Family Planning Providers and Contraceptive Users in Rwanda Don’t Consider Discontinuation an Option

Hilary Schwandt, Western Washington University
Julia Corey, Wheaton College
Madeline Zeiler, Western Washington University
Angel Boulware, Spelman College
Ana Herrera, Northwest Vista Community College
Ethan Hudler, Whatcom Community College
Claudette Imbabazi, INES-Ruhengeri – Institute of Applied Sciences
Ilia King, Xavier University
Jessica Linus, University of Maryland, Baltimore County
Innocent Manzi, INES-Ruhengeri – Institute of Applied Sciences
Maddie Merritt, Western Washington University
Lyn Mezier, State University of New York at Oswego (SUNY)
Abigail Miller, Western Washington University
Haley Morris, Western Oregon University
Dieudonne Musemakweli, INES-Ruhengeri – Institute of Applied Sciences
Uwase Musekura, Eastern Oregon University
Divine Mutuyimana, INES-Ruhengeri – Institute of Applied Sciences
Chimene Ntakarutimana, University of Kentucky
Nrali Patel, Arcadia University
Adriana Scanteianu, Rutgers University
Biganette-Evidente Shemeza, INES-Ruhengeri – Institute of Applied Sciences
Madi Stapleton, Western Washington University
Gi'Anna Sterling-Donaldson, Drexel University
Chantal Umutoni, INES-Ruhengeri – Institute of Applied Sciences
Liz Uwera, INES-Ruhengeri – Institute of Applied Sciences
Seth L. Feinberg , Western Washington University

Family planning (FP) programs cannot succeed without considering discontinuation. In some contexts, over half of users cease use within one year. Side effects (SE) are common causes of cessation. In this 2018 study, eight focus groups with providers and 32 interviews with FP users were conducted in Rwanda’s Musanze and Nyamasheke districts. Data was analyzed via thematic content analysis. IRB approval was obtained and informed consent forms were signed by participants. Respondents either persisted through SE or switched methods when SE were too severe. Even those identified as discontinuers were actually still using methods to avoid pregnancy. Discontinuation was only seen as viable when pregnancy was desired, or when proper method use proved impossible. Providers instruct those who complain of SE to persevere or consider another method. Rwanda’s impressive success and low discontinuation rates may be rooted in providers and users refusing to acknowledge discontinuation as an option.

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 Presented in Session 148. Contraception in Context