Family planning demand generation in Rwanda: Government efforts at the national and community level impact interpersonal communication and family norms

• Published in: PloS one 2022-04, Vol.17 (4), p.e0266520-e0266520
• Main Authors: Corey, Julia, Schwandt, Hilary, Boulware, Angel, Herrera, Ana, Hudler, Ethan, Imbabazi, Claudette, King, Ilia, Linus, Jessica, Manzi, Innocent, Merrit, Madelyn, Mezier, Lyn, Miller, Abigail, Morris, Haley, Musemakweli, Dieudonne, Musekura, Uwase, Mutuyimana, Divine, Ntakarutimana, Chimene, Patel, Nirali, Scanteianu, Adriana, Shemeza, Biganette-Evidente, Sterling-Donaldson, Gi'anna, Umutoni, Chantal, Uwera, Lyse, Zeiler, Madeleine, Feinberg, Seth
• Format: Article
• Language: English
• Subjects: Abortion; Biology and Life Sciences; Birth control; Births; Channels; Communication; Community colleges; Contraception Behavior; Contraceptive Agents; Contraceptives; Engineering and Technology; Evaluation; Family planning; Family Planning Services; Female; Fertility; Government; Humans; Information sources; Innovations; Interpersonal communication; Marriage; Married couples; Mass media; Mass media effects; Maternal mortality; Medicine and Health Sciences; Meetings; Methods; Norms; People and Places; Personal communication; Public health administration; Rwanda; Social Sciences; Sociology; Taboos; Wives; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0266520

Between 2005 and 2020, total contraceptive use among married women in Rwanda increased from 17% to 64%. The aim of this study is to better understand how the Rwandan government's mobilization and demand generation efforts have impacted community norms and interpersonal discourse surrounding family planning. Eight focus group discussions with family planning providers and 32 in-depth interviews with experienced modern contraceptive users were conducted in 2018 in the two Rwandan districts with the highest and the lowest contraceptive prevalence rates. Results suggest that outspoken government support, mass media, and community meetings were valuable sources of information about family planning. Information received through these channels generated interpersonal dialogue about contraceptives through both conversation and observation; however, rumors and misinformation remained a significant barrier to use. A once taboo subject is now normative among married couples. Continuing to address common fears and misinformation through communication channels such as mass media and community meetings may help to further increase contraceptive uptake in Rwanda.