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Difference between revisions of "Kigali"

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'''OVERVIEW'''  
 
'''OVERVIEW'''  
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Rwanda is a country that has shown remarkable progress related to sexual and reproductive health care in the past few decades. You can legally obtain oral contraceptives (birth control pills) without a prescription, and condoms are widely sold in pharmacies, kiosks, bars and markets. Other contraceptive methods, such as IUDs and injectables, are also available. Furthermore, you can obtain the emergency contraceptive pill (morning after pill) without a prescription. The country provides universal health care coverage for HIV patients, and aggressive efforts have been made to reduce HIV transmission from parent to child in the country. While we're not sure if PrEP is available in Rwanda, PEP should be available. Menstrual hygiene is a challenging issue in Rwanda, where many women have inadequate access to menstrual products and may miss school during their periods. We have provided more information on this topic in the "Menstruation" section. Regarding pregnancy, women are entitled to 12 weeks of maternity leave with full pay, though this right may not translate to all workers and all work environments. Finally, abortion is permitted in some cases, which are detailed in the "Abortion" section. Overall, Rwanda, like all countries, experiences challenges and hurdles related to women's health care. However, it has also demonstrated focused and effective strategies to rebuild its health care infrastructure and tackle immediate issues of concern, such as HIV transmission from mother to child.
  
 
==Contraception (Birth Control)==
 
==Contraception (Birth Control)==
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Contraceptive Use Worldwide 2015]</ref>
 
Contraceptive Use Worldwide 2015]</ref>
  
Despite significant progress, there is certainly room for improvement related to contraceptive accessibility and education. In Rwandan schools, there is no comprehensive sex-education,<ref>[http://www.newtimes.co.rw/section/read/65697/ Sex education remains unspoken in secondary schools]</ref> though efforts have been made to improve teacher training in sex-education topics by UNFPA, as of 2016.<ref>[http://rwanda.unfpa.org/en/news/new-curriculum-promote-sex-education-schools New curriculum to promote sex education in schools]</ref> Furthermore, nearly half of all pregnancies (47%) in Rwanda are unintended, as of 2013.<ref>[https://www.guttmacher.org/fact-sheet/abortion-rwanda Guttmacher Institute: Abortion in Rwanda, April 2013]</ref> There are significant issues related to sexual trauma, sexual violence and bodily autonomy experienced by many Rwandans, as well, following the Rwandan Civil War (1990-1994). To speak broadly, sexual and reproductive health care has massively improved in Rwanda since the end of the war, yet there are topics related to education, accessibility and sensitivity that the country continues to grapple with.
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Despite notable progress, there is room for improvement related to contraceptive accessibility and education. In Rwandan schools, there exists no comprehensive sex-education,<ref>[http://www.newtimes.co.rw/section/read/65697/ Sex education remains unspoken in secondary schools]</ref> though efforts have been made to improve teacher training in sex-education by UNFPA, as of 2016.<ref>[http://rwanda.unfpa.org/en/news/new-curriculum-promote-sex-education-schools New curriculum to promote sex education in schools]</ref> Furthermore, nearly half of all pregnancies (47%) in Rwanda are unintended, as of 2013.<ref>[https://www.guttmacher.org/fact-sheet/abortion-rwanda Guttmacher Institute: Abortion in Rwanda, April 2013]</ref> There are significant issues related to sexual trauma, sexual violence and bodily autonomy experienced by many Rwandans, following the Rwandan Civil War and Rwandan Genocide, as well. To speak broadly, sexual and reproductive health care options have expanded since 2000, yet education, accessibility and sensitivity are still major issues that the country continues to grapple with.
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According to a Kigali local: "The stigma of birth control has diminished as the country develops, and especially as a lot more young Rwandans return home after doing their studies abroad. It's a lot more common now to openly admit that you are on the pill, for example. However, there is a huge difference in class here. Middle-class or Rwandans (or those that have returned recently from US, Europe, or Canada) are totally fine going on birth control. Among the majority of the population (still living in relative poverty), pre-marital sex is still frowned upon, and as a result, contraceptives are viewed as promiscuous. Condoms are promoted (moth male and female), but for 'good, God-fearing' people, it is not good to be seen with a condom on you, as this seen as a signal that you are sleeping around." (March 2018)
  
 
===What to Get & Where to Get It===
 
===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.<ref>[http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@ilo_aids/documents/legaldocument/wcms_132562.pdf Rwanda National Policy on Condoms]</ref> If you want to purchase condoms online, you can find Moods and Kama X condoms sold on the [https://www.kasha.rw/product-category/love-sex/ Kasha website] for 1000 RWF per pack, as of February 2018.
 
