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Difference between revisions of "Kigali"

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(Emergency Contraception (Morning After Pill))
(What to Get & Where to Get It)
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* In Rwanda, you can purchase emergency contraceptive pills (morning after pills) without a prescription. You can find them at pharmacy and health centers. Some of the brands you can expect to see are Pill 2 and Pill 72.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/rwanda/ ICEC: EC Status and Availability: Rwanda]</ref> You can also buy NorLevo (emergency contraceptive pill) online at [https://www.kasha.rw/product-category/love-sex/ Kasha]. For one tablet, you pay 6000 RWF, as of February 2018.  
 
* In Rwanda, you can purchase emergency contraceptive pills (morning after pills) without a prescription. You can find them at pharmacy and health centers. Some of the brands you can expect to see are Pill 2 and Pill 72.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/rwanda/ ICEC: EC Status and Availability: Rwanda]</ref> You can also buy NorLevo (emergency contraceptive pill) online at [https://www.kasha.rw/product-category/love-sex/ Kasha]. For one tablet, you pay 6000 RWF, as of February 2018.  
* If you cannot obtain dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as replacement emergency contraception. To do this, you can take Ovrette (Take 40 pills within 120 hours after unprotected sex), Neogynon (Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later),  
+
* If you cannot obtain dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as replacement emergency contraception. To do this, you can take Ovrette (Take 40 pills within 120 hours after unprotected sex), Neogynon (Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Lo-Femenal (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) or Microgynon-30 (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref> Note that, in 28-day packs, only the first 21 pills can be used. For updated information on how and when to take birth control pills as replacement ECPs, please visit the [http://ec.princeton.edu/ Princeton EC Website].
Lo-Femenal (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) or Microgynon-30 (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref> Note that, in 28-day packs, only the first 21 pills can be used. For updated information on how and when to take birth control pills as replacement ECPs, please visit the [http://ec.princeton.edu/ Princeton EC Website].
+
* You can also use an intra-urine device (IUD) as emergency contraception. Consult with your physician or local health care provider to find more details.
  
 
===Costs===
 
===Costs===

Revision as of 01:05, 27 February 2018

Rwanda / Kigali
Kigali.jpg

OVERVIEW

Contraception (Birth Control)

General Note: There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click here.

Laws & Social Stigmas

In Rwanda, you can obtain oral contraceptives (birth control pills) without a prescription.[1] [2]

According to a 2015 UN report, it was found that 53.5% of women in Rwanda (who are married/in unions and of reproductive age) use some form of contraception, including traditional methods. Meanwhile, about 20% of Rwandan women have unmet family planning needs. The number of women who are using contraceptives are high for the East African region, where about 40% of women use contraceptives on average..[3]

In Rwanda, the most common forms of contraception for women are by far contraceptive injectables, which are used by 28.1% of women. After injectables, women tend to use various forms of traditional methods (17%), though there are low rates of usage for traditional methods such as the rhythm method (0.5%) and withdrawal (0.4%). Regarding modern contraceptive methods, women sometimes use birth control pills (7.6%) and contraceptive implants (6.7%), though numbers remain relatively low. There are very low usage rates for condoms (3.1%) or IUDs (0.5%).[4]

There is certainly work to be done to improve contraceptive accessibility and education in the country. In Rwanda, there is no comprehensive sex-education in schools,[5] though efforts have been made to improve the training of teachers in sex-education topics by UNFPA, as of 2016.[6]

What to Get & Where to Get It

  • In Rwanda, you can find condoms distributed in boutiques, pharmacies, kiosks, bars, health facilities, outreach centers (like community-based distributors) and online stores. The condoms provided in the public sector tend to be generic, non-brand condoms. If you go to the social-marketing centers, you may get condoms that are under the name "Prudence Plus." Overall, Rwanda doesn't have a high level of diversity in the condom sector yet, and only a few main brands are for sale. They tend to be most readily available in urban boutiques, but stock-outs can be an issue experienced by all vendors and facilities at times.[7] If you want to purchase condoms online, you can find Moods and Kama X condoms sold on the Kasha website for 1000 RWF per pack, as of February 2018.
  • You should be able to find oral contraceptives (birth control pills) sold in pharmacies and online retailers, like Kasha. Some of the brands you can expect to see are Diane-35, Microgynon, Microlut, Neogynon, Lo-Femenal and Ovrette.[8]
  • You can find intra-urine devices (IUDs) in Rwanda. On the Kasha website, you can purchase the SMB copper IUD for 14,000 RWF or the Mirena IUD for 90,000 RWF, as of February 2018.
  • You can find contraceptive shots/injectables in Rwanda. On the Kasha website, you can purchase a 3-months supply of Depo-Provera for 700 RWF, or you can purchase Norigynon injectables for 1000 RWF (1-month supply) or 2000 RWF (2-month supply), as of February 2018.
  • You can find contraceptive implants in Rwanda. On the Kasha website, you can purchase the Implanon implant, which lasts 3 years, for 5000 RWF, or you can you can purchase the Jadelle implant, which lasts 5 years, for 5000 RWF, as of February 2018.

