Medical Doctors For Choice held a workshop that brought together medical professionals from hospitals across Rwanda to deepen their understanding of the evolving legal and policy environment governing safe abortion and to explore innovative approaches for strengthening digital referral systems within comprehensive abortion care.
The workshop created an interactive learning space where participants exchanged experiences, reflected on current practices, and developed practical ideas for improving service delivery at both hospital and health-center levels. Through presentations, discussions, and group reflections, the workshop highlighted how legal reforms and technology can jointly transform the landscape of reproductive health care in Rwanda.
Objectives
The workshop sought to achieve the following objectives:
- To enhance participants’ understanding of Rwanda’s Abortion Law and the 2024 Ministerial Order amendments.
- To examine the current trends and statistics on maternal deaths and safe abortion service provision in Rwanda.
- To identify existing gaps in the implementation of the Ministerial Order and propose feasible solutions.
- To introduce and strengthen the use of digital referral systems for linking patients to comprehensive abortion care.
- To encourage peer learning and collaboration among healthcare providers to promote safe and stigma-free abortion services.
Key Takeaways
1. Insights on the Rwanda Abortion Law and Service Trends
Dr. Claude presented updated data showing that 1,728 maternal deaths occurred in Rwanda over the past five years, with 10% linked to abortion-related complications. The number of induced abortions increased from 60,000 (pre-2024) to about 80,000 in 2025, yet only 5,748 were safely performed in health facilities.
The gradual increase in safe abortion cases from 80 in 2019 to 2,152 in 2023 was attributed to policy reforms and rising public awareness. Kigali City accounted for 45% of all safe abortion services, followed by the Eastern (20%), Western (15%), Southern (11%), and Northern (9%) provinces.
2. Legal and Policy Shifts
The 2024 amendment to Article 5 of the Ministerial Order expanded service provision from hospitals and polyclinics to include authorized health centers and clinics that meet required standards. Currently, 518 health centers are eligible to offer safe abortion services.
However, challenges remain, such as:
- Shortage of doctors at health-center level
- Limited training on abortion procedures
- Insufficient medical equipment and supplies
3. Reforms in Health Services Law
The session also covered key reforms in Rwanda’s Health Services Law, notably:
- Lowering the age of consent for adolescents to access reproductive health services without parental approval
- Integration of digital health systems (telemedicine, electronic records, AI, and mHealth tools)
- Professionalization and standardization of healthcare services
Digital health was highlighted as a transformative tool for improving access, quality, and efficiency of healthcare delivery.
4. Practical Recommendations from Participants
Participants suggested the following measures to operationalize Article 5 and improve service delivery:
- Use telemedicine and digital platforms to bridge doctor shortages in rural areas.
- Train and mentor health-center staff to deliver safe abortion services.
- Introduce a referral system model linking non-providing (especially faith-based) facilities to those offering the service.
- Equip and authorize medicalized health centers to expand safe service coverage.
- Assign mentors in each facility to guide providers in implementing abortion care standards.
5. Enhancing the Digital Referral System
In the second session, Mr. Richard led discussions on the SAAF digital referral model, focusing on its usage, data trends, and implementation challenges.
Participants highlighted the following key points:
- While the system is accessible, notifications via SMS and email would improve responsiveness.
- Each user should have personalized passwords for secure access.
- Persistent stigma and misconceptions about abortion deter patients from using digital systems.
- Limited internet access, poor network coverage, and lack of smartphones remain major barriers.
Participants proposed introducing alternative communication methods such as SMS-based systems, printed referral directories, and closer coordination between hospitals and faith-based facilities to strengthen referral pathways.
Recommendations
Based on the discussions, the following recommendations were provided:
- Expand Capacity Building: Conduct regular training and mentorship programs for health-center staff on safe abortion procedures and use of digital health tools.
- Strengthen Infrastructure: Ensure that health centers are equipped with the necessary tools, supplies, and connectivity to deliver quality abortion care.
- Enhance the Referral System: Integrate SMS and email alerts, provide offline access options, and ensure user-friendly interfaces for healthcare workers.
- Leverage Telemedicine: Use teleconsultations to support health centers with limited medical personnel.
- Address Stigma and Misconceptions: Develop targeted awareness campaigns to normalize abortion as a health service and encourage patients to seek care without fear or judgment.
- Policy Implementation Support: Advocate for the full operationalization of the amended Ministerial Order by empowering licensed health centers and monitoring their compliance.
Conclusion
The workshop reaffirmed MDFC’s commitment to advancing safe, accessible, and technology-enabled abortion care across Rwanda. Participants left with a deeper understanding of the evolving legal landscape, the potential of digital health innovations, and the importance of inter-facility collaboration.
By combining policy awareness, digital solutions, and capacity strengthening, Rwanda can significantly reduce unsafe abortions and ensure that all individuals regardless of location or circumstance can access timely, dignified, and safe reproductive healthcare.