanda. The use of traditional contraceptive methods is examined and major constraints to modern contraceptive use are discussed, both for potential users (low demand) and family planning delivery systems (poor supply). Current contraceptive prevalence, as well as evidence of potentially higher demand, are analyzed. Contraceptive prevalence for modern methods is estimated at 3-4 percent, for 1988, of women of reproductive age who are at risk of exposure to conception. An attempt is also made to target future contraceptive prevalence rates needed to attain specific levels of fertility. Finally, the prospects for family planning as well as recommendations to increase contraceptive use are reviewed.
PIP: Because Rwanda is experiencing a dramatic population increase, the challenge for the future is how to balance the population with the progressive lack of available land and diminishing natural resources. This paper: 1) examines the major constraints on family planning (FP); 2) estimates the current contraceptive prevalence rate (CPR); 3) examines the method mix required to reduce fertility; and 4) assesses future prospects for FP activities. Rwanda's population is 7.1 million with a growth rate of 3.7%; the total fertility rate is 8.6 and the infant mortality rate is 120/1000. In 1981, the National Office of Population (ONAPO) was established to coordinate population activities, while the Ministry of Health is responsible for service delivery. ONAPO has set a target of 6.5 children per woman by the year 2001 which translates to increasing the CPR to 30%. The low levels of CPR are attributed to: 1) social, cultural and religious reticence; 2) illiteracy; 3) economic constraints; 4) fear of side effects; and 5) misconceptions. Constraints to service delivery include the absence of FP services in Catholic facilities, lack of FP in some public centers, separation of MCH from FP, lack of widely available FP and poor logistical distribution. Despite efforts to promote FP, as of 1988 only 3-4% of women at risk were using contraception. However, results of the 1988 National Fertility Survey showed that 80% of women interviewed know of 1 modern method of contraception and results of a 1985 study showed that 31% of pregnant women interviewed said that their pregnancy was unwanted. A more systematic approach to FP could increase CPR.