Resources & Organizations

  • Rwanda Women's Network: "The RWN offers medical services, with the main focus areas being gender-based violence, HIV/Aids, mental and reproductive health." Mailing Address: Kagugu, Mucyo Estate KG 54, off KG 482 – Kinyinya Sector (Near SOS Technical School), P.O Box 3157, Kigali, RWANDA. Tel: +250 788 334 257. E-mail: rwawnet@rwanda1.rw / info@rwandawomennetwork.org

Costs

Emergency Contraception (Morning After Pill)

Important Notes: Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC as soon as possible after unprotected sex. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) You must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click here and here.

Laws & Social Stigmas

In Rwanda, it appears that you can obtain emergency contraceptive pills (morning after pills) without a prescription. Furthermore, emergency contraception is included in police protocol for survivors of rape or sexual violence. However, Rwandan laws related to emergency contraception are rather vague and don't clearly defined what is permitted. For example, the National Family Planning Policy does not include information related to emergency contraception and Rwanda’s Health Sector Strategic Plan for 2009-2012 also does not mention emergency contraception. Yet, Rwanda’s National Training Module for Family Planning (March 2008) does include a chapter on emergency contraception. This leads to a muddled understanding of emergency contraception that translates into confusion on hospital floors. In 2009, a survey found that only 13% of Rwandan clinics had guidelines related to EC, and many of these facilities did not have EC available in the rooms that they had dedicated to working with victims of sexual violence. However, the Yuzpe method of emergency contraception (i.e. using regular birth control pills as EC) was available in 62% of the surveyed facilities.[9]

What to Get & Where to Get It

  • In Rwanda, you can purchase emergency contraceptive pills (morning after pills) without a prescription. You can find them at pharmacy and health centers. Some of the brands you can expect to see are Pill 2 and Pill 72.[10] You can also buy NorLevo (emergency contraceptive pill) online at Kasha. For one tablet, you pay 6000 RWF, as of February 2018.
  • If you cannot obtain dedicated emergency contraception, you can use regular oral contraceptives (birth control pills) as replacement emergency contraception. To do this, you can take Ovrette (Take 40 pills within 120 hours after unprotected sex), Neogynon (Take 2 pills within 120 hours after unprotected sex and take 2 more pills 12 hours later), Lo-Femenal (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later) or Microgynon-30 (Take 4 pills within 120 hours after unprotected sex and take 4 more pills 12 hours later).[11] Note that, in 28-day packs, only the first 21 pills can be used. For updated information on how and when to take birth control pills as replacement ECPs, please visit the Princeton EC Website.
  • You can also use an intra-urine device (IUD) as emergency contraception. Consult with your physician or local health care provider to find more details.

Costs

Sexually Transmitted Infections (STIs/STDs)

Important Notes - Learn about PEP and PrEP: If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click here. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click here.

Laws & Social Stigmas

In Rwanda, there are no travel restrictions related to HIV/AIDS. This means that, if you're a foreigner and you plan to visit Rwanda, you will not be asked about your HIV status or be required to share any medical information. If you're a foreigner and want to live in Rwanda as a legal resident, the information related to this topic is a bit mixed. Some sources seem to state that foreigners who apply for residency will not face any regulations or threats of deportation related to the HIV status. However, other sources seem to state that, if someone is infected with HIV/AIDS, their residency application may be refused.[12] If you have updated information about this topic, please update the page.

