Women in Rubavu district have said that though they are willing to adopt family planning to limit number of children, they still misuse contraceptivesand end up delivering more children due to discontinuation.
A 40 years old Sarah Mukeshimana who resides in Rugerero sector in Rubavu district, started adopting family planning when she had five children in order to limit the number of children, to be able to raise her kids andto get engaged in other activities.
She says that she came to this decision aftershe had agreed with her husband that five children were enough for the family.
So, that is when the couple decided to use contraceptive methods. At first, she consulted nurses at Gisenyi Health Center which is based in Rubavu and she was advised to use the Depo Provera Injection also known as an injectable method.
However, it didn’t go well. Mukeshimana says that shortly after she started using contraceptive methods, for the second injection, she endured severe side effects that made her to decide to stop using the method.
“I injected the injection of three months for the second time but Istarted having side effects shortly after I had the injection, I could have longer bleeding during menstruation and I could have menstruation twice a month,” she narrates
“Sometimes people could tell me that I was dirty because of unexpected periods.I could also feel turbulence and changes in my body. Due to the extreme side effects, I stopped without informing both my doctor and my husband, I got pregnant and I delivered a baby which was the sixth,” she says
The vegetable vendor in Rubavu district who regularly crosses the border that separates Rwanda and D R Congo says that this became a burden to her and her family.
This is because she had an unexpected baby and was later forcedto sit for months without working.
“I later went back to see the doctor and they put me on pills, I hoped I could not deliver with pills but one time after I had the period, I stopped taking them hoping that it was safe and I could not get pregnant, but then it was a different story and I got pregnant,” she says
The second pregnancy put the number of Mukeshimana’s children to seven and she says it is too hard to for the couple to raise them.
Mukeshimana regrets that she often ignored the nurse’s advice and ended up delivering unexpected children.
“I think I could not have got pregnant if I had thought advice from medics,”
She is now using pills and had vowed not to ever jump any day.
According to the Rwandan Demographic Health Survey (RDHS) 2014-2015, 28 percent of women who started using family planning method discontinued using it within 12 months. The discontinuation rates are highest among pill users 42 percent and lowest among users of implants which is 3 percent, the survey states.
The most common reason for discontinuing a method, according to the survey is health concerns or side effects at 34 percent followed by the desire to become pregnant which is 28 percent.
Others are the desire for a more effective method and disappointment of becoming pregnant while using it which stands at 11 percent each.
The main reason for discontinuation of the pill, IUDs, injectable, and implants was side effects or health concerns. In some other cases, reasons like sexual violations, insufficiency of nurses, domestic violence are advanced among others.
According to DR. Francine Uwineza, the director of health at Rubavu district, contraceptive prevalence rate stands at 38 percent and the district has embarked on campaigns to ensure that more couples to use contraceptive methods.
“We will keep organizing campaigns to ensure that more people use contraceptive methods and that those who stop them before seeking medical advice no longer do that,” noted Uwineza.
What does the ministry of Health say?
The ministry of health says that main contraceptives methods are available in all the villages being offered by community health workers
According to Dr. Felix Sayinzoga, Maternal, Child and Community Health Division Manager at Rwanda Biomedical Centre (RBC), there was a campaign to mobilize people about the use of family planning and what methods they should apply that could not compromise their health.
“Before we offer family planning method, we first engage beneficiaries and they choose what is suitable for them based on the explanations. There are some symptoms that can prevent someone from using a certain method,” Explained Sayinzoga
Currently, women are given contraceptive methods from health facilities shortly after delivery and they leave the hospital after they have received the services.