








EndTeenagePregnancy,ExploringTheGapsIn AdolescentsSexualAndReproductiveRights
Goodday,everyone.
I am Emmanuel Bizimana, President of the Medical Students Association of Rwanda (MEDSAR) It is my honor to welcome you all to the Scientific Conference and MEDSAR Day 2024, themed “End Teenage Pregnancy: Exploring Gaps in Adolescent Sexual Reproductive Health and Rights.”
Emmanuel BIZIMANA
MEDSAR President2023-2024
We are privileged to have distinguished guests from the Ministry of Health, the University of Rwanda, WHO, UNFPA, UNICEF, AHF, NAR, and many other notable organizations MEDSAR, since its inception in 1997, has been committed to empowering medical students to become competent healthcare providers and public health leaders, with a focus on thinking globally and acting locally.
This conference is particularly significant as it directly aligns with our mission of initiating and participating in all programs that aim at promoting the living standards of Rwandan citizens Specifically, we are here to explore and address different gaps available in ASRHR The issue of teenage pregnancy presents significant challenges that demand our collective efforts. We are here to share knowledge, discuss strategies, and collaborate on creating positive change MEDSAR has played a pivotal role in developing leadership and clinical skills among medical students, many of whom now contribute significantly to various health sectors
Our pre-conference activities, including community health camps in Kirehe, Kayonza, and Burera districts, have made a substantial impact, increasing access to SRHR services and NCD screening We have reached over 23,000 people and provided services to more than 12,000 individuals This success is a testament to the dedication of the MEDSAR Executive Board and OrganizingCommittee
Much appreciation to our partners (WHO Rwanda, UNFPA Rwanda, UNICEF Rwanda, AHF Rwanda, HDI, CHAI, Rwanda NGOs Forum, AfriYAN, YLabs, RBC, Medical Doctors for Choice, Rwanda NCD Alliance, Rwanda Diabetes Association, University of Rwanda, University of Global Health Equity, Young Women Christian Association, and SFH) and attendees for your commitment to addressing ASRHR issues and enhancing the Rwandan health system. Your presence here today is invaluable, andIwishyouallafruitfulevent.
Thankyou
DearReaders,
WelcometothespecialeditionofourReport,dedicatedtotheScientific ConferenceandMEDSARDay2024 Wearethrilledtobringyou comprehensivecoverageandinsightsfromthislandmarkevent,held underthetheme"EndTeenagePregnancy:ExploringtheGapsin Adolescents'SexualandReproductiveRights."
Thisconferencehasbeenabeaconofknowledge,innovation,and collaboration,bringingtogetherhealthcareprofessionals,researchers, policymakers,advocates,andmedicalstudentsfromaroundtheworld.As youturnthesepages,youwilldelveintotheheartofthediscussions, exploringthelatestadvancements,sharinginthegroundbreaking research,anddiscoveringthestrategiesthatareshapingthefutureof adolescenthealthcare.
GAHIRE Hubert
MEDSARDay2024VChair
Ourgoalistoprovideyouwithawindowintotherich,impactfulsessions andworkshopsthattookplace,highlightingthecollectiveeffortsto addressteenagepregnancyandenhancethesexualandreproductive rightsofadolescents Theinsightsandexperiencessharedduringthis conferenceareinvaluable,andweareexcitedtopresentthemtoyouin thisedition
Wehopethatthismagazinenotonlyinformsbutalsoinspiresyouto contributetotheongoingdialogueandeffortsinimprovingadolescent healthcare Together,wecancreateamoreinformed,supportive,and healthiersocietyforouryouth.
Thankyouforjoiningusonthisjourney Enjoyreading!
Warmregards,
GAHIREHubert ViceChair|MEDSARDAY2024
Health camp
Kangukaumenye
TargetingtheKayonza,Burera, andKirehedistrictsfrom29th April2024to16thmay 2024.
