Some women say it is hard to access antenatal care services from health centres for single mothers, as they are required to bring men who are responsible for their pregnancies, and often they are not available.
Pregnant women have to undertake at least four antenatal care visits. At the first time it is compulsory to bring husbands, or the men who are responsible for their pregnancies for HIV testing, a close which seems to be a barrier to single mothers.
From 6 am at Kacyiru health centre, pregnant women with their husbands are sitting outside, waiting for nurses to receive them.
Some are at their first phase, others came on the appointments given the previous time. 7 am, 2 nurses arrived and called couples to enter the room where they are going to receive instructions.
“Listen carefully, those who came alone at their first time without their husbands, please get out, don’t delay us. You know very well we can’t receive you,” a nurse spoke to the women, in a tough voice.
A big number of the women had come with the men on their side, however few of them were alone.
“Please, I’m still single, and the man who impregnated me don’t want to come with me. I beg you please, don’t send me back,” a woman said.
Despite the effort she made to explain her concern, nurses put her out saying that she should come with a document from local leaders, showing that she is single.
It has been the case for other women who came alone on that day.
Ariane Uwimana 28, (Not her real name), got pregnant when she was studying abroad. When she came back for a holiday, she paid Community Insurance to be able to give birth from a public hospital, which would be affordable to her.
However, when she went to the hospital for final antenatal care visit, as her pregnancy was on term, they refused to receive her, saying that she should come with the husband.
“I tried to explain that the father was not in the country and they totally denied me services. They told me to bring paper from the local leaders, and I didn’t know where to start from. I decided to go to the private hospital, despite the big amount of money I was going to pay,” she said.
Some bring fake husbands
Esperance Mujawamariya got an unwanted pregnancy and the father denied his responsibility. She went to the health centre for the first antenatal test and she was denied service and the next time she went backwith a friend who she presented to the nurses as her husband.
“It is done in my village, some even take their fathers in order to be given antenatal services. However, some especially teenagers and girls go there only when they are on labour,” she said.
Besides, even the married women sometimes meet the same challenge as these single mothers.
“Husband can work far from his home, or due to domestic violence, he may refuse to go together with his wife. It would be better if they become flexible and understand every woman as she comes because when she is denied service, it increases the health risks to the lives of both baby and mother which should be avoided if she was tested early,” she said.
According to the Ministry of Health, there no instructions denying women antenatal checkups when they come without their husbands, though it is highly recommended to maximize Prevention of Mother-to-child transmission, especially when it comes to HIV and Sexual Transmitted Diseases.
According to Ministry’s PMTCT instructions, when a pregnant woman goes to the health centre for antenatal checkup, health professionals have to receive her and tell her to bring her husband next time.
In urgent case, the health centre may even send an invitation letter to the husband, but he has to come willingly.
However, all these effort to find the father, should not be a barrier to the woman to get services she is searching from a health centre.
Infant mortality rate decreased from 56.9 deaths per thousand lives per births in 2007 to 27 deaths per thousand lives per births in 2018 mostly due to the effort put into antenatal care service.