* 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.<ref>[http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@ilo_aids/documents/legaldocument/wcms_132562.pdf Rwanda National Policy on Condoms]</ref> If you want to purchase condoms online, you can find Moods and Kama X condoms sold on the [https://www.kasha.rw/product-category/love-sex/ 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 [https://www.kasha.rw/product-category/love-sex/ Kasha]. Some of the brands you can expect to see are Diane-35, Microgynon, Microlut, Neogynon, Lo-Femenal and Ovrette.<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref>  
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* You should be able to find '''oral contraceptives (birth control pills)''' sold in pharmacies and online retailers, like [https://www.kasha.rw/product-category/love-sex/ Kasha]. Some of the brands you can expect to see are Diane-35, Microgynon, Microlut, Neogynon, Lo-Femenal, Ovrette, and Yasmine.<ref>[http://ec.princeton.edu/ Princeton EC Website]</ref> <ref>[Conversation with pharmacy in Kigali, May 2018]</ref>
* You can find '''intra-urine devices (IUDs)''' in Rwanda. On the [https://www.kasha.rw/product-category/love-sex/ 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.
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* You can find '''intrauterine devices (IUDs)''' in Rwanda. You can get an IUD inserted at [http://legacyclinics.rw/ Legacy Clinics] for 10,000 RWF, as of March 2018. Furthermore, on the [https://www.kasha.rw/product-category/love-sex/ 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 [https://www.kasha.rw/product-category/love-sex/ 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.
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* You can find '''contraceptive shots/injectables''' in Rwanda. One pharmacy in Kigali told us that they sold Confiance, an injectable that lasts for 3 months for 500 RWF, as of May 2018.<ref>[Conversation with pharmacy in Kigali, May 2018]</ref> Furthermore, on the [https://www.kasha.rw/product-category/love-sex/ 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 [https://www.kasha.rw/product-category/love-sex/ 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.
 
* You can find '''contraceptive implants''' in Rwanda. On the [https://www.kasha.rw/product-category/love-sex/ 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.
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* According to a local source, the '''contraceptive ring (Nuvaring)''' is available in Rwanda, but we'll need more information to confirm.
  
 
===Resources & Organizations===
 
===Resources & Organizations===
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===Costs===
 
===Costs===
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* In a conversation with one pharmacy in Kigali, we were told that they sold Confiance (contraceptive injectables) for 500 RWF, and they sold Microgynon for 1000 RWF (as of May 2018).<ref>[Conversation with pharmacy in Kigali, May 2018]</ref>
  
 
==Emergency Contraception (Morning After Pill)==
 
==Emergency Contraception (Morning After Pill)==
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===Laws & Social Stigmas===
 
===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.<ref>[http://www.cecinfo.org/custom-content/uploads/2013/09/Rwanda_2013.pdf COUNTING WHAT COUNTS: TRACKING ACCESS TO EMERGENCY CONTRACEPTION IN RWANDA]</ref>
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In Rwanda, it appears that you can obtain emergency contraceptive pills (morning after pills) without a prescription at pharmacies. However, due to the price of ECPs at pharmacies, it is often too expensive for most Rwandan locals.
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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.<ref>[http://www.cecinfo.org/custom-content/uploads/2013/09/Rwanda_2013.pdf COUNTING WHAT COUNTS: TRACKING ACCESS TO EMERGENCY CONTRACEPTION IN RWANDA]</ref>
  
 
===What to Get & Where to Get It===
 
===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.<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.  
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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 NorLevo 1.5mg, Pill 2, Pill 72.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/rwanda/ ICEC: EC Status and Availability: Rwanda]</ref> <ref>[Conversation with pharmacy in Kigali, May 2018]</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 if you buy it online, 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).<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].
 
* 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].
 
* 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.
 
* 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===
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You can expect to pay between 6,000 RWF to 15,000 RWF for the emergency contraceptive pill (morning after pill), as of May 2018. This is very expensive for most local Rwandans, so most people cannot afford it.
  
