Rwanda has taken a significant step in expanding access to abortion services with an updated ministerial order, published on November 29, 2024. The new order allows health centers and private clinics to perform abortions, provided they obtain authorization from the Ministry of Health. This change revises the 2019 directive, which limited abortion services to hospitals and polyclinics.
Under previous regulations, only medical doctors with at least a Bachelor’s Degree in Medicine, registered with Rwanda’s health regulatory body, were allowed to perform abortions. Nurses and midwives were excluded from this practice. With the updated guidelines, the scope for providing abortion services is broadened, potentially increasing access to safe reproductive healthcare.
A 2019 Ministry of Health report revealed that Rwanda had 1,648 registered doctors, with only 452 working in the public sector. In comparison, there were 15,050 nurses and midwives, with 7,593 employed in public health facilities.
The need for expanded abortion access has long been evident. A 2022 study by the World Health Organization and the Guttmacher Institute highlighted the risks associated with limited access to safe abortion services in Rwanda. The study found that nearly 50% of abortions were performed by nurses or untrained individuals, while 34% were carried out by traditional healers and 17% were self-induced. The government spends approximately $1.7 million annually on treating complications arising from unsafe abortions.
Reproductive rights advocates have long argued that restricting abortion services does not eliminate the practice but forces women to seek unsafe alternatives, which endanger their health. The updated ministerial order addresses this issue, aiming to provide more comprehensive and safer options for women.
Under Rwandan law, abortion is permitted within the first 22 weeks of pregnancy in cases of rape, incest, forced marriage, or when the mother’s life is at risk. While this expanded access is a positive step, challenges remain, particularly in terms of ensuring accessibility for women in remote areas or with limited resources.
This move signifies Rwanda’s continued commitment to improving reproductive healthcare and protecting women’s rights, ensuring that no one is left behind in accessing safe and legal abortion services.