CapacityBuilding
MEDSAR2edCB
Workshopwasheldon17th–18th may2024attheUniversityof Rwanda-HuyeCampus Scientificconference MEDSARDay24 on1stjuneatlemigohoteli;policy markers,ASRHRAdovocate, NGOleadersand more300 medicalstudentshadafruitfull
In Rwanda, Sexual and Reproductive Health and Rights (SRHR)forwomenandgirlsfacesignificantchallengesdue to insufficient access to quality services and information A study revealed that while 943% of health facilities provide information on SRH services to adolescents, only 51.6% offer these services at a low cost. The accessibility of some servic-esremainslimited.
Non-communicable diseases (NCDs) are a major health burden, accounting for 50% of all deaths in Rwanda as of 2019. In resource-limited countries, NCDs account for 85% of all premature deaths among individuals aged 30-69 years.
Mental health awareness efforts in Rwanda are progressing, but gaps persist. Despite the high prevalence of mental disorders among the general population and genocide survivors, utilization of available mental health services is low Approximately 25% of Rwandan citizens struggle with post-traumatic stress disorder (PTSD), and one in six people suffer from depression. These statistics highlight the need for ongoing interventions to improve overallhealthoutcomesinRwanda.
That's when I feel most alive, when I'm helping people. Paul Farmer
Overview
TotalIndividualsReached:7000
ServicesProvided:2320individuals
SRHR Services
HIV Testing:1150
individuals(10positive)
Family Planning:1340
individuals
CondomUse:800
BirthControlPills:210
InjectableContraceptives:160
Implants:150
IntrauterineDevice(IUD):20
PermanentContraception:0
NCDs Services
BMI Screening:2300
BP Screening:2300
Blood Sugar Screening:2200
The best way to find yourself is to lose yourself in the service of others MahatmaGandhi
Volunteers do not necessarily have the time; they just have the heart
ElizabethAndrew
Overview
TotalIndividualsReached:8000
ServicesProvided:2180individuals
SRHR Services
HIV Testing:1275individuals
(19positive)
Family Planning:1739
individuals
CondomUse:1051
BirthControlPills:234
InjectableContraceptives:170
Implants:227
IntrauterineDevice(IUD):38
PermanentContraception:6
NCDs Services
BMI Screening:2149
BP Screening:2150
Blood Sugar Screening:2104
Overview
TotalIndividualsReached:7500
ServicesProvided:2554individuals
SRHR Services
HIV Testing:1940individuals (12positive)
Family Planning:1484 individuals
CondomUse:628
BirthControlPills:75
InjectableContraceptives:143
Implants:406
IntrauterineDevice(IUD):24
PermanentContraception:5
NCDs Services
BMI Screening:2549
BP Screening:2549
Blood Sugar Screening:2472
Volunteers do not necessarily have the time; they just have the heart
ElizabethAndrew
The second edition of the MEDSAR-CB Camp, held from May 17th to 18th at the KOICA Building on the University of Rwanda's Huye Campus, gathered MEDSAR members to tackle the critical issue of teenage pregnancy in Rwanda. The focus was on identifying gaps in adolescents' sexual and reproductive rights (SRHR) and devising actionable strategies to enhance comprehensive Adolescent Sexual and Reproductive Health (ASRH) services Through expert-led discussions and interactive sessions, the workshop aimed to empower participants to advocate for youth-friendly SRHR services and improve thewell-beingofadolescentsinRwanda.
Webuildagenerationto change theRwanda healthsystem MEDSARis aproduc extracurricularformed students,theygain knowledge andskillstochallengetrending healthissue
Ms IRYANYAWERA Marie Claire
MOH
PUBLIC HEALTH STRATEGIES FOR ACCESSIBILITY AND AWARENESS OF ADOLESCENT SRHR SERVICES
Objectives:
I.Toexplorecommunity-centeredapproachesinraising awarenessaboutadolescentSRHR.
II.Tounderstandtherolesofyouthcenters,NGOs,and governmentinitiatives.
