Women’s Perceptions and Attitudes Related to Family Planning Use among Poor Population in Rural Rwanda

INTRODUCTION: In 2012, Rwandan Government has declared family planning (FP) a national priority for poverty reduction and socioeconomic development. However, rural areas still contribute to higher fertility rates. OBJECTIVE: To explore factors to influence FP uptake in rural families. METHODS: This study used mixed (quantitative and qualitative) methods consisted of two separate surveys. The first survey (quantitative-based cross-sectional design) determined FP use in households while the second survey (qualitative-based design) identified socio-cultural factors which hindered FP uptake in households. In total, 119 households with women in reproductive age (15 - 45) were targeted in rural areas in Western province, Karongi District. The data collected during door-to-door visits using paper-based-questionnaires and administered through interviews. A database mask was designed under OnaCollect, then processed in SPSS software. The results were presented in tables of frequencies, the difference between proportions assessed using Chi-Square-test, the difference between means assessed using t-tests, significance at p = or <0.05, confidence level at 0.95, and a margin error of 0.09. RESULTS: Socio-cultural norms influenced no use of contraception (32.8%) or only promoted natural methods (12.6%). Social norms were religious in origin (38.5%) where Christianity (91.8%) discouraged modern methods (viewed as killing children) but encouraged using natural methods, preferably abstinence (73.3%). Cultural norms (17.9%) influenced families to have many children as resources of wealth, evidence of productivity, and a way to decrease parents’ workloads including assisting mothers in home-based activities such as cooking, and assisting fathers in farming activities such as keeping cows, goats and pigs. Other attitudes included gender-based issues (2.5%) mainly due to spousal disapproval (men dominated in taking FP decisions in families), whereas other non-users of modern methods (28.2%) feared side-effects. This study was registered with IRB: CMHS/IRB/097/2019. CONCLUSION: Religious, social, and cultural norms affect FP in rural areas. In order to accelerate FP uptake, men and religious leaders should be targeted as key partners who influence women’s choices.