Family Planning Providers and Contraceptive users in Rwanda Employ Strategies to Prevent Discontinuation

Background: Contraceptive discontinuation is a common event. Family planning programs often focus more on recruitment of new users as opposed to maintaining use among current users. A focus on sustaining users is imperative for long-term family planning program success. Methods: This qualitative study in Rwanda in 2018 included eight focus group discussions with 88 family planning providers and 32 in-depth interviews with contraceptive users. The data were collected in the two districts with the highest and lowest rates of contraceptive use, Musanze and Nyamasheke, respectively. The aim of this study is to better understand how providers and contraceptive users in Rwanda navigate one of the greatest challenges to family planning programs: contraceptive discontinuation. Results: Family planning providers and current users in Rwanda do not consider method discontinuation an option. Providers give support and medicine for side effects for continuers and counseling for those opting to switch. Current users are willing to try many methods until they find the right one for them – and once they find the right method, they plan to, or use the method, for long durations. Conclusions: The Rwandan family planning program is primed to meet the needs of users in their sustained use of contraceptives through empathetic and responsive counseling. Concurrently, family planning users are determined to use family planning to meet their desired family size goals. The matching goals of both providers and clients indicates that contraceptive use will likely continue to increase in Rwanda. Due to long periods of pregnancy prevention desired by users the increased use of long acting methods should be encouraged.