Rwanda

Samson Radeny

ihadmin2 — Tue, 26 Sep 2023 20:30:37 +0000

Samson Radeny East and Southern Africa regional director ihadmin2 September 26, 2023

Samson Radeny is a senior international development professional with over 20 years of experience developing and implementing health and social development programs. He has honed an exceptional balance of technical, leadership, and managerial skills over the course of his career, overseeing multi-sectoral projects in more than ten African nations.

Radeny is highly skilled in designing and executing programs to catalyze change in host communities, positioning local organizations to lead and sustain results.

Prior to joining IntraHealth, Radeny served as chief of party of the USAID/Rwanda Improved Services for Vulnerable Populations (ISVP) Program, which aims to promote resiliency among highly vulnerable communities and families.

Radeny earned his master’s degree and doctorate in sociology from the University of Nairobi, Kenya.

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Community Advocacy Leads to New Maternity Unit at Rwanda Health Center

cbales — Tue, 11 Jul 2023 14:21:08 +0000

Community Advocacy Leads to New Maternity Unit at Rwanda Health Center cbales July 11, 2023

July 11, 2023

An innovative approach is helping community members, health workers, and local leaders improve maternal care.

For years, maternity services at Gashaki Health Center in Rwanda’s Muzanze District were hindered by poor infrastructure, congestion, and a lack of community participation.

“We had such a small delivery room that we couldn't accommodate more than two women at the same time,” says Sylvain Ndagiwenimana, the health center manager. “This lack of space contributed to an increase in home deliveries.”

Now clients and community members have a say in the type and quality of services they receive.

Lack of space contributed to an increase in home deliveries.

The USAID-funded Ingobyi Activity, led by IntraHealth International, used a Patient Voice Program–Citizen Voice and Action (PVP-CVA) approach to enhance service quality at the health center. PVP-CVA gives health facity leadership and districts insights into how the community views the services they provide and offers community members the opportunity to participate in efforts to improve service delivery.

After a January 2019 data review and analysis showed the health center was consistently under-performing in most indicators related to reproductive, maternal, newborn, and child health (RMNCH) and malaria, Ingobyi targeted Gashaki Health Center with the PVP-CVA intervention.

In May 2019, Ingobyi organized a “scorecard meeting” with community members, health workers from the health center, and some of the district leaders. Community members listed services they received at the health center and ranked their quality. One of the issues that stood out was the old maternity unit, which didn’t provide a comfortable place for delivery or postpartum stay.

Women are now happy to deliver in the new maternity unit.

The meeting participants agreed the facility needed a new maternity unit and formally advocated to district leaders to provide the funds for a new building. In December 2019, district leaders promised to allocate funds in the next fiscal year budget to build a new, modern maternity unit at the health center.

Construction began in November 2021 and the new maternity unit opened its doors in August 2022. Since completion, 330 women have delivered their babies in the new maternity ward.

“The new maternity unit offers much space and ensures privacy to our clients,” Ndagiwenimana says. “Women are well received and are happy to deliver in this new unit. The average quality score for maternity services has increased from 81% in 2021 to 100% in 2023.”

A nurse (right) and Ingobyi Activity staff member (left) visited the new maternity unit while it was under construction. Photo by Bosco Bazimaziki for IntraHealth International

More than a maternity unit

This is just one result of the PVP-CVA approach, and shows what can be achieved when communities, health workers, and local leaders come together.

The approach came into being back in September 2018. That was when the Ministry of Health introduced the Patient Voice Program (PVP) initiative in administrative sectors to promote interaction between health workers and patients to ensure continuous improvement in quality of care. Around the same time, Ingobyi introduced the Citizen Voice and Action (CVA) approach with an added aspect of engaging local government and community members in dialogue with health workers to find solutions to health system challenges. The ministry and Ingobyi integrated the two initiatives with the aim of strengthening community participation in improving the quality of RMNCH and malaria services.

When Ingobyi applies the PVP-CVA approach, community members learn about health as a basic human right, and work collaboratively with leaders and health workers to compare their reality against the government’s commitments to universal health coverage. The approach enables joint action planning to address structural, policy, and service delivery gaps.

Four elements of the PVP-CVA approach

Ingobyi created a PVP-CVA user manual and has used it to orient more than 850 district leaders across 20 districts on the approach and to establish and train 245 PVP-CVA working groups with 4,827 members. The working groups have supported 267 health centers, under the supervision of Ingobyi staff and district health leaders, and have facilitated community meetings involving 17,527 community members to gather community feedback on RMNCH and malaria services.