IIIToexaminetheinfluenceoftechnologyandsocial mediaonSRHRaccessibility
Outcomes:
Participantsgainedinsightsintosuccessful community-centeredSRHRprograms. Identifiedpracticalstrategiesforleveraging technologyandsocialmediatoimproveSRHR awareness
Developedactionplansforenhancingcollaborations betweengovernment,NGOs,andyouthcenters
Key Discussions:
Community-Centered Approaches: -ImportanceofinvolvinglocalcommunitiesinSRHReducation -SuccessstoriesfromyouthcenterseffectivelyprovidingSRHRSerivices -CollaborationwithNGOstoextendoutreachprograms Role of Youth Centers and NGOs: -YouthcentersassafespacesforadolescentstoreceiveSRHRservices -NGOs’contributionstoresourceprovisionandprogramimplementation -PartnershipmodelsbetweengovernmentandNGOs
Influence of Technology and Social Media: -UtilizingsocialmediaplatformstodisseminateSRHRinformation -DigitalliteracyprogramstohelpadolescentsaccessreliableSRHRresources -CasestudiesonsuccessfulSRHRawarenesscampaignsconductedonline
APPROACH TO ADOLESCENTS’ ACCESS TO CONTRACEPTION AND HIV/AIDS PREVENTION MEASURES
Objectives:
I Todiscusseffectivesexualeducationandinformeddecision-making
II ToaddressstigmarelatedtocontraceptionuseandHIV/AIDS
III Topromotecollaborativeapproachesforcontraceptionuseand HIV/AIDSprevention
Outcomes:
Enhancedunderstandingofcomprehensivesexualeducation. Practicalapproachestoaddressingstigmaandpromoting contraceptiveuse.
Collaborationframeworksforimprovingaccesstocontraception andHIV/AIDSpreventionservices
Key Discussions::
Sexual Education:
-Comprehensivesexualeducationcurriculatailoredfor adolescents -Techniquesforengagingadolescentsindiscussionsaboutsexualhealth. -Importanceofparentalinvolvementandcommunitysupport
Stigma and Prevention:
-StrategiesforreducingstigmaassociatedwithcontraceptionandHIV/AIDS -Communityoutreachprogramstonormalizecontraceptiveuse. -BestpracticesforHIV/AIDSpreventionandeducation
Collaborative Approaches:
-Multi-sectoralpartnershipstoenhancecontraceptionandHIV/AIDSservices -IntegrationofcontraceptionandHIV/AIDSpreventionintoprimaryhealthcare. -RoleofpeereducatorsinpromotingSRHRamongadolescents
ASRH SERVICES THROUGH THE LENS OF EQUITY AND HUMAN RIGHTS
Objectives:
IToapplyhumanrightsprinciplestoASRHservices
IITopromoteequityandinclusivityinASRHservices
IIITostrengthenmulti-sectoralapproachesensuringculturalsensitivity
Outcomes:
Participantslearnedtoincorporatehumanrights principlesintoASRHservices.
Developedstrategiestoensureequityandinclusivity inSRHRprograms.
GainedskillsindeliveringculturallysensitiveSRHR services
Human Rights Principles
-Understandingtherights-basedapproachtoSRHR
-InternationalandnationalframeworkssupportingadolescentSRHR
-Casestudiesonrights-basedASRHservices
Promoting Equity and Inclusivity:
-AddressingdisparitiesinSRHRaccessamongdifferentadolescentgroups
-Strategiesforinclusiveservicedeliverythatrespectsculturalcontexts
-ProgramsthatsuccessfullypromoteequityinSRHR
Cultural Sensitivity:
-ImportanceofculturalcompetenceinSRHRserviceprovision
-Traininghealthcareprovidersonculturalsensitivity
-Buildingtrustwithincommunitiesthroughculturallysensitivepractices
HEALTHCARE PROVIDERS' TRAINING AND ROLE IN PROVIDING YOUTH-FRIENDLY SRHR SERVICES
Objectives:
IITointegrateSRHRintomedicaleducationandtraining
IIToidentifybestpracticesforadolescents’healthservices
Todevelopeffectivecommunicationstrategiesandculturalsensitivity
Outcomes:
ImprovedintegrationofSRHRinmedicaleducation. Identificationofbestpracticesforyouth-friendly SRHRservices.
