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Abortion is illegal in Rwanda except when necessary to protect a woman's physical health or to save her life. Many women in Rwanda obtain unsafe abortions, and some experience health complications as a result. To estimate the incidence of induced abortion, we conducted a national sample survey of health facilities that provide postabortion care and a purposive sample survey of key informants knowledgeable about abortion conditions. We found that more than 16,700 women received care for complications resulting from induced abortion in Rwanda in 2009, or 7 per 1,000 women aged 15-44. Approximately 40 percent of abortions are estimated to lead to complications requiring treatment, but about a third of those who experienced a complication did not obtain treatment. Nationally, the estimated induced abortion rate is 25 abortions per 1,000 women aged 15-44, or approximately 60,000 abortions annually. An urgent need exists in Rwanda to address unmet need for contraception, to strengthen family planning services, to broaden access to legal abortion, and to improve postabortion care. (StudieS in Family Planning 2012; 43[1]: 11-20).

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The Millennium Challenge Corporation (MCC), a US foreign aid agency working with selected countries, emphasises rigorous evaluations to support poverty reduction through economic growth. MCC's experience with early impact evaluations and its growing evaluation portfolio has motivated actions to enhance the quality of evaluations. Specifically, MCC has introduced formal reviews that (i) better balance evaluation designs to ensure learning while respecting accountability, (ii) more selectively use impact evaluations and (iii) strengthen the programme logic and its documentation. MCC has also developed an explicit results dissemination strategy to ensure public access to evaluation results and most evaluation data, subject to ethical protections of respondents.