At least 64% of the gaps identified from the community meetings have been resolved, including absence of nurses during break hours, uncleanliness due to insufficient sanitation materials, poor customer care, lack of privacy in maternal units, and delay in receiving patients and offering services. Ingobyi is urging district and central leaders to address the remaining issues that have been raised by communities.

Read more about Ingobyi Activity’s PVP-CVA approach here.

By Betty Murerwa

Community health engagement specialist

Maternal, Newborn, & Child Health Policy & Advocacy Quality of Care Rwanda

Is In The Media

The new maternity unit at Gashaki Health Center. Photo courtesy Mathieu Niyonkuru

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How Can We See More Smiling Babies in Rwanda and Around the World?

ihadmin2 — Mon, 15 May 2023 13:53:58 +0000

How Can We See More Smiling Babies in Rwanda and Around the World?

ihadmin2 May 15, 2023

May 08, 2023

Health workers are key, says Kayinamura Mwali Assumpta, along with ensuring they have the training, support, and equipment they need.

We’re almost at the halfway mark for meeting the Sustainable Development Goals, including dramatically reducing maternal mortality, ending preventable newborn and child deaths, and ensuring universal access to sexual and reproductive health services. But new reports show that many countries are off track.

I sat down with Kayinamura Mwali Assumpta, a pediatrician who serves as IntraHealth International's deputy chief of party and technical director for our USAID-funded Ingobyi Activity in Rwanda. We talked about her work and research to improve maternal and child health in Rwanda, including helping health workers scale up evidence-based practices, and what she thinks needs to happen next.

1. What motivated you to become a pediatrician?

During my medical school internship in the pediatric department, I had very good mentors. And what moved me is the way you can see a baby coming in very sick and then when you give them the right treatment, in a few days—or even a few hours—the baby will start to smile and to play. It's a personal satisfaction to see the progress of a baby in a very short time.

2. Why did you decide to go from clinical practice to working in public health, and focusing on maternal and child health?

After finishing my master’s degree in pediatrics, I led the neonatal service in CHUK, the teaching hospital in Kigali. A colleague working with the Ministry of Health saw my work and asked me to help pilot the first neonatal unit in a rural district hospital, in Rwamagana. That was around 2009, and at that time only teaching and referral hospitals could admit babies.

So we planned, designed the program, developed neonatal protocols, trained health workers, and started a small unit. Then we published the results. The ministry's head of maternal and child health was very happy and asked me to lead the scale-up. Now all the district hospitals have at least a Level 2 Neonatal Unit.

Through my work I saw how newborns are linked to mothers—you can't achieve good newborn health outcomes if you’re not also working on maternal health. So that's why I started also focusing on maternal health, and began working at nongovernmental organizations implementing maternal and child health projects.

Dr. Assumpta Kayinamura Mwali helped pilot the first district neonatal unit in Rwanda at Rwamaganda District Hospital. Photo by Innocent Ishimwe for IntraHealth International.

Janviere Bamushima, a maternity nurse, examines a pregnant woman in Ngoma District. Photo by Innocent Ishimwe for IntraHealth International.

A health worker examines a pregnant woman in the maternity waiting room at Kibungo Referral Hospital. Photo by Innocent Ishimwe for IntraHealth International.

Nurse Cecile Mutuyimana cares for a newborn in an incubator at Kibungo Referral Hospital. Photo by Innocent Ishimwe for IntraHealth International.

Uwimana Jeanne, a health worker, poses outside of Nyanza District Hospital. Photo by Innocent Ishimwe for IntraHealth International.

3. Rwanda has made great strides in improving maternal and child health through its commitment to universal health coverage. What are some of the remaining challenges?

Rwanda is implementing all the high-impact maternal and child health interventions, from antenatal care to childbirth up to adolescent care, but we still have some problems with the quality of care. First, the shortage of staff in maternity, pediatrics, and in health centers and primary health care is a big challenge. When the workload is too high, health workers become stressed and of course this affects their motivation and the quality of care they provide.

Another problem is the lack of sufficient equipment, like CPAP (continuous positive airway pressure) machines, ultrasound machines, incubators, etc. We have basic equipment, but not enough, and it is not well maintained due to the lack of spare parts in the country.