Enhancedcommunicationskillsforhealthcare providers.
Key Discussions:
Medical Education:
-IncorporatingSRHRtopicsintomedicalandnursingcurricula -Continuousprofessionaldevelopmentforhealthcareproviders -EvaluatingtheimpactofSRHRtrainingonhealthcaredelivery Best Practices:
-Adoptingevidence-basedpracticesinadolescenthealthservices
-Roleofyouth-friendlyclinicsinprovidingSRHRservices
-CasestudiesofsuccessfulSRHRservicemodels Communication Strategies::
-Techniquesforeffectivecommunicationwithadolescents
-AddressingculturalbarriersinSRHRdiscussions
-AddressingculturalbarriersinSRHRdiscussions
SHAPING THE FUTURE OF ADOLESCENT SRHR THROUGH RESEARCH AND EXCHANGE
Objectives:
II.Toemphasizetheimportanceofmedicalethicsandclinicalprofessionalism. IITopromoteinnovativeresearchinadolescentSRHR IIIToadvocateforpolicydevelopmentsupportingSRHRservices
Outcomes:
ParticipantsgainedanunderstandingofethicalissuesinSRHRresearch IdentifiedinnovativeresearchapproachestoimproveSRHR Developedskillsforeffectivepolicyadvocacy
Key Discussions:
Medical Ethics and Professionalism:
-EthicalconsiderationsinadolescentSRHRresearch
-Professionalresponsibilitiesofhealthcareproviders
-Balancingpatientconfidentialitywithpublichealthneeds. Innovative Research:
-Cutting-edgeresearchmethodologiesinSRHR
-Collaborationbetweenacademicinstitutionsandhealthcareproviders -Impactofresearchfindingsonpolicyandpractice.
Impact of research findings on policy and practice. -StrategiesforinfluencingSRHRpolicies
-Roleofevidence-basedadvocacyinpolicydevelopment
-CasestudiesofsuccessfulSRHRpolicyinterventions.
“EXPLORING AND ADDRESSING GAPS IN THE ASRHR, INCLUDING RAISING HIVCASES
..Cultural norms isakey player
We need to do it right now, no time to wait.
Dr. NDUWIMANA Colyse CHAI
We are failingthe unprivilegedadolescents Icallto collaboration ,innovation, Prioritizing them.
Dr. Christelle UGHE
....unused facilities, unskilled HCPs,lackofinclusivity
We need fostering meaningful inclusive youth participation Ms. Angel AfriYAN
Proactively engage in the ASRH advocacy and ending teenage pregnancy
Ms Benithe
“DO YOU BELIEVE ALLOWING ADOLESCENTS TO USE CONTRACEPTIVE METHODS WILL MITIGATE TEENAGE PREGNANCY?”
