Improving mother health throughout pregnancy, labour, and the postpartum period is critical for saving lives and reducing pregnancy and childbirth problems. However, issues remain in Rwanda and throughout the globe.
Global maternal mortality in 2020 was 152 deaths per 100,000 live births, up from 151 in 2019.
Rwanda’s maternal mortality fell from 1,071 per 100,000 live births in 2000 to 203 in 2020.
This progress is due to initiatives to encourage women to give birth in hospitals and better prenatal care.
The New Times’ Davis Higiro spoke Rwanda Biomedical Centre’s Director of Health Facility Unit, Dr Regis Francois Cyiza, on strategies that have improved mother and newborn care and what more can be done.
Rwandan maternal health:
According to the Rwanda Demographic Health Survey, maternal health in Rwanda has improved dramatically over the previous 20 years. Maternal mortality has fallen from 1,071 per 100,000 live births in 2000 to 203 per 100,000 live births.
Most women deliver in hospitals, growing from 27% in 2000 to 93% in 2020. In 2020, 94% of hospital and health centre births were supported by a competent professional, up from 31% in 2000. In 2020, 98% of pregnant women had antenatal care (DHS 2019/2020). The total contraceptive rate is 64%, which helps reduce maternal mortality and improve mother health.
What has Rwanda done to enhance maternal health?
Due to political commitment, understanding and societal behaviour have changed, particularly for pregnant women. Community health workers and health care professionals now track and accompany pregnant women more closely.
Increasing and decentralising health facilities, so that each sector has at least one, and providing community-based health insurance (‘Mutuelle de Santé’) have also been important.
Increasing the number of health care personnel at health facilities (nurses, midwives, and physicians), training, onsite training via mentorships, and equipment and commodities have been game changers.
Do you no longer face any challenges?
Health care services require continual development, therefore I’d say there are no longer financial or geographical restrictions, however hilly areas may be a hindrance to accessing certain health facilities.
Increasing the number of health posts in each community is the Ministry of Health’s goal.
Many difficulties have been solved, however sustainability and continuing improvement are essential as health care services or systems are never 100%.
Prenatal and postpartum depression status? What do you do?
Prenatal and postnatal depression are rare in my clinical experience, but they do occur. Mental health department numbers, if any.
Rwanda infant mortality rate
Rwanda had 33 fatalities per 1,000 live births in 2020 (DHS 2019/2020), compared to 107 in 2000.
How were newborn deaths reduced?
Diarrhea, malaria, and pneumonia are significant causes of baby and under-5 mortality. Community health workers did this.
Improving the quality of health care services in institutions, decentralising them, and moving them closer to the people have also helped.
Improving the referral health system, raising awareness, and prompt health-seeking by parents have also helped lower infant mortality. Increased prenatal care and skillful births have helped reduce new-born mortality.
How can we enhance maternal health?
Pregnant women should seek prental care as soon as they realise they are pregnant, particularly in the first three months (1st trimester).
This helps women be followed up for any concerns they may have and prevents birth defects.
This includes counselling on diet, illness prevention, and preparing women to avoid complications during pregnancy, birth, or after.
All pregnant women should deliver at health facilities and seek medical assistance sooner for any problems their children may have, instead than contacting traditional healers or using traditional techniques, or waiting at home until the mother or newborn is too frail to be rescued.
Infants, moms, and family members need good diet and cleanliness. Ensure a healthy lifestyle through exercising and screening for malignancies, high blood pressure, and diabetes.
Family planning is vital for moms, babies, and the family.
Malaria may be avoided by using insecticide-treated bed netting. Malaria kills many young children under five.
Families should have health insurance to eliminate financial barriers to services.