Women's Perceptions and Attitudes toward Family Planning and Its Barriers in Poor Rural Settings: Advancing Rwanda’s Family Planning Policy

Rwanda's government designated family planning (FP) as a national priority for poverty reduction and socioeconomic development in 2012. Rural areas, on the other hand, continue to contribute to higher fertility rates. To help implement FP policies more successfully in poor rural communities, this study first explored sociocultural perceptions and attitudes that hinder acceptance of FP in poor rural households and then inferred crucial strategies that could be used to influence rural people’s perceptions and behavior shifts in favor of contraceptive use and smaller family size to take advantage of smaller families in terms of health and educational opportunities.

Mixed methods: a quantitative-based cross-sectional design determined FP use in households and a qualitative-based design explored socio-cultural factors that hindered FP use. In total, 119 households with women of reproductive age (15–45) in poor rural areas of Rwanda's western province, Karongi District, were targeted.

Socio-cultural norms did not influence contraception use (32.8 percent) or only promoted natural methods (12.6 percent). Social norms were religious in origin (38.5 percent), with Christianity (91.8 percent) discouraging modern methods (which were seen as killing children) and encouraging the use of natural methods, preferably abstinence (73.3 percent). Cultural norms (17.9 percent) influenced families to have a large number of children as a source of wealth, evidence of productivity, and a way to reduce parents' workloads, such as assisting mothers in family activities such as preparing food and assisting fathers in farming activities such as keeping cows, goats, and pigs. Other attitudes included gender-based issues (2.5%), primarily due to spousal disapproval (men dominated in making FP decisions in families), and other non-users of modern methods (28.2%) were concerned about side effects.

Religious, social, and cultural norms affect FP in poor rural areas. In order to speed up FP uptake, men and religious leaders should be targeted as key partners who influence women's choices.