 
==Sexually Transmitted Infections (STIs/STDs)==
 
==Sexually Transmitted Infections (STIs/STDs)==
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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.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref> If you have updated information about this topic, please update the page.
 
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.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref> If you have updated information about this topic, please update the page.
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Generally speaking, Rwanda has shown remarkable progress in rebuilding its HIV/AIDS resources in the past few decades. The Rwandan genocide destroyed the HIV treatment infrastructure in the country, which needed to then be rebuilt from the ground up. Since that time, Rwanda has focused on trying to prevent more HIV infections, especially from mother to child. In 2016, it was estimated that about 220,000 people (adults and children) in Rwanda and about 3.1% of adults in Rwanda are living with HIV.<ref>[http://www.unaids.org/en/regionscountries/countries/rwanda UNAIDS Country factsheets - RWANDA 2016]</ref> The country provides universal health coverage for HIV patients, though the effort to ensure that everyone is covered is still ongoing.<ref>[http://www.aidsmap.com/Abolishing-HIV-in-Rwanda/page/2845701/ Abolishing HIV in Rwanda]</ref> You can watch a PBS special on Rwanda's efforts to prevent HIV transmission and ensure that HIV-positive people are properly medicated [https://www.pbs.org/newshour/show/rwanda-torn-genocide-became-global-anti-aids-leader here].
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From a Kigali local: "Tests for STI/STDs are very easy to get at the many medical centers around town. It can be costly at some of the private clinics, but you can also find cheaper options at public hospitals. HIV tests are cheap, and people are encouraged to get tested. Among the Rwandans I know, getting tested is a completely normal thing --- it is not shameful. People will even go with their partner, as part of the dating ritual. Again, this is what I know from the Rwandans I spend time with, and these are middle-class." (March 2018)
  
 
===Testing Facilities===
 
===Testing Facilities===
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===Support===
 
===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).<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>
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* 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 the current price. The doctor in charge at the CHK is Dr. Kogame (internist).<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>
 
* University Hospital, Butare: They have antiretroviral medication in stock, but they're probably more expensive than Centre Hospitalier De Kigali.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>
 
* University Hospital, Butare: They have antiretroviral medication in stock, but they're probably more expensive than Centre Hospitalier De Kigali.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>
 
* You can find antiretroviral medication in some pharmacies in Kigali, but they may be more expensive than obtaining them from Centre Hospitalier De Kigali.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>
 
* You can find antiretroviral medication in some pharmacies in Kigali, but they may be more expensive than obtaining them from Centre Hospitalier De Kigali.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=150 RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref>
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===Costs===
 
===Costs===
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There is universal health coverage of HIV treatment in Rwanda. However, the efforts to ensure that everyone is covered and receiving treatment in Rwanda is still ongoing. In 2014, it was found that some health centers covered about 80% of patients while others only covered about 20%.<ref>[http://www.aidsmap.com/Abolishing-HIV-in-Rwanda/page/2845701/ Abolishing HIV in Rwanda]</ref> However, the rate of coverage may have improved in the years since the study was conducted.
  
 
==Medications & Vaccines==
 
==Medications & Vaccines==
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===What to Get & Where to Get It===
 
===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.
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* If you have a '''yeast infection''', you can find medications over-the-counter at pharmacies. No prescription is required and the medications tend to be rather affordable. 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.
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* If you have a '''urinary tract infection (UTI)''', you can find medications over-the-counter at pharmacies. No prescription is required and the medications tend to be rather affordable.
 
* 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.<ref>[http://www.hpvcentre.net/statistics/reports/RWA.pdf Human Papillomavirus and Related Diseases Report - RWANDA, 2017]</ref>
 
* 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.<ref>[http://www.hpvcentre.net/statistics/reports/RWA.pdf Human Papillomavirus and Related Diseases Report - RWANDA, 2017]</ref>
 
* Regarding '''Pre-exposure Prophylaxis (PrEP)''', it doesn't appear to be widely available yet in Rwanda, as of February 2018.<ref>[https://www.prepwatch.org/ PrEPWatch World Map]</ref> 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.<ref>[https://www.avac.org/sites/default/files/resource-files/PREP%20Brochure%20final.pdf Health Development Initiative - PRE-EXPOSURE PROPHYLAXIS TO END HIV]</ref>
 