4. What studies or interventions are you most excited about for further improving maternal and newborn health in Rwanda?

The Ingobyi Activity uses training and clinical mentorship to build the capacity of health workers and improve maternal and newborn care. Last year we designed a neonatal nurse mentorship program with over 25 mentors and 80 neonatal nurses in district hospitals, to improve the use of neonatal equipment, infection prevention and control, and family-centered care. For example, a recent study in Rwanda revealed that respiratory distress syndrome was contributing to most preterm deaths, but pediatricians were not using CPAP machines to save babies. So mentors trained neonatal nurse specialists on those machines. Now neonatal nurses in the district hospital are using that equipment. Overall we’ve seen improvement in health outcomes–neonatal mortality has reduced.

Through the USAID-funded MOMENTUM Safe Surgery in Family Planning and Obstetrics project we are leading a learning agenda on the active follow-up of pregnant women who have already had a cesarean delivery, to prevent them from having an emergency c-section. We know that an emergency c-section increases the risk of complications, such as risk of uterine rupture. So we are identifying these women in antenatal care, and immediately referring them to nurses at health centers to follow up and make sure they reach the hospital and receive a delivery plan. So this helps ensure they have an elective c-section, instead of waiting until they have signs of labor to come to the hospital. With this intervention, we are already seeing almost a 50% reduction in emergency c-sections.

Ingobyi conducted research on compliance and utilization of the right package of antenatal care. We found that, although ANC coverage has improved in Rwanda, provision of the recommended ANC package is inconsistent—health workers are not screening many women for malnutrition or syphilis or testing them for anemia. We also identified challenges health workers were facing, like stockouts of blood collection tubes. And with these data, we advocated to the Ministry of Health to avail those kits and reagents. We are beginning to see improvements in the delivery of the recommended package of ANC services.

5. What more do you think needs to happen to improve the health of mothers and newborns in Rwanda and around the world?

Countries and donors need to invest more in health workers, including community health workers (CHWs), and in the supplies they need. Because if we have enough skilled, motivated, and equipped health worker teams, we'll save and improve more moms’ and babies’ lives.

For example, Rwanda is investing in reforming its community health workforce. Previously we had two kinds of CHWS—the ASM (Agents de Santé Maternelle), all female, in charge of maternal and newborn health, and binomes (female-male teams) in charge of integrated community case management of childhood illness, family planning, and nutrition. Now the country is training all CHWs to deliver a comprehensive package of all community health services (14 modules) to their assigned households in the villages.

CHWs are contributing a lot to improving maternal and child health. So countries should provide comprehensive training for CHWs and ensure they have the equipment they need to do their work. Ingobyi recently piloted an eLearning course for CHWs to replace the current didactic refresher training. Results show it was effective in increasing CHWs’ knowledge, including in community-based newborn health management.

Additional research is also needed, because when we have local evidence and use it to address gaps, we see big changes. In Rwanda, we have a program on maternal and perinatal death surveillance and response, and through confidential enquiry into maternal death survey, we can see the root cause of those deaths, and take appropriate measures to prevent them in future.

Meet Assumpta at the International Maternal Newborn and Child Health Conference, taking place May 8 - 11 in Cape Town, South Africa! She’ll present IntraHealth’s research and work in Rwanda during two sessions:

New research and program learning from Rwanda | Tuesday, May 09, 11:00am
Expanding maternal and perinatal death surveillance and response as a holistic quality improvement approach to accelerate saving maternal and newborn lives | Thursday, May 11, 3:15 pm SAST

By Carol Bales

Strategic communications manager

By Kayinamura Mwali Assumpta

Deputy chief of party/Technical director for the Ingobyi Activity

Maternal, Newborn, & Child Health Health Workforce & Systems Rwanda

Is In The Media

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International Maternal Newborn Health Conference

ihadmin2 — Mon, 17 Apr 2023 15:10:48 +0000

International Maternal Newborn Health Conference ihadmin2 April 17, 2023

May 08, 2023 - May 11, 2023

The International Maternal Newborn Health Conference marks a pivotal moment as we get closer to 2030, the end date of globally agreed upon goals for maternal and newborn health and prevention of stillbirths. IMNHC will convene the maternal newborn health community to drive urgent action for the health of mothers and newborns by collaborating and fostering strong connections, exchanging the most effective tools, sharing best practices and evidence, and investing in proven interventions.

Aligning TOGETHER. Accelerating TOGETHER. Saving lives TOGETHER.

