Political Commitment for Family Planning in Rwanda

Presented by Dr. Fidele NgaboMCH Coordinator, Ministry of Health, Rwanda

23 March 2010

“High population growth is a major challenge facing Rwanda. Slowing down population growth requires innovative measures, including the strengthening of reproductive health services and family planning and ensuring free access to information, education and contraceptive services.”

RWANDA ECONOMIC DEVELOPMENT & POVERTY REDUCTION STRATEGY, 2008 - 2012

RAPID Model in Rwanda

• RAPID projections of the social and economic consequences of high fertility and rapid population growth for such sectors as labor, education, health, urbanization and agriculture shared with President, Cabinet, Parliamentarians

• Made clear goals of poverty reduction could not be reached with high rates of population growth

• Highlighted advantages (access to education, health services) possible with reduced family size

RAPID Model: Key Results for Rwanda

2005 (actual) 2035 ProjectionCurrent Fertility

2035 Projection:Reduced Fertility

Population 8.8 million 21.5 million 16.4 million

Primary School Teachers needed(1 to 44 students)

29,000 76,100 46,400

Doctors(1 to 10,000 persons)

500 2,148 1,068

Food Crop Requirements

7.4 million metric tons

19.1 million metric tons

13.9 million metric tons

Per Capita GDP(8% growth rate)

266 USD 857 USD 1,182 USD

Government of Rwanda Commitment and Actions

• Government believes population levels must be addressed to tackle poverty

• FP integrated into GoR development strategies: Economic Development and Poverty Reduction Strategy, 2008-2012; Vision 2020; contracts with districts

• National Family Planning Policy• National Population Policy• FP integrated into national PBF indicators• The Rwandan Parliamentarians’ Network for Population and

Development (RPRPD) established 2002• National TWG for FP• Government funds portion of contraceptive procurement• Mutuelles de sante increased access to information and services

Multi-Sector and Partner Involvement

• Office of the President• Parliament and Senate• Office of the Prime Minister • Ministry of Health• Ministry of Finance• Ministry of Local Administration• Ministry of Education• Ministry of Gender and Family• Ministry of Youth• Ministry of Agriculture

Non-governmental Partners:• Civil Society Partners

– Profem– Rwanda Women’s

Network– Urunana– Network of Rwandans

living with HIV• NGOs• Development Partners• UN Agencies

District Level Commitment

• Trainers at district level supporting in-service training in FP

• FP integrated into District performance contracts, Imihigos: accountability to the President for these efforts

• District Mayors and Governors are trained and act as FP Champions

• District Hospitals and Health Centers

Community Level Commitment

• Decentralization – focus on decisions coming from the community and community-level accountability

• Performance contracts (imihigo) from district to sector to cell to umudugudu to household levels

• FP sensitization and education provided to the community through Umuganda (monthly community service days)

• FP Champions in the community• Health Committees at the Sector level unite community

members and health facilities• Community Health Workers

Political Commitment…The First Step

Commitment is the essential starting point, but it needs to be supported by:– Advocacy– Supportive policy – Resources– Evidence-based programming– Continuing supervision– Training– Strong monitoring and evaluation