* Regarding '''Pre-exposure Prophylaxis (PrEP)''', it doesn't appear to be widely available yet in Rwanda, as of February 2018.<ref>[https://www.prepwatch.org/ PrEPWatch World Map]</ref> 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.<ref>[https://www.avac.org/sites/default/files/resource-files/PREP%20Brochure%20final.pdf Health Development Initiative - PRE-EXPOSURE PROPHYLAXIS TO END HIV]</ref>
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===What to Get & Where to Get It===
 
===What to Get & Where to Get It===
  
* [http://legacyclinics.rw/ 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.
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* [http://www.bahopolyclinic.com/ Baho Polyclinic]: This medical center was established in 2009 and has multiple ob/gyns on staff. It was recommended by a Kigali local. A consultation is typically around 13,000 RWF (as of March 2018). Address: KN 4 Avenue 36, Nyarugenge, Kigali Rwanda. Email: info@bahopolyclinic.com. Phone: 3130. Mobile: (+250)789339974. Hours: Mon - Sun: 24/7 Hours.
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* [http://legacyclinics.rw/ Legacy Clinics]: This specialty clinic has four gynecologists. The average cost of a gynecological exam is  28000 rwf (as of March 2018), and the cost of a pap smear is 30900 rwf (as of March 2018). Recommended 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.
 
* 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.
  
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===Laws & Social Stigmas===
 
===Laws & Social Stigmas===
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In Rwanda, women are entitled to 12 weeks of maternity leave with full pay. If there are complications in the delivery, the mother is entitled to an additional month of maternity leave. To be eligible for maternity leave, the mother must have contributed social security at least one month before the maternity leave is planned to start.<ref>[http://www.rssb.rw/content/maternity-leave RSSB (Rwanda Social Security Board): Maternity Leave]</ref> For more information on maternity leave laws in Rwanda, you can visit the [http://www.rssb.rw/content/maternity-leave RSSB (Rwanda Social Security Board) website].
  
 
===What to Get & Where to Get It===
 
===What to Get & Where to Get It===
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* [http://www.rwandawomennetwork.org/healthCare&support.html 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."
 
* [http://www.rwandawomennetwork.org/healthCare&support.html 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."
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* [http://avega.org.rw/ AVEGA - RWANDA (Association of the survivors of the genocide)]: They provide medical care and treatment related to trauma issues. They also help widows in rebuilding their lives. BP 1535 Kigali-Rwanda. Tel/Fax: 0171 460 0596
  
 
===Costs===
 
===Costs===
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* [http://www.rwandawomennetwork.org/ 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
 
* [http://www.rwandawomennetwork.org/ 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
 
* [https://www.womenforwomen.org/what-we-do/countries/rwanda Women for Women International - Rwanda]: "Since 1997, Women for Women International – Rwanda has served more than 75,000 women through our yearlong program."  
 
* [https://www.womenforwomen.org/what-we-do/countries/rwanda Women for Women International - Rwanda]: "Since 1997, Women for Women International – Rwanda has served more than 75,000 women through our yearlong program."  
 +
* [http://www.ywcaofrwanda.org/ YWCA of Rwanda]: "The Young Women’s Christian Association (YWCA) of Rwanda is a non-governmental, non-profit organisation that works at the grass roots level. It is a membership organization for women and young girls. It was established following the genocide and in response to the rising concern for the many widows and children left in its wake. The organisation became affiliated to the World YWCA movement in 1999 and was legally recognized by the Rwandan government in September 2005. YWCA Rwanda currently works across 8 districts in Rwanda." Mailing Address: P.O. Box 48 KIGALI. Telephone number: +250 788484514. E-mail address: ywcarwa@yahoo.fr or ywca.rwa@gmail.com,info@ywcaofrwanda.org
 +
* [https://www.nwc-umutima.org/ Nyamirambo Women’s Center (NWC)]: "Nyamirambo Women’s Center (NWC), a Rwandan NGO, was launched at the end of 2007 by 18 Rwandese women living in Nyamirambo, Kigali. Together they created a project which aimed to address gender-based violence, gender inequality and discrimination. Today, NWC’s mission is to provide education and vocational training to women who do not have the means to pay for such training on their own, so that they can gain better opportunities for employment." Address: Nyamirambo Women’s Center, House 22, KN 7 Avenue (on the corner with KN 132 Street), PO BOX 1418, Kigali, Rwanda. Opening Hours: Monday to Saturday, 9am to 5pm (except for Umuganda Saturday, the last Saturday of every month: 12pm to 5pm). Phone: +250 782 111 860. Email: nwcoffice.kigali@gmail.com
 +
* [http://urugowoc.org/ Urugo Women’s Opportunity Center]: "Built and operated by Women for Women International with the generous funding from Bloomberg Philanthropies and others, the Urugo Women’s Opportunity Center provides a safe environment and dedicated facilities where women can learn, build new skills, and operate businesses that directly contribute to the local communities." Phone: +250 788350577. Email: guwamariya@urugowoc.com.
 
