POST-PARTUM FAMILY PLANNING
For more than 20 years, the Government of Rwanda has been working to rebuild its health personnel and infrastructure shattered during the genocide.
With two-thirds of the population under the age of 25, in 2017 Rwanda revised its commitment from 2012 to measure successful demand creation for family planning and increase total demand for contraception for married women from 72% to 82% by 2020.
Traditionally, having children has been a source of pride and respect and, as a result, Rwanda is the most densely populated country in Africa.
Until today, there is still an unmet 37% of women and girls in need of modern contraceptive and family planning methods. To accelerate the pace of contraceptive uptake, Medical Doctors For Choice identified the need to focus on developing strategies for reaching new users, such as postpartum women, unmarried women, sexually active adolescents, and young adults as well as decreasing discontinuation particularly among the younger cohort of 15-19.
MDFC is working on increasing postpartum family planning (PPFP) by increasing knowledge through mentorship with medical doctors and other health care providers.
Why do we focus on this program? Postpartum women are an important target of the FP/ASRH program. They represent a population with frequent interactions or contacts with the health system – from pregnancy through to the 12 months following birth – and thus a target for integrated PPFP service delivery.
Indeed almost all Rwandan pregnant women (99%) received at least one ANC from skilled personnel and 91% deliver in a health facility. The RDHS calendar data shows that initially there is very low use of modern PPFP, followed by a sharp increase from about three months to seven months However, even at 7 months, use of modern PPFP is low relative to overall FP use in Rwanda. This is particularly unfortunate because if a woman becomes pregnant in the first year following a birth, the birth spacing will fall short of the recommendation of at least two years.
How are we doing it? Mentorship regarding various methods of available contraceptives, and modes of communication to women with Consultation simulations. We are increasing the effective use of couple counseling and engaging men and boys as supportive partners and use of Family planning methods.
What are our objectives? Providers will benefit from additional instruction on postpartum women’s FP needs and eligibility for contraception. Women will benefit from messages that effectively communicate about the risk of pregnancy, particularly in the postpartum period. Presentation of information about IUDs and sterilization to couples will be improved. Information supporting family planning needs will reach men, who play a key role in a woman’s decision to use contraception.