As Rwanda expands access to family planning services for young people, health experts warn that availability alone will not guarantee sustained use.
Evidence from national data and personal experiences shows that side effects, misinformation, and limited counselling remain major barriers, especially for first-time users.
The Government of Rwanda’s recent move to allow adolescents and young adults to access family planning services marks a significant step toward reducing unintended pregnancies and improving reproductive health outcomes.
However, researchers and medical professionals emphasize that policy change must be matched with comprehensive education and continuous medical guidance if young people are to benefit fully from modern contraceptive methods.
Data from the Rwanda Demographic and Health Survey (DHS) 2019–20 indicate that side effects and health concerns are the leading reason women discontinue modern contraceptive methods within 12 months, accounting for nearly one-third of all discontinuations.
Other reasons include the desire for a more effective method and plans to become pregnant, suggesting that method satisfaction and understanding play a crucial role in continued use.
“Some married women still avoid modern contraception, fearing side effects such as weight gain, headaches, or changes in their menstrual cycle,” explains Dr. Kenneth Ruzindana, a reproductive health expert in Rwanda.
He adds that missed periods and irregular bleeding, which are common with methods like injectables and implants, are often misunderstood. “Although these effects are usually harmless, they are sometimes seen as signs of illness or future infertility. Awareness does not always mean understanding, and misconceptions about side effects persist,” he says.
These concerns are echoed in the experiences of young women navigating family planning for the first time. Mutesi Joy, a 22-year-old student at Kigali Independent University, recalls her six-month experience using an intrauterine device (IUD).
She reports drastic weight loss, acne, and constant spotting due to changes in her menstrual cycle, which ultimately led her to discontinue the method. “I wasn’t prepared for what would happen to my body,” she says, encouraging her peers to seek detailed information before choosing a contraceptive.
Despite these challenges, the DHS reports that 61.4% of women using modern contraceptive methods were informed about possible side effects or problems associated with their chosen method. Health professionals argue that this still leaves a significant gap between information delivery and meaningful counselling.
“Irregular bleeding and headaches are among the most commonly reported side effects of modern contraceptives,” notes Dr. Clarisse Niyonsenga, a pediatrician based in Kigali. “Proper counselling before and after method adoption can help women understand these effects so they are not unduly alarmed.”
As Rwanda broadens family planning access for young people, experts stress that sustained success will depend not only on policy reform, but also on clear communication, follow-up care, and youth-friendly health services that address fears, expectations, and bodily changes with scientific clarity.
Prisca Gikundiro / The Kaminuza Star