* Association Rwandaise Des Femmes Pour L'environnement Et Le Developpement: Mailing Address: P.O. Box 1364, Kigali, Rwanda. Tel: 250 77283. Fax: 250 76574
 
* 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.
 
* 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
 
* Ministry of Family and Women in Development (MIFAPROFE): B.P. 969, Kigali, Rwanda

Latest revision as of 23:12, 28 August 2018

Rwanda / Kigali
Kigali.jpg

OVERVIEW

Rwanda is a country that has shown remarkable progress related to sexual and reproductive health care in the past few decades. You can legally obtain oral contraceptives (birth control pills) without a prescription, and condoms are widely sold in pharmacies, kiosks, bars and markets. Other contraceptive methods, such as IUDs and injectables, are also available. Furthermore, you can obtain the emergency contraceptive pill (morning after pill) without a prescription. The country provides universal health care coverage for HIV patients, and aggressive efforts have been made to reduce HIV transmission from parent to child in the country. While we're not sure if PrEP is available in Rwanda, PEP should be available. Menstrual hygiene is a challenging issue in Rwanda, where many women have inadequate access to menstrual products and may miss school during their periods. We have provided more information on this topic in the "Menstruation" section. Regarding pregnancy, women are entitled to 12 weeks of maternity leave with full pay, though this right may not translate to all workers and all work environments. Finally, abortion is permitted in some cases, which are detailed in the "Abortion" section. Overall, Rwanda, like all countries, experiences challenges and hurdles related to women's health care. However, it has also demonstrated focused and effective strategies to rebuild its health care infrastructure and tackle immediate issues of concern, such as HIV transmission from mother to child.

Contraception (Birth Control)[edit]

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[edit]

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

Overall, Rwanda has shown massive progress when it comes to reproductive health care access. From 2000 to 2010, the proportion of married women using modern contraceptive methods went from 4% to 40%, and the percentage of women with unmet family planning needs went from 36% to 19%.[3] 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 Rwandan women who use contraceptives is higher than the East African regional average, where about 40% of women use contraceptives.[4]

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%).[5]

Despite notable progress, there is room for improvement related to contraceptive accessibility and education. In Rwandan schools, there exists no comprehensive sex-education,[6] though efforts have been made to improve teacher training in sex-education by UNFPA, as of 2016.[7] Furthermore, nearly half of all pregnancies (47%) in Rwanda are unintended, as of 2013.[8] There are significant issues related to sexual trauma, sexual violence and bodily autonomy experienced by many Rwandans, following the Rwandan Civil War and Rwandan Genocide, as well. To speak broadly, sexual and reproductive health care options have expanded since 2000, yet education, accessibility and sensitivity are still major issues that the country continues to grapple with.

According to a Kigali local: "The stigma of birth control has diminished as the country develops, and especially as a lot more young Rwandans return home after doing their studies abroad. It's a lot more common now to openly admit that you are on the pill, for example. However, there is a huge difference in class here. Middle-class or Rwandans (or those that have returned recently from US, Europe, or Canada) are totally fine going on birth control. Among the majority of the population (still living in relative poverty), pre-marital sex is still frowned upon, and as a result, contraceptives are viewed as promiscuous. Condoms are promoted (moth male and female), but for 'good, God-fearing' people, it is not good to be seen with a condom on you, as this seen as a signal that you are sleeping around." (March 2018)

What to Get & Where to Get It[edit]

  • 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.[9] 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, Ovrette, and Yasmine.[10] [11]
  • You can find intrauterine devices (IUDs) in Rwanda. You can get an IUD inserted at Legacy Clinics for 10,000 RWF, as of March 2018. Furthermore, 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. One pharmacy in Kigali told us that they sold Confiance, an injectable that lasts for 3 months for 500 RWF, as of May 2018.[12] Furthermore, 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.
  • According to a local source, the contraceptive ring (Nuvaring) is available in Rwanda, but we'll need more information to confirm.

