How do conversations on social media help to explain financial barriers to family planning services for Rwandan adolescent girls within the prevailing cultural and legal context?

PURPOSE: Financial barriers to health services have been identified in African countries. Rwanda has a pro-poor, countrywide insurance scheme that includes a package of family planning services. However, there is lower utilisation by adolescents. This qualitative study explored conversations on social media platforms around financial barriers to family planning in Rwanda, particularly for adolescents. The study's objective was to provide direction to policy revisions to improve access to contraceptives for adolescents. METHODS: A search string was used to capture conversations on social media around financing barriers to family planning services for adolescents. Key themes were identified through analysis of the content of these messages. The themes were compared with existing literature on this topic. RESULTS: There is a paucity of direct postings on public sites by adolescents, reflecting social stigma related to teenage sexual activity and lack of inter-generational dialogue on this subject. Key themes identified from the conversations were: prohibitive prices for socially acceptable contraceptives in the private sector, social stigma affecting access to affordable publicly available services and backfiring of well-intentioned laws and policies. CONCLUSION: The financial barriers to contraceptives by adolescents are compounded by legal frameworks, social and cultural factors and the intersection between them. The ‘relationship’ between the conversations captured on social media and socio-cultural and legal context is recursive. Careful consideration to both policies and interventions is required to increase access to contraceptives for adolescents.