“The big enemy for this country is poverty, and we cannot fight it without controlling our population growth…let’s multiply our efforts to be champions of family planning,”

says Deo Kabagamba, Executive Secretary of the Northern Province, who participated in an IntraHealth International-led family planning training.

From March through July, 2009, IntraHealth collaborated with Rwandan partners to train district mayors and other Rwandan local authorities to become family planning champions. The training was part of a Hewlett Foundation-funded initiative to support the solidification of Rwanda’s political commitment to population and family planning. The use of modern contraceptives in Rwanda increased dramatically from 4% in 2000 to 10% in 2005. By early 2008, when this Hewlett-supported initiative was launched, modern contraceptive use had reached 27.4%, reflecting an additional dramatic gain in less than three years[1], due in large part to Rwanda’s political leadership in this area.

District mayors and other local authorities play a particularly crucial role in advancing public health initiatives in Rwanda. As part of a decentralization effort, district mayors now oversee health districts and sign annual performance-based contracts with Rwanda’s president. The contracts hold the mayors accountable for meeting objectives related to health and other social services and include health indicators (one of which is the use of modern family planning methods). District mayors can advocate for public health initiatives among their constituents, increase their local health budgets and demand additional resources from national health programs.

Although district mayors and other local authorities were committed to supporting family planning as an integral component of public health, gaps existed in their knowledge and capacities to clearly articulate the impact of family planning policy on both health and development goals. These gaps hindered them from being true champions of family planning and population issues.

Under the Ministry of Local Government’s leadership, IntraHealth aimed to address and fill in those gaps by collaborating with several other Rwandan ministries—Health; Economic Planning and Finance; and Gender and Family Promotion. IntraHealth also collaborated with the Rwandan Network of Parliamentarians for Population and Development and other local partners. Together, they worked to train district mayors and other opinion leaders to become champions of population and development with an emphasis on family planning and reproductive health services.

Deo Kabagama was one of many who participated in the trainings held in each of Rwanda’s four provinces and in Kigali City. The sessions attracted district mayors and other local leaders such as vice mayors, district hospital directors, health unit directors at the district level, representatives of youth and women councils, security officers (army and police), district consultative committees and provincial leaders as well as journalists. In total, 177 district mayors and local leaders participated.

The trainings covered topics such as: family planning as a necessity for maternal, child and family health; available family planning methods; population factors; family planning as a tool for social welfare and gender equity; the draft of the reproductive health law and where it stands today; and what local government can do to support family planning, reproductive health and population issues. Participants received an information packet that included educational materials on family planning and population that can be used in making public speeches. The packet also contained guidance on how to engage constituents on these issues, and assistance on the budgeting of local resources to support family planning activities.

Following the training, participants presented recommendations on how to advance the progress of family planning and reproductive health services. Some focused on legal aspects, such as creating a legal framework that is conducive to informed choices about family planning. Other recommendations concentrated on service delivery, including integrating family planning services in all health facilities and communities, and advocating for the Ministry of Health and Ministry of Finance to provide additional resources for high-quality family planning services. Many recommendations focused on family planning campaigns.

What’s certain is that the training strategy has opened the door to more frequent and better-informed public dialogue about family planning led by district and provincial leaders focusing on free and informed choices and the wide range of family planning options available to individuals. In addition, district authorities feel empowered to advocate for positive policy change at the national level; the expected result is district authorities’ commitment of additional resources to family planning and population interventions.

“Family planning champions will come from Kigali City because we are committed to increase the number of family planning users; we hope that in the future, IntraHealth will help us to share our experiences with other countries,” summed up Jeanne Gakuba, Vice Mayor in charge of Social Affairs in Kigali City, who offered opening remarks at the training.

[1] National Institute of Statistics, Ministry of Finance and Economic Planning, Ministry of Health, and Macro International. Interim Demographic and Health Survey 2007-08 Preliminary Report. July 2008. Calverton, MD.