Testing Facilities

  • Remera Health Center: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Address: Remera Gasabo, Kigali, Rwanda. Phone: (+250) 788614060
  • Kinyinya Health Center: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Address: Kinyinya Gasabo, Kigali Rwanda. Phone: (+250) 788777798
  • Kagugu Health Center: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Address: Kagugu Gasabo, Kigali Rwanda. Phone: (+250) 788527621
  • Kabuye Health Center: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Address: Kabuye Gasabo, Kigali Rwanda. Phone: (+250) 788440372
  • Kacyiru Police Health: Address: This clinic is included in the AIDS Healthcare Foundation Global Directory, so they should either provide HIV tests or be able to direct you to a clinic that does. Center Kacyiru Gasabo, Kigali Rwanda. Phone: (+250) 788842179

Support

  • Centre Hospitalier De Kigali: This hospital seems to be the main provider of HIV treatment in Rwanda. They provide antiretroviral medication, such as Combivir, Epivir, Crixivan, Sustiva. They may also have Videx and Zerit. In the past, the monthly cost of combination therapy was 130'000 Rwandan Francs (ca. 700 DEM), but we're not sure about teh current price. The doctor in charge at the CHK is Dr. Kogame (internist).[13]
  • University Hospital, Butare: They have antiretroviral medication in stock, but they're probably more expensive than Centre Hospitalier De Kigali.[14]
  • You can find antiretroviral medication in some pharmacies in Kigali, but they may be more expensive than obtaining them from Centre Hospitalier De Kigali.[15]
  • Rwanda Women's Network: "The RWN offers medical services, with the main focus areas being gender-based violence, HIV/Aids, mental and reproductive health." Mailing Address: Kagugu, Mucyo Estate KG 54, off KG 482 – Kinyinya Sector (Near SOS Technical School), P.O Box 3157, Kigali, RWANDA. Tel: +250 788 334 257. E-mail: rwawnet@rwanda1.rw / info@rwandawomennetwork.org
  • Republic of Rwanda, Ministry of Health - National AIDS Control Programme, PNLS (Programme National de Lutte contre le Sida): Director of the programme: Innocent Ntaganira - E-mail: pnls@rwanda1.com. Phone: +250 78 471/2. Fax: +250 78 473.
  • Centre d'Information sur le Sida à Byumba: This is an AIDS information centre that is being planned in Byumba.

Costs

Medications & Vaccines

Laws & Social Stigmas

What to Get & Where to Get It

  • If you have a yeast infection, you can try to ask the pharmacist for Fluconazole, which treats fungal infections. If they don't have Fluconazole, they may have something that is similar.
  • Regarding the HPV vaccine, Rwanda has had a nationwide vaccination program in place since 2011. The program targets all girls in Primary 6 (ages 11-12 years old) for vaccination, and the vaccination consists of three doses to be considered complete.[16]
  • Regarding Pre-exposure Prophylaxis (PrEP), it doesn't appear to be widely available yet in Rwanda, as of February 2018.[17] However, Health Development Initiative (HDI) and AVAC, a US-based NGO, are working to raise media awareness and influence policymakers in support of PrEP access and awareness in Rwanda.[18]
  • Regarding Post-Exposure Prophylaxis (PEP), it appears that it's available in Rwanda, and under the PMTCT program, ARV prophylaxis is provided to pregnant women in need.[19]

Costs

Menstruation

Note: In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click here. To learn more about menstrual underwear, click here.

Laws & Social Stigmas

In Rwanda, menstrual hygiene is a challenging topic for many women. The majority of women use disposable pads, if they come from wealthier families, or reusable cloths, if they come from poorer families, during their periods. While some schools do provide sanitary napkins to their students, they are typically only provided in emergency situations and they're not available at all schools. Girls receive basic menstrual hygiene education at schools, but the government is interested in improving menstrual resources, accessibility and education for women in the country. Currently, girls who use reusable cloths tend to stay home (and not attend school) during their periods. This is largely due to lack of proper or private washing facilities at schools. For this reason, it's recommended that more Rwandan schools have private bathrooms for girls only, so they can comfortably manage their periods while at school.[20]

A campaign has been launched to help break the stigma and taboo around menstruation in Rwanda. Click here to learn more.

What to Get & Where to Get It

  • Most women in Rwanda use disposable pads/pantyliners (if they can afford it) or reusable cloths during their periods. You can find pads/pantyliners sold in supermarkets, pharmacies and certain retail chain stores.
  • While they are less commonly used than pads, you can find tampons in Rwanda, particularly in larger cities like Kigali. You can probably find them in Nakumatt, a large retail chain store with multiple locations, or pharmacies (though they may be more expensive at pharmacies). You can also purchase o.b. and Tampax tampons online from Rwandan-based retail websites, such as Kasha.
  • If you want to purchase a menstrual cup, you can buy one online from retailers that cater to the Rwandan market. For example, you can buy RubyCup on Kasha for 21,700 RWF (as of February 2018). However, there are no known local sellers of major brands, like DivaCup, RubyCup or Lunette, in Rwandan stores. You can also find menstrual cups for sale in other countries in the region, such as