Resources & Organizations[edit]

  • 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[edit]

  • In a conversation with one pharmacy in Kigali, we were told that they sold Confiance (contraceptive injectables) for 500 RWF, and they sold Microgynon for 1000 RWF (as of May 2018).[13]

Emergency Contraception (Morning After Pill)[edit]

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[edit]

In Rwanda, it appears that you can obtain emergency contraceptive pills (morning after pills) without a prescription at pharmacies. However, due to the price of ECPs at pharmacies, it is often too expensive for most Rwandan locals.

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.[14]

What to Get & Where to Get It[edit]

  • 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 NorLevo 1.5mg, Pill 2, Pill 72.[15] [16] You can also buy NorLevo (emergency contraceptive pill) online at Kasha. For one tablet, you pay 6000 RWF if you buy it online, 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).[17] 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[edit]

You can expect to pay between 6,000 RWF to 15,000 RWF for the emergency contraceptive pill (morning after pill), as of May 2018. This is very expensive for most local Rwandans, so most people cannot afford it.

Sexually Transmitted Infections (STIs/STDs)[edit]

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[edit]

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.[18] If you have updated information about this topic, please update the page.

Generally speaking, Rwanda has shown remarkable progress in rebuilding its HIV/AIDS resources in the past few decades. The Rwandan genocide destroyed the HIV treatment infrastructure in the country, which needed to then be rebuilt from the ground up. Since that time, Rwanda has focused on trying to prevent more HIV infections, especially from mother to child. In 2016, it was estimated that about 220,000 people (adults and children) in Rwanda and about 3.1% of adults in Rwanda are living with HIV.[19] The country provides universal health coverage for HIV patients, though the effort to ensure that everyone is covered is still ongoing.[20] You can watch a PBS special on Rwanda's efforts to prevent HIV transmission and ensure that HIV-positive people are properly medicated here.

From a Kigali local: "Tests for STI/STDs are very easy to get at the many medical centers around town. It can be costly at some of the private clinics, but you can also find cheaper options at public hospitals. HIV tests are cheap, and people are encouraged to get tested. Among the Rwandans I know, getting tested is a completely normal thing --- it is not shameful. People will even go with their partner, as part of the dating ritual. Again, this is what I know from the Rwandans I spend time with, and these are middle-class." (March 2018)

Testing Facilities[edit]

  • 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[edit]

  • 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 the current price. The doctor in charge at the CHK is Dr. Kogame (internist).[21]
  • University Hospital, Butare: They have antiretroviral medication in stock, but they're probably more expensive than Centre Hospitalier De Kigali.[22]
  • You can find antiretroviral medication in some pharmacies in Kigali, but they may be more expensive than obtaining them from Centre Hospitalier De Kigali.[23]
  • 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[edit]

There is universal health coverage of HIV treatment in Rwanda. However, the efforts to ensure that everyone is covered and receiving treatment in Rwanda is still ongoing. In 2014, it was found that some health centers covered about 80% of patients while others only covered about 20%.[24] However, the rate of coverage may have improved in the years since the study was conducted.

Medications & Vaccines[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

  • If you have a yeast infection, you can find medications over-the-counter at pharmacies. No prescription is required and the medications tend to be rather affordable. 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.
  • If you have a urinary tract infection (UTI), you can find medications over-the-counter at pharmacies. No prescription is required and the medications tend to be rather affordable.
  • 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.[25]
  • Regarding Pre-exposure Prophylaxis (PrEP), it doesn't appear to be widely available yet in Rwanda, as of February 2018.[26] 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.[27]
  • 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.[28]

Costs[edit]

Menstruation[edit]

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[edit]

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.[29]

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[edit]

  • 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[edit]

  • 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[edit]

