Rwanda’s health centers authorized to perform legal abortions

By The Inspirer.

A ministerial order issued by the Ministry of Health in Rwanda now allows health centers and private clinics to legally perform abortions, provided they are authorized to do so.

Previously, civil society organizations working in sexual and reproductive health had raised concerns that legal abortion services were accessible only at higher-level medical facilities, making it difficult for many women and girls in need to access them.

The law permits medical facilities to perform abortions under specific circumstances, including:

• Pregnancy resulting from rape.
• Pregnancy from forced cohabitation, such as child marriage.
• Pregnancy caused by incest, up to the second degree of kinship.
• When the pregnancy endangers the health of the mother or the fetus.
• Cases where the pregnant individual is a minor.

The Ministerial Order of November 29, 2024, outlines the requirements for medical practitioners to provide abortion services and expands the types of facilities authorized to perform the procedure.

The most notable change is in Article 5, which states:
“Abortions can be performed in public or private health facilities authorized by the Ministry of Health to operate as hospitals, health centers, or polyclinics. However, the Ministry of Health may also grant permission to clinics meeting specific requirements to provide abortion services after thorough assessment.”

Rwanda currently has over 512 health centers, and the government plans to ensure that all of them are staffed with qualified medical professionals within the next three years to offer services typically available only at hospitals.

The Health Development Initiative (HDI Rwanda) welcomed the changes, stating:
“This reform is a significant step in protecting the health and lives of women and girls, particularly in addressing the severe consequences of unsafe abortions, which often lead to injuries or death. This decision increases access to safe, reliable, and timely health services for women and girls in need.”

Data from the Rwanda Biomedical Center (RBC) shows that between 2020 and 2023, 4,378 women and girls underwent legal abortions for various reasons. The statistics reveal that:

• 60% were due to rape.
• 32% were because the pregnancy endangered the mother’s or fetus’s health.
• 3% involved minors.
• 2% were due to incest.
• 1% resulted from forced cohabitation.

A study by the National Commission for Human Rights found that 57.1% of girls under 18 who became pregnant were impregnated by someone they knew, such as friends or acquaintances.

In 2023 alone, 75 children aged 10 to 14 gave birth in Rwanda, underscoring the urgent need for expanded access to reproductive health services.

The law stipulates that abortions, except when the pregnancy endangers the mother or fetus, must not exceed 22 weeks of gestation.