Rwanda risks a reversal of gains in its family planning efforts after the Catholic church stopped the distribution of contraceptives at its affiliated health facilities around the country.
According to Dr Anicet Nzabonimpa, a family planning integration expert at the Rwanda Biomedical Centre (RBC), this decision will put pressure on government health facilities to absorb those who were served by faith-based facilities.
In a letter addressed to health facilities in his territory, Bishop Philippe Rukamba of Catholic Diocese of Butare urged them to fully implement a directive that he said was issued by the church five years back.
“In 2010 the Episcopal Conference of Rwanda was clear that contraception methods should note be offered but some of our affiliated health facilities did not fully implement the directive,” Fr Rukamba, who is also the spokesperson of the Catholic Church in Rwanda said.
Many of the Catholic church affiliated health centres are in rural areas, which might considerably hurt the government’s family planning campaigns.
This decision comes at a time, when the country has been registering tremendous progress in reducing rapid population growth through a combination of measures such as improved female education levels, higher women’s participation in the labour force and an overall increase in household living standards. This is in addition to expanding usage of contraceptives countrywide.
According to the latest Demographic Health Survey (DHS) 2014-2015, more than half of currently married women (53 per cent) are using contraceptives.
Between 2005 and 2010, fertility rates in Rwanda dropped by 25 per cent, according to the 2014 World Bank report “Seizing the Opportunities for Growth, with a Special Focus on Harnessing the Demographic Dividend.”
Experts warn that losing a heavyweight partner like the Catholic church might translate into unexpected population growth increasing the already prevalent pressure on the government’s resources with the same replicating on individual families.
Rwanda is ranked the second most densely populated country in Africa after Mauritius, with a population of around 440 per square kilometre, according to the US-based Maps of World.
Population projections indicate that the country will have approximately 16.3 million people, about 50 per cent more than the current population, by 2032.
With this trend, the rapid population growth is likely to overtake the country’s economic development.
The Vatican is a proponent of the natural methods of birth control.
“The natural birth control methods have a very high rate of failure because of divergent menstrual cycles that require high vigilance not expected from the targeted mostly less or uneducated population,” argues Dr Abdul Namugongo, a gynaecologist with King Faisal Hospital.
Fr Rukamba justified the directive of the Catholic Church with reports that artificial contraceptive methods come with life threatening side effects.
“Side effects from contraceptives are not different from other side effects associated with any medicine” assured Dr Nzabonimpa.
“And they are observed in a small number of users,” he added.
To counter the shock caused by the Catholic church decision, RBC has asked government to support districts to avail staff based in secondary health post to provide the family planning services not delivered at faith-based health centres.