AlignMNH Secretariat

International Maternal Newborn Health Conference | #IMNCH2023

Our Participation

Panel Discussions

New research and program learning from Rwanda

Date(s):	May 09, 2023 11:00am - 12:15pm SAST (05:00am - 06:15am EDT)
More Information:	Two IntraHealth experts will participate in this panel discussion. Kathryn Mimno will deliver a presentation, "Factors associated with labor companionship in Rwanda." Assumpta Kayinamura Mwali will deliver two presentations, "Factors influencing delivery of the recommended service package for first antenatal care visit in Rwanda—a mixed method study" and "Reducing missed opportunities for first ANC visits through linkage of general OPD to ANC services in rural Rwanda."
Location:	Daisy Room
Presenter(s):	Kathryn Mimno and Assumpta Kayinamura Mwali

Every woman everywhere has a right to quality care: Addressing quality gaps in humanitarian settings

Date(s):	May 11, 2023 01:55pm - 02:55pm SAST (07:55am - 08:55am EDT)
More Information:	Onikepe Owolabi will be a panelist during this session and will deliver a presentation, "Improving referral outcomes in eastern Uganda through a social media digital platform."
Location:	Room 1.41-1.42
Presenter(s):	Onikepe Owolabi

Comment améliorer l’accès et l’adhésion aux soins pour une expérience positive de la grossesse (en français)

Date(s):	May 11, 2023 01:55pm - 02:55pm SAST (07:55am - 08:55am EDT)
More Information:	Marguerite Ndour will be a panelist during this session and will deliver a presentation, "Intégrer les soins maternels, néonatals, infantiles, nutrition et planification familiale en Afrique francophone occidentale augmente la résilience à COVID-19 et la couverture universelle en saisissant les opportunités d'offre de services."
Location:	Auditorium 2
Presenter(s):	Marguerite Ndour

Expanding maternal and perinatal death surveillance and response (MPDSR) as a holistic quality improvement (QI) approach to accelerate saving maternal and newborn lives

Date(s):	May 11, 2023 03:15pm - 04:00pm SAST (09:15am - 10:00am EDT)
More Information:	Kathryn Mimno will be a moderator and Assumpta Kayinamura Mwali will be a panelist during this MOMENTUM Safe Surgery in Family Planning and Obstetrics thematic session.
Location:	Daisy Room
Presenter(s):	Kathryn Mimno and Assumpta Kayinamura Mwali

Poster Presentation

To what extent are maternal and child health, family planning, and nutrition services integrated in the national-level policies in Burkina Faso, Cote d’Ivoire, and Niger?

Date(s):	May 10, 2023 01:05pm - 02:05pm SAST (07:05am - 08:05am EDT)
Presenter(s):	Isabelle Bicaba

Participants

Robert Bambara

Monitoring, evaluation, and learning officer, INSPiRE

Isabelle Bicaba

Family planning/maternal and newborn health specialist, INSPiRE

Kathryn Mimno

Senior technical advisor

Assumpta Kayinamura Mwali

Deputy chief of party/Technical director, Ingobyi Activity, Rwanda

Marguerite Ndour

Project director, INSPiRE

Onikepe Owolabi

Senior global technical director for family planning and maternal, newborn, and child health

Fatoumata Tounkara

Monitoring, evaluation, research, and learning officer, Mali

Burkina Faso Côte d’Ivoire Nigeria Rwanda Uganda Maternal, Newborn, & Child Health Digital Health

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Cape Town, South Africa

These New Pediatric Development Clinics in Rwanda Save Lives

ihadmin2 — Mon, 06 Feb 2023 14:14:33 +0000

These New Pediatric Development Clinics in Rwanda Save Lives ihadmin2 February 06, 2023

January 31, 2023

Thanks to health workers who are now trained to manage birth complications.

The birth of a baby is often a joyous, momentous occasion. For Izabayo Marcel, however, August 2021 was a heartbreaking month. His wife died while giving birth to their baby, Sebastien Duhirwe, and Sebastien suffered from birth asphyxia, which left him fighting for his life.

The doctors and nurses at the Ruhengeri Referral Hospital acted quickly—and their skills saved baby Sebastien.

At-risk infants often don't get optimal support for their health.

Babies such as Sebastien who experience asphyxiated births face greater risk of complications, including cerebral palsy, seizures, paralysis, and slowed mental development. Although advances in technology and greater quality of care have helped more at-risk infants survive the early neonatal period, these infants face more challenges once they leave the hospital and go back to their communities, where they often don’t get optimal support for their health, nutrition, and development. Their chances of survival go down.

To help health workers provide holistic care (including medical, nutritional, and psychosocial support to boost physical and cognitive development of at-risk children), IntraHealth International’s Ingobyi Activity initiated Pediatric Development Clinics (PDCs) in selected health facilities in the Musanze and Rutsiro districts.

