• Rwanda has scaled up its Community Based Provision Programme across the country. Through this programme, all community health workers are trained on the provision of pills, injectables (DMPA), male and female condoms, and cycle beads, provide them and refer women to the health center if a client wants to change her method, or if a client is a new family planning user. Community health worker data is reported to the health center; they have never experienced stock out.

• All 45,000 community health workers provide comprehensive information on family planning and refer clients to health facilities for long acting and permanent methods, according to the informed and free choice Integrated Maternal and Child Health Week Campaigns are organized twice a year and constitute a good opportunity to provide information and services on family planning. Additional opportunities include Community Work (Umuganda) organized on a monthly basis (last Saturday of each month), World Population Day Commemoration (11 July), Vasectomy day (18 October), International Women Day (8 March), State of World Population day, World AIDS Day, etc.

• Behavior change communication materials on family planning have been developed and are currently being distributed to the general population with the aim of increasing awareness on family planning benefits, addressing social norms, rumors and misconceptions around family planning and impacting behavior change.

• However, unmet needs for family planning is still high and requires strengthening awareness of the general population including young people, parents and teachers in order to increase the demand side and reach the Contraceptive Prevalence Rate targets in Economic Development Poverty Reduction Strategy II.

• Long acting methods (Intra Uterine Device and Implants/Jadelle) were scaled up in all health facilities and each health facility has at least two health providers skilled in insertion and removal of the above methods. To increase methods mix and broad range of contraceptives, Implanon has been introduced and as end of August 2014, 17 out of 30 districts are covered. Vasectomy and Tubal ligation were also scaled up in all hospitals. 

• Rwanda has already made significant progress in the implementation of family planning and other health services integration. Policies were reviewed regarding the integration of family planning and other health indicators. Many tools were also reviewed towards monitoring the integration of family planning and other health services and programs. Family Planning indicators are also included in the Health Management Information System (HMIS), and reported by health facilities. 

• On the job trainings are being offered to family planning providers for all facilities. Family planning related topics are shared at staff meetings with other health topics. Joint supervisions are conducted on a quarterly basis by central, district hospital and health center levels. Ministry of Health monthly coordination meetings are held with the inclusion of family planning on the agenda.

• All of these interventions are intended to ensure high quality integrated family services in Rwanda.

• Quality assurance, supervision, and monitoring and evaluation activities are conducted on regular basis to ensure the implementation of family planning activities

During the London Summit on Family Planning, the government of Rwanda committed to ensuring the availability of family planning services in each of the 14,841 Rwandan administrative villages (Imidugudu) through delivery by the 45,000 community health workers already in service. In 2014, the government reported that family planning services had been scaled across the country through community health workers.

In 2015-2016, the government of Rwanda reported that family planning services were provided countrywide at community level by Community Health Workers (CHWs) and the following activities were undertaken in support of this commitment:

• Updating and procuring FP tools used at community level, related to the register, supply chain management, reporting, and referral forms for CHWs
• Training new CHWs to overcome the dropout among CHWs and additional CHWs (ASM)
• Refresher training of already trained CHWs
• Training and monitoring of the Supply Chain Management and Waste Management system.

The government of Rwanda engaged in the following activities to expand existing family planning communications programs to raise awareness of family planning choices:

• A communications campaign was organized countrywide to raise awareness of FP choices and provide clear messages on contraceptives, benefits of FP use, and management of side effects. All four provinces and Kigali City were reached and 10 districts out of 30 conducted a special mobilization through community events, dramas, and meetings with community leaders.
• Mass mobilization activities were planned and organized by the Rwanda Health Communication Center (RHCC) with regular talk shows on national and local radios and TVs
• Training of journalists and the creation of a network of journalists on reproductive health and maternal and child health (including family planning)

The Government of Rwanda engaged in the following activities to introduce LAPMS and high-quality integrated family planning services in hospital and health centers:

• Health care providers from hospitals and health centers were trained on the clinical FP focusing on long-acting Methods (Implants and IUDs) for two weeks per session, with one week for theory and exercises on anatomic models and one week for practice on clients
• Physicians and counselors were trained on FP permanent methods: In total 22 district hospitals were trained on Tubal Ligation on local anesthesia (MINILAP) and 10 district hospitals trained on No Scalpel Vasectomy (NSV). The validation of trained staff and the post training follow will continue across the 2016-2017 year.