Adolescents engage in early sex .... FPalonewill not stop teenage pregnancy, good parentingand adolescents centered will also help
Ms. Gato Saidath PIH-IBM
...Usecontraceptivesis notreallyaproblem but they should be informed
Eugene Karangwa RBC
Theyneed to acquire Infosaboutcontraceptive methodsat a young age
Ms. UWICYEZA grace
AHF
EveryoneShould t ASRH problems as his/her own problem
Ms Sandrine
RWANDA:
ThisstudyusedmixedmethodstocollectandanalyzedataonASRH services Both quantitativeandqualitativedatawerecollectedfrom adolescentsandyoungpersons,with andwithoutdisabilities The quantitativeanalysisincludeddescriptivestatistics,chi-square tests,andlogisticregression,focusingonriskysexualbehaviorasthe outcomevariable The qualitativedatawereanalyzedusingthematic contentanalysis Variableswithp<005were consideredsignificant
Dieudonne Ndatimana PrincipalInvestigator:
AccesstoandutilizationofASRHservices amongadolescentswithdisabilityglobaly remainspoor ASRHservicesinRwandaare primarilyofferedinhealthfacilities Rwandahas madesignificantprogressinimprovingthe SRHofitspopulation,especiallyyoung persons However,youngandadolescentpersonswith disabilitiesstillfacemanybarriersand challengesinaccessingSRHservicesand information
Thisstudyaimtogenerateevidence-baseddataand informationaboutthe statusofknowledgeattitude,practices,prevalenceof SRHissuesandbarrierstoaccessand utilizationofASRHadolescentsandyoungpersons withdisabilitiesinRwanda Thegenerated evidencewillinformpolicyandpracticetoimprove ASRHoutcomesforadolescentsand youngpersonswithdisabilitiesinRwanda
Thestudyshowsadolescentswithdisabilitiesfacemorechallenges, engagein riskiersexualbehavior,andhavelessaccesstosexualhealth servicescomparedtothosewithoutdisabilitiesThefindingshighlight theneedfortargetedinterventionsforadolescents withdisabilities
Tuyishimire Norbert Co-Investigator:
Teenagepregnancyremainsasignificantpublic healthissueglobally,withadverseeffectssuch asunsafeabortionsandeducationaldisruption InRwanda,despiteaglobaldecline,teenage pregnanciesarerisingduetofactorslikelimited contraceptionknowledge,economic challenges,andfamilyconflicts,exacerbatedby COVID-19’simpactonhealthcareaccess.Efforts toimproveeducationandhealthservicesface barrierslikedistanceandculturalnorms,while gender-basedviolenceandsubstanceabuse alsoplayarole Understandingtheinterplayof thesefactorsandthecircumstancesofyoung mothersiscrucialfordevelopingeffective preventionstrategies.
Describingthelevelofaccessandbarriersto utilisationofASRHinformationamongyoung mothersandadolescentsaged15-19yearsold,
2
1 Toidentifythepsychosocialriskfactorsofteen pregnancyamongyoungmothersandfinallyto describethecurrentlivingcircumstanceofyoung mothers
Thestudyutilizedacase-controldesignacross selectedRwandandistrictswithhighteen pregnancyrates,comparingpregnantteensand non-pregnantadolescentsmatchedbyageand location.Statisticalanalysis,includingthe McNemartest,wasconductedtoidentify significantfactorsassociatedwithteenpregnancy.
Age and Pregnancy Status
School Attendance and Pregnancy
Education Completion
Risk Factors for Adolescent Pregnancy
Toaddressteenpregnancy,it’sessentialtofostercommunitydialogue, expandyouth-friendlyhealthservices,combatgender-basedviolence throughpreventionandsupportprograms,andprovidepsychosocial supportalongsideeconomicopportunitiesforyoungmothers
Delphine Mizero
MBBS25UGHE MedicalStudent
Exploring the immediate socioeconomic impacts of pregnancy on teenage mothers in Rwanda: The Case of Nyampinga Ubushoye Project”
Thestudyinvestigatesthesocioeconomic consequencesofteenagepregnancyinRwanda, focusingontheNyampingaUbushoyeProject Thisinitiativeaimstounderstandthechallenges facedbyyoungmothersandassesstheproject’s effectivenessinmitigatingtheseimpacts
MANIRAKOMEYE Jehovanis
MBBS26UR-CMHS MedicalStudent
Exploring the gaps in ASRHR Knowledge, Attitudes and Practices of Secondary School Teachers and CHWs in Rwandan rural areas