=Menstrual Resources

  • She Innovates: This NGO is based in Rwanda and New York, and they sell a product called Go! Pads. "SHE is helping women jumpstart social businesses to manufacture and distribute affordable menstrual pads. Coupled with health education and advocacy, girls and women will have even more productive lives than before." Address: Sustainable Health Ventures, KG 5 AVE, Plot N02, P.O Box 2183, Kigali, Rwanda. Phone: +250 723878534

Costs

Gynecological Exams

Laws & Social Stigmas

What to Get & Where to Get It

  • Legacy Clinics: This specialty clinic has four gynecologists. Dr.Mohamed Okasha (male gynecologist) has been recommended by a Kigali local. You can walk in, call them or book an appointment online. Address: KK 3 Rd, Kigali, Rwanda. Hotline: 8000. TEL: +250-788382000/ +250-723382000/ +250-733682000. Email: info@legacyclinics.rw.
  • Kigali Medical Center: This clinic is located in Kimironko. Dr Heba (female gynecologist) has been recommended by a Kigali local who says "she's great" and paid 13,000 for a visit. Address: KG 78 St, Kigali, Rwanda.

Costs

Pregnancy

Laws & Social Stigmas

What to Get & Where to Get It

Costs

Abortion

Important Note: There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click here.

Laws & Social Stigmas

What to Get & Where to Get It

Costs

Advocacy & Counseling

Laws & Social Stigmas

What to Get & Where to Get It

  • Polyclinic of Hope: "The Polyclinic of Hope (PoH) came into being in 1997 as an intervention of the Rwanda Women’s Network. Adopting a holistic approach, the PoH responded to the plight of women survivors of sexual and gender-based violence by addressing their health, psychosocial, shelter and socio-economic needs in the aftermath of the 1994 genocide."

Costs

List of Additional Resources

  • Rwanda Women's Network: "Rwanda Women’s Network (RWN) is a national humanitarian non-governmental organization (NGO) dedicated to promotion and improvement of the socio-economic welfare of women in Rwanda since coming to being in 1997." Mailing Address: Kagugu, Mucyo Estate KG 54, off KG 482 – Kinyinya Sector (Near SOS Technical School), P.O Box 3157, Kigali, RWANDA. Tel: +250 788 334 257. E-mail: rwawnet@rwanda1.rw / info@rwandawomennetwork.org
  • Women for Women International - Rwanda: "Since 1997, Women for Women International – Rwanda has served more than 75,000 women through our yearlong program."
  • Association Rwandaise Des Femmes Pour L'environnement Et Le Developpement: Mailing Address: P.O. Box 1364, Kigali, Rwanda. Tel: 250 77283. Fax: 250 76574
  • AVEGA - RWANDA (Association of the survivors of the genocide): BP 1535 Kigali-Rwanda. Tel/Fax: 0171 460 0596
  • International Criminal Tribunal for Rwanda: Mailing Address: P.O.Box 749, Kigali, Rwanda. Tel: (212)963-9906.
  • Ministry of Family and Women in Development (MIFAPROFE): B.P. 969, Kigali, Rwanda
  • Reseau des Femmes pour le Developpement Rural: BP 1295 Kigali, Rwanda. Tel: 723.10
  • Réseau des Femmes Oeuvrant pour le Développement Rural (Network of women striving for rural development): P.O. Box 2368, Kigali, Rwanda. Tel:+250 86350 or +250 86351. Fax: +250 86350. E-mail: alvera.mparaye@wfp.org

References

  1. Global Oral Contraception Availability
  2. Free the Pill: Where on Earth
  3. [http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]
  4. [http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]
  5. Sex education remains unspoken in secondary schools
  6. New curriculum to promote sex education in schools
  7. Rwanda National Policy on Condoms
  8. Princeton EC Website
  9. COUNTING WHAT COUNTS: TRACKING ACCESS TO EMERGENCY CONTRACEPTION IN RWANDA
  10. ICEC: EC Status and Availability: Rwanda
  11. Princeton EC Website
  12. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  13. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  14. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  15. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  16. Human Papillomavirus and Related Diseases Report - RWANDA, 2017
  17. PrEPWatch World Map
  18. Health Development Initiative - PRE-EXPOSURE PROPHYLAXIS TO END HIV
  19. Republic of Rwanda, Ministry of Health - Rwanda: Global AIDS Response Progress Report
  20. UNICEF: Menstrual Hygiene Management in Schools - An Assessment for Applied Learning and Improved Practice in Gicumbi District, Rwanda