Contribution of Contraceptive Use on Fertility Reduction in Rwanda


 Objectives: In this study, the contribution of contraceptive use on fertility rate reduction in Rwanda was assessed using the data from RDHS 2014/2015 and the sample was constituted with 5,954 household respondents where the targeted population were male between 15-59 years and female between 15-49 years of age, multinomial logistic regression was used to prove the full contribution of contraceptive use to the fertility reduction in the country in order to improve Rwandan’s welfare.Results: Compared to the traditional method and modern method it was found that 48.54% of male use modern method, while 5.39% uses traditional method; otherwise, 33.70% of female use modern method while 1.24% of female use traditional method, finally sexual and reproductive health programs should be encouraged and the parents must teach their children about the sexual and reproductive health (SRH) which will reduce the adolescent fertility which is rising day to day.


Introduction
Worldwide, 922 million women of reproductive age (or their partners) are contraceptive users. Among the 1.9 billion women of reproductive age (15-49 years) living in the world in (2019), 1.1 billion have a need for family planning, that means they are current users of contraceptives, 842 million use modern methods of contraception and 80 million use traditional methods or have an unmet need for family planning while 190 million women want to avoid pregnancy and do not use any contraceptive method, [1].
In Rwanda, the statistics by United Nations on the estimated prevalence of contraceptive use among women of reproductive ages (15-49 years) shows that in 2014, the 3,283,000 women of reproductive ages, 32.3% prefer to use any method, male and female sterilization are 0.1% and 0.8% respectively, pills are used at a rate of 5%, male condom was at 2.3%, rhythm (1.6%), and withdrawal at 1.3%, [1] Rwanda has shown a rise in the use of contraception from 17-52% between 2010 and 2015 due to the promotion of family planning. Despite, the increase in number of contraceptive use there still a high rate of fertility rate which is the increase of population growth in Rwanda, [2].
Most of the methods of contraception either modern or traditional are allowed in this country and we encourage people to use them to have families who they are able to feed and who they wish to have in the future at the right time. Those methods will help people to prevent unwanted pregnancies and some methods can reduce the possibilities of being affected by HIV/AIDS. Therefore, this study will help families and the government to stabilize the number of children born per year which will lead to a sustainable population growth and hence economic development, [3]. The problem we want to address in this research paper is about how we can increase the number of people using the modern contraceptive methods in order to reduce the fertility rate hence, stabilizing the population growth of the country.
The putpose of this research paper is to examine whether there is a contribution of contraceptive use on fertility rate reduction in Rwanda.

Methods
Multinomial Logistic Regression and STATA have been used to explain the variation and contribution of every explanatory variable.
The explanatory variables (gender, province, religion, place of residence, education level, and age) and the response variable (Contraception). Logistic regression is given by

Study setting
Rwanda is a land-locked country in the Great Rift Valley with a total population of about 12,663,116 in 2019, and the majority lives in the rural area where 17.6 % of the population is urban residents. Its population is equivalent to 0.17% of the total world population and the population density in Rwanda is 525 per Km 2 where the median age is 20 years , [ 4]. Basic on recent researches, it is shown that the fertility rate in Rwanda was 3.9 births per woman in 2020, which is reduced a half than it was in 1980 where fertility was about 8.4 births per woman (Macrotrends, Rwanda Fertility Rate 1950-2021, 2021) shows that Rwanda is taking a good step to reach the replacement level of 2.1 children per woman.

Data description
In this section of data description, the investigator will use the secondary data from Rwanda    Consequently, the country did not achieve its 2012 target of increasing contraceptive use to 70% as set in the FP strategic plan 2012-2016 by increasing access to contraceptive use to all women in all reproductive age group between 15 up to 49 years and increase source of information to sexual and reproductive health and contraceptive use, by increasing contraceptive facilities like hospital and educate people about use of contraceptive method will reduce fertility and vice-versa.

Conclusion
The most commonly used method among currently married women is injectable 24%, the pills 8% and the implants with 8%. However, the use of contraception among current married women varies by age gradually rising from 35% among women age 15-19 to peak of 58% among women age 35 to 39 before dropping to 42% women age to 45to 49 most women who have been sterilized are age 35 or old while young women are more likely to use non-permanently methods of contraception such injectable and pills. Therefore, Modern method is used more compare to traditional method where 48.54% of male use modern method while 5.39% use traditional method, 33.70% of female use modern method while 1.24% of female use traditional method. Moreover, the people between 25-29 age groups have a higher percentage of using pills compare to other method of contraception and the people who have completed secondary school have a higher percentage of using pills compare to other level of education. Finally, Policy makers should consider programs to keep girls in schools, at least up to secondary level. Furthermore, sexual and reproductive health programs should be encouraged in the adolescents.

Limitations
In 2010, Rwanda Demographic Health survey showed that 26% of women stated that the distance to the hospitals is a problem for family planning use. Therefore, Rwanda is trying to distribute the family planning services all over the country, in all districts in order to solve the issue so that people in all villages can access those facilities through the community-based provision of Family planning. Some facilities are expensive like injectable contraceptives, intrauterine devices, pills but others are free provided in all hospitals like condoms. Therefore, there is a need for advocacy on how many contraceptive facilities can be distributed around the communities and to provide the information to people about the use of contraception.