Gynecological Exams[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

  • Baho Polyclinic: This medical center was established in 2009 and has multiple ob/gyns on staff. It was recommended by a Kigali local. A consultation is typically around 13,000 RWF (as of March 2018). Address: KN 4 Avenue 36, Nyarugenge, Kigali Rwanda. Email: info@bahopolyclinic.com. Phone: 3130. Mobile: (+250)789339974. Hours: Mon - Sun: 24/7 Hours.
  • Legacy Clinics: This specialty clinic has four gynecologists. The average cost of a gynecological exam is 28000 rwf (as of March 2018), and the cost of a pap smear is 30900 rwf (as of March 2018). Recommended 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[edit]

Pregnancy[edit]

Laws & Social Stigmas[edit]

In Rwanda, women are entitled to 12 weeks of maternity leave with full pay. If there are complications in the delivery, the mother is entitled to an additional month of maternity leave. To be eligible for maternity leave, the mother must have contributed social security at least one month before the maternity leave is planned to start.[30] For more information on maternity leave laws in Rwanda, you can visit the RSSB (Rwanda Social Security Board) website.

What to Get & Where to Get It[edit]

Costs[edit]

Abortion[edit]

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[edit]

In Rwanda, abortion is legally permitted when the pregnancy endangers the life of the pregnant individual, when the pregnancy endangers the physical or mental health of the pregnant individual, when there is severe risk of fetal impairment, or when the pregnancy is the result of rape, incest or forced marriage.[31] [32] [33] [34] In all other cases, abortion is not legally permitted. This means that it is not available upon request and it is not available for social or economic reasons. If someone illegally tries to self-induce an abortion, they may be subject to fines and up to three years in prison.[35] The current laws are based on Rwanda's Penal Code of 1977 and the updated Penal Code of 2012.[36] For a copy of Rwanda's abortion provisions, click here.

For an abortion to be legal, it must first be approved by a judge and it can only be performed by a doctor. If the abortion is legally permitted for health-related reasons, it must receive the written approval of two doctors before it can be performed. These restrictions create severe hurdles for many people, as they must have the money and resources to hire lawyers and work within the legal and medical systems before receiving approval for an abortion. Furthermore, courts can be slow in permitting abortions. For example, court orders for an abortion in cases of rape often usually occur after the rapist has been convicted, leading to potentially significant delays for the individual seeking an abortion.[37]

For these reasons, it is much more common for Rwandans to seek underground or clandestine abortions than to seek out abortions through legal channels.[38] In 2013 report, it was found that nearly half (47%) of pregnancies were unintended and an estimated 22% of unintended pregnancies result in abortion. In 2009, there were 60,000 abortions in Rwanda per year, which roughly equaled 25 abortions per 1000 woman, aged 15-44. The most abortions are performed in Kigali, which account for one-third of all abortions in the country. About half of the abortions in Rwanda are performed by medical professionals, such as trained midwives or medical assistants, but another half are performed by people who do not have medical training, and these abortions are considered high-risk. It is estimated that about 40% of women who have abortions experience complications, and 30% of women who have complications do not obtain the medical treatment and attention that they need. The highest rate of complications result from women who try to induce abortions themselves or who go to traditional healers.[39]

What to Get & Where to Get It[edit]

  • You may be able to obtain Misopostrol (the abortion pill) from Women on Waves. Visit their website for more details.
  • If you are considering leaving the country to obtain a legal abortion, you can get legal abortions upon request in Mozambique. You can get an abortion for social or economic reasons (but we don't know how difficult this is to prove) in Zambia. Outside the East Africa region, you can receive abortions upon request in countries such as South Africa, Tunisia, China, Vietnam and India, as well as many European countries.

Costs[edit]

If you are pregnant and considering getting an abortion outside Rwanda, you will need to consider the following costs: visa processing and appointment costs, transportation to the country where you will be obtaining an abortion, hotel or accommodation costs in that country, cost of the abortion in the country and the total amount of days you may need to be in the country both before and after the abortion.

