Limited inclusion of the youth and teenagers in family planning and reproductive health programmes has led to a decline in usage of contraceptives among young people, exposing many to sexually transmitted diseases and early pregnancies.

Sexually active teenagers and youth are increasingly shunning contraceptives like condoms and engaging in unprotected sex, which has resulted in a surge in early pregnancies.

Although contraceptives, including condoms are free in public hospitals for Mutuelle de santé holders, it has been noted that young people do not go for them.

A survey done between July and September last year by CLADHO — an umbrella of 12 human rights civil society organisations in the Western Province — revealed that an average of 25 girls are impregnated every day.

Statistics from the Ministry of Health showed that in 2017 alone, 17,444 teenagers had unwanted pregnancies across the country.

“We are not happy with the current low contraceptives uptake, a number of factors have led to this. There is inadequate sexual reproductive education especially from parents, the culture and myths around sex,” said Kagaba Aphrodis, executive director of Health Development Initiative (HDI).

Mr Aphrodis said HDI has observed that many people are not using condoms, and that this varies to different groups of people. This has been attributed to limited access and affordability.

“There is still a lot of stigma associated to buying condoms; we need to increase private spaces for young people to access condoms because many find it hard to line up alongside their uncles to get condoms,” he said.

The latest gender and adolescent global evidence report showed that seven per cent of girls aged 15-19 in Rwanda reported having had their first sexual intercourse by age 15, and that the median age at first sexual intercourse is 21.8 years.

The report says that in general, girls in Rwanda start engaging in sexual intercourse early with older men and that transactional sex is common.

The report also shows that 65 per cent of married girls and 88 per cent of unmarried sexually active girls do not use any contraception, with 93 per cent of adolescent girls who are not using contraception reported not discussing family planning at a health facility or with a health worker.

The norms around sexuality have deterred girls from seeking contraceptive services or asking their partners to use a condom because they fear embarrassment or being perceived as “bad girls.”
Adolescent fertility declined from 11 per cent in 1992 to four per cent in 2005, but increased in 2014-15 with seven per cent of girls aged 15-19 having children.

A survey conducted by Rwanda Biomedical Centre (RBC) indicated that there is a decline in condom usage mainly in the high risk groups with only 25 per cent of those who had casual sex reporting to have used a condom while only 33.1 per cent for those who tested HIV positive said they used condoms regularly.

Condom shortage

Mr Kagaba revealed that there is currently a shortage of condoms in the country.

“There is a shortage in condoms, we don’t have enough in the country, this has partly influenced the price condoms are sold at different points”

The demand for condoms in the country increased to 150 million in 2015, from 130 million in 2014. The country recorded 132,386,779 male condoms distributed between July 2013 and June 2014, while female condoms, which are rarely used, amounted to 45,020 condoms in that period.

The government spends up to $200 million in fight against HIV/AIDS, including distribution of condoms, ARVs and testing.