Thisstudyinvestigatestheknowledge,attitudes, andpracticesrelatedtoASRHRamong secondaryschoolteachersandCHWsinrural Rwanda.Byidentifyinggapsandchallenges,the researchaimstoinformtargetedinterventions andimproveASRHReducationandsupport
“STRATEGIC
Mr GAHIRE Hubert
VicechairofMEDSAR DAY24
The2030Agendasetout17SustainableDevelopment Goals(SDGs)whichwereadoptedbyallMember StatesoftheUnitedNationsin2015.Tobuildonthis long-termdevelopmentplan,andtoguideits implementationoftheSDGs,theMedicalStudents AssociationofRwanda(MEDSAR)hasdevelopedthe AdolescentandYouthHealthStrategicPlan(20242030) ThisidentifieskeysuccessfactorsforRwandato achievetheSDGs Oneoftheseisto:“EnhanceSocial CohesionandResilience”,includingtheprovisionof “AdequateAccesstoHealthCare
Thepurposeof AHYP-MEDSAR30Policy,istoestablish arobustandcomprehensiveframeworkthatguides theMedicalStudents’AssociationofRwanda (MEDSAR)initseffortstoaddressthecriticalissueof teenagepregnancyandtoupholdthesexualand reproductivehealthrights(ASRHR)ofadolescents This policyisdesignedtoensurethatMEDSAR’sinitiatives andoperationsarestrategicallyalignedtopromote ASRHR,preventingteenagepregnancy,and guaranteeingthatadolescentshaveaccesstoessential healthservices,education,andsupportmechanisms
1|PromoteAwareness Toenhancethe understandingand awareness
2|PreventTeenage Pregnancy Toimplementstrategic initiativestoaddressthegap
3|Advocatefor ASRHR Forpoliciesandpractices thatupholdASRHR
4|AccesstoServices Toensurethatadolescents haveunfetteredaccessto essential
The conference included an exhibition area where healthcare-related NGOs and institutions showcased their products, services, and initiatives The exhibitions provided a valuable opportunity for participants to learn about innovative healthcare solutions, network with representatives from various organizations, and explore potential collaborations. The exhibition area was a vibrant space that facilitated knowledge exchange and the dissemination of best practices in ASRHR
Based on the discussions and outcomes of the conference, several recommendations were made:
Expand Community Outreach Programs: Continue and expand community outreach programs like “Kanguka Umenye” to improve access to SRH services and education in underserved areas.
Enhance Capacity Building Efforts: Strengthen capacity-building efforts for medical students and healthcare providers through workshops, training sessions, and mentor ship programs
Foster Multi-Sectoral Collaborations: Promote interdisciplinary and multisectoral col laborations to address ASRHR challenges effectively.
Implement Supportive Policies: Advocate for and implement policies and initiatives that prevent early pregnancies and support adolescents’ health and rights
Engage Adolescents and Parents: Involve adolescents and their parents in shared decision-making processes related to SRH to ensure that services and interventions meet their needs and preferences
SRHR:SexualandReproductiveHealthand Rights
SRH:SexualandReproductiveHealth
ASRH:AdolescentSexualandReproductive Health
ASRHR:AdolescentSexualandReproductive HealthRights
FP:FamilyPlanning
STI:SexuallyTransmittedInfection
HIV:HumanImmunodeficiencyVirus
AIDS:AcquiredImmunodeficiencySyndrome
GBV:Gender-BasedViolence
FGM:FemaleGenitalMutilation
CSE:ComprehensiveSexualityEducation
UNFPA:UnitedNationsPopulationFund
LGBTILesbianGayBisexualTransgenderand Intersex
MCWHMaternal,ChildandWomen’sHealth
MDRMulti-drugResistant
WHO: World Health Organization
UNAIDS: Joint United Nations Programme on HIV/AIDS
UNESCO: United Nations Educational, Scientific and Cultural Organization
UNICEF: United Nations Children’s Fund
AIDS: Acquired Immunodeficiency Syndrome
AYFS: Adolescent and Youth Friendly Services
ARVs: Antiretrovirals
AYHP: Adolescent and Youth Health Policy
CBO Community-based Organization
CHW Community Health Workers/Community Care Workers
FBO Faith-Based Organisations
HIV Human Immunodeficiency Virus
HCT HIV Counselling and Testing
ISHP Integrated School Health Programme