Advocacy & Counseling[edit]

Laws & Social Stigmas[edit]

What to Get & Where to Get It[edit]

  • 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."
  • AVEGA - RWANDA (Association of the survivors of the genocide): They provide medical care and treatment related to trauma issues. They also help widows in rebuilding their lives. BP 1535 Kigali-Rwanda. Tel/Fax: 0171 460 0596

Costs[edit]

List of Additional Resources[edit]

  • 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."
  • YWCA of Rwanda: "The Young Women’s Christian Association (YWCA) of Rwanda is a non-governmental, non-profit organisation that works at the grass roots level. It is a membership organization for women and young girls. It was established following the genocide and in response to the rising concern for the many widows and children left in its wake. The organisation became affiliated to the World YWCA movement in 1999 and was legally recognized by the Rwandan government in September 2005. YWCA Rwanda currently works across 8 districts in Rwanda." Mailing Address: P.O. Box 48 KIGALI. Telephone number: +250 788484514. E-mail address: ywcarwa@yahoo.fr or ywca.rwa@gmail.com,info@ywcaofrwanda.org
  • Nyamirambo Women’s Center (NWC): "Nyamirambo Women’s Center (NWC), a Rwandan NGO, was launched at the end of 2007 by 18 Rwandese women living in Nyamirambo, Kigali. Together they created a project which aimed to address gender-based violence, gender inequality and discrimination. Today, NWC’s mission is to provide education and vocational training to women who do not have the means to pay for such training on their own, so that they can gain better opportunities for employment." Address: Nyamirambo Women’s Center, House 22, KN 7 Avenue (on the corner with KN 132 Street), PO BOX 1418, Kigali, Rwanda. Opening Hours: Monday to Saturday, 9am to 5pm (except for Umuganda Saturday, the last Saturday of every month: 12pm to 5pm). Phone: +250 782 111 860. Email: nwcoffice.kigali@gmail.com
  • Urugo Women’s Opportunity Center: "Built and operated by Women for Women International with the generous funding from Bloomberg Philanthropies and others, the Urugo Women’s Opportunity Center provides a safe environment and dedicated facilities where women can learn, build new skills, and operate businesses that directly contribute to the local communities." Phone: +250 788350577. Email: guwamariya@urugowoc.com.
  • Association Rwandaise Des Femmes Pour L'environnement Et Le Developpement: Mailing Address: P.O. Box 1364, Kigali, Rwanda. Tel: 250 77283. Fax: 250 76574
  • 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[edit]

  1. Global Oral Contraception Availability
  2. Free the Pill: Where on Earth
  3. Guttmacher Institute: Abortion in Rwanda, April 2013
  4. [http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]
  5. [http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]
  6. Sex education remains unspoken in secondary schools
  7. New curriculum to promote sex education in schools
  8. Guttmacher Institute: Abortion in Rwanda, April 2013
  9. Rwanda National Policy on Condoms
  10. Princeton EC Website
  11. [Conversation with pharmacy in Kigali, May 2018]
  12. [Conversation with pharmacy in Kigali, May 2018]
  13. [Conversation with pharmacy in Kigali, May 2018]
  14. COUNTING WHAT COUNTS: TRACKING ACCESS TO EMERGENCY CONTRACEPTION IN RWANDA
  15. ICEC: EC Status and Availability: Rwanda
  16. [Conversation with pharmacy in Kigali, May 2018]
  17. Princeton EC Website
  18. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  19. UNAIDS Country factsheets - RWANDA 2016
  20. Abolishing HIV in Rwanda
  21. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  22. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  23. RWANDA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV
  24. Abolishing HIV in Rwanda
  25. Human Papillomavirus and Related Diseases Report - RWANDA, 2017
  26. PrEPWatch World Map
  27. Health Development Initiative - PRE-EXPOSURE PROPHYLAXIS TO END HIV
  28. Republic of Rwanda, Ministry of Health - Rwanda: Global AIDS Response Progress Report
  29. UNICEF: Menstrual Hygiene Management in Schools - An Assessment for Applied Learning and Improved Practice in Gicumbi District, Rwanda
  30. RSSB (Rwanda Social Security Board): Maternity Leave
  31. Women on Waves: Abortion Law in Rwanda
  32. World Abortion Laws Map
  33. Rwanda: Government Moves to Relax Anti-Abortion Law
  34. Rwandan rape survivors jailed for abortion despite law to help them
  35. Rwanda Abortion Law
  36. East Africa Centre for Law and Justice: Abortion in Rwanda
  37. Rwandan rape survivors jailed for abortion despite law to help them
  38. Why are more women opting for illegal abortion?
  39. Guttmacher Institute: Abortion in Rwanda, 2013