Access to healthcare is one of the fundamental rights of every child. However, children born to teenage mothers in Huye District are being deprived of this right due to difficulties in accessing community-based health insurance (Mutuelle de Santé). Many of these children are not officially registered under any household, either on the mother’s or the father’s side, as some families reject responsibility. In other cases, families agree to register the child but demand that the young mothers pay the health insurance contribution for the entire household an impossible burden for most.
Several teenage mothers who spoke to Impamo.net all under the age of 18 and requesting anonymity said their children face serious barriers to medical care because they are not recognized within any household classification system.
One 15-year-old mother, whose child’s father is unknown, shared her ordeal:
“When I returned home with my baby, my mother kept telling me that my father was about to kill the child. He would constantly say that he would never raise ‘children without Mutuelle, children who do not belong anywhere.’ He would remind us that he sent us to school, not to give birth.”
She added that life at her partner’s family was equally hostile:
“My in-laws insulted me daily, saying we enjoyed ourselves without them and that they were not responsible for raising our child. They kept saying the baby belongs nowhere. When the child falls sick, I am told to cover 100% of the costs. One day my baby was seriously ill and I went to RIB. An officer took pity on me and gave me 5,000 RWF so I could seek treatment. If I have money, I treat my child; if I don’t, there is nothing I can do.”
Another teenage mother, aged 17, said the father of her child continues to make promises without action:
“He keeps saying he will register the child under his household, but he does nothing. He now lives near us and has a job, yet he provides no support. The child is registered only under my name. He acknowledges the child but refuses to officially include them in his household. When the baby gets sick, I buy medicine from the pharmacy. He tells me to wait until he removes himself from his parents’ household so he can request his own classification and then include the child.”
Some young mothers said their children were eventually added to their parents’ household classification, but only under extreme pressure and emergency circumstances.
“My child was registered under my parents’ household only after she inserted a bean into her ear and became critically ill. My parents were reluctant. I later requested my own household classification, but my family is large, and they cannot afford to pay insurance for everyone. To this day, the insurance has not been paid.”
Another mother described discriminatory language and systemic barriers:
“The social affairs officer told me that there is no household classification for someone living with their parents ‘there is no category for prostitutes,’ he told me. There are 11 people in the household. When I ask why the insurance is not paid, they tell me it is my responsibility. I cannot afford it, so my child remains untreated.”
One particularly distressing case involved a teenage mother who was expelled from her home after becoming pregnant and now lives independently. She says she was subjected to sexual harassment while seeking administrative assistance:
“My mother chased me away. I tried to apply for my own household classification as someone living alone. When I went to the sector executive secretary, instead of helping me, he asked if I could come to his house in the evening so we could ‘discuss’ the issue. I refused. I later begged my mother to register me under her household and paid the insurance for the entire family myself.”
She added that the harassment continued even after childbirth:
“When I returned after giving birth, he told me that since I had refused his request, I would not get any household classification. I gave up. My child was later registered under a household, but I still live alone. I am asking for help so my child can be removed from that household and so I can pay Mutuelle independently.”
Local Authorities Respond
Kayitesi Seraphine, the Social Affairs Officer at Huye Sector, said that teenage mothers, like all citizens, should raise their concerns through community assemblies (inteko z’abaturage), where many social issues are resolved.
“When a child faces such challenges, we summon the parents and discuss the issue in community meetings. If they fail to attend, official summons (convocations) is issued by the Executive Secretary, with the support of DASSO. These structures exist to resolve such problems.”
Havugimana Curio Joseph, the Communications Officer at the Ministry of Local Government (MINALOC), clarified that the traditional Ubudehe categories are no longer in use.
“What people commonly refer to as Ubudehe categories has been replaced by a social registry system that captures the socio-economic profile of households. This system is now used, including for Mutuelle de Santé. All planning and social protection programs are based on this registry.”
Regarding children of teenage mothers, Curio emphasized that resolving these issues is a responsibility of local authorities:
“Parents who refuse to include their grandchildren in their households should be advised and sensitized. The best solution is dialogue so that children are recognized as household members. Expelling a child and allowing them to live in hardship is far worse than accepting the situation and moving forward together.”
He added that families and young mothers should report unresolved cases to authorities so that mediation and child protection mechanisms can be activated.
Legal and Human Rights Perspective
Sengoga Christophe, Head of Rights and Health at HDI, stressed that Rwandan laws provide strong protection for both teenage mothers and their children.
“Even when social systems fail, the law protects people. The law on sexual and reproductive health assigns parents the responsibility to guide, protect, and support children. The 2018 Law on the Rights of the Child clearly states that the child’s best interests must be prioritized and that no child should be subjected to abuse or neglect.”
He further cited Article 19 of the Constitution, which obliges parents to raise and protect their children from violence:
“Children have the right to healthcare and protection from violence. When families fail to protect them, they must be assisted and shielded from further harm.”
Government Guidance
MINALOC reports that the national social registry system has been in place since August 2022. Citizens are encouraged to dial *195# to verify their household information. If corrections are needed such as adding grandchildren or dependents individuals are advised to visit their local village or cell offices.
For teenage mothers living with their parents, authorities emphasize that childbirth does not automatically establish a new household. However, children must still be formally recognized within a family structure to ensure access to essential services, including healthcare.
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