Ingobyi used a cascade training approach to train health workers from Ruhengeri and Murunda on the PDC approach and how to implement it, and how to support lower levels of the health system. Ingobyi trained 97 health workers who went on to train other health workers from facilities in their catchment areas. The hospital teams worked with health center providers to establish the PDCs with the Ingobyi Activity, providing the required equipment and materials for each health center.

Sebastien was as the Ruhengeri Referral Hospital PDC. While there, he received continual services, such as family-centered care, nesting, intermittent and continuous Kangaroo Mother Care, and milk fortification.

Marcel also benefitted from the PDC. Since Sebastien’s birth, he has received monthly training and counseling from PDC staff at the hospital on how to take care of Sebastien, including proper nutrition, hypothermia prevention, hygiene, and how to interact with him to boost his cognitive and emotional development. These sessions were crucial for Marcel.

“After my wife died, I didn’t know what to do, how to feed him,” Marcel says. “But when we attended the clinic sessions, I was relieved because the health workers answered a lot of questions on how to raise Sebastien.”

As Sebastien had no mother to breastfeed him, the clinic provided fortified infant formula milk to boost his physical development.

Sebastien has grown into a vibrant, healthy boy.

Now weighing 7.22 kilograms, Sebastien has grown into a vibrant, healthy boy, thanks to the help he received at the clinic.

“When my nephew was born, I didn’t have any hope for him to survive,” says Uwimbabazi Goreth, Sebastien’s aunt. “However, after attending PDC appointments, my hopes were raised. I can’t believe he is this resilient, considering how fragile he looked when he was born.”

Sebastien will continue to receive childhood development services at the PDC until he is two years old.

IntraHealth’s Ingobyi Activity supports PDC services in two hospitals and 26 health centers in the Musanze and Rutsiro districts and aims to scale up the clinics to all supported facilities nationwide.

So far, Ingobyi has trained 48 pediatric development clinic staff for Musanze and 49 for Rutsiro who have cared for 296 at-risk infants, with a 99% survival rate. Some of these infants were born prematurely, while others were born with perinatal asphyxia, failure to thrive, central nervous system infections, or congenital malformation, such as cleft lip, trisomy 21 (or Down syndrome), and hydrocephalus.

By Déogratias Rwangabo Nkurunziza

Communication Officer

By Richard Kalisa

Newborn and child health advisor

Maternal, Newborn, & Child Health Health workforce development Midwives Nurses Rwanda

Photos

A PDC nurse examines baby Sebastien at Ruhengeri Referral Hospital. Photo by Deogratias Rwangabo Nkurunziza for IntraHealth International.

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International Conference on Public Health in Africa

ihadmin2 — Fri, 13 Jan 2023 19:22:52 +0000

International Conference on Public Health in Africa ihadmin2 January 13, 2023 December 13, 2022 - December 15, 2022

The International Conference on Public Health in Africa (CPHIA) 2022 will provide a unique platform for African researchers, policymakers, and stakeholders to come together and share perspectives and research findings in public health while ushering in a new era of strengthened scientific collaboration and innovation across the continent. Building on CPHIA 2021, this year’s conference will also serve as a catalyst to build more resilient health systems that allow African countries to better prepare for and manage emerging health threats while also addressing long-standing infectious diseases.

African Union

Africa CDC

Rwanda Ministry of Health

Rwanda Biomedical Centre

https://cphia2022.com/

Our Participation

Presentations

The effect of e-Learning on retention of maternal and neonatal health knowledge among community health workers in Rwanda

Date(s):	December 14, 2022 03:00pm CAT (08:00am EST)
Location:	Kigali Convention Center AD 10+11+12
Presenter(s):	Yves Sangwa

Poster Presentation

Factors influencing completeness of the recommend package for first antenatal care visits in Rwanda

Date(s):	December 13, 2022 09:00am - December 15, 2022 05:00pm CAT (02:00am - 10:00am EST)
More Information:	Posters on display throughout the conference.
Location:	Kigali Convention Center Foyer 1A
Presenter(s):	Egide Freddy Muragijimana

Knowledge, attitude, and practice of youth toward adolescent sexual reproductive health in Rwanda

Date(s):	December 13, 2022 09:00am - December 15, 2022 05:00pm CAT (02:00am - 10:00am EST)
More Information:	Posters on display throughout the conference.
Location:	Kigali Convention Center Foyer 1A
Presenter(s):	Redempta Sagiza

Fighting COVID with health workforce data: Findings from the early COVID-19 response in Mali and Kenya

Date(s):	December 13, 2022 09:00am - December 15, 2022 05:00pm CAT (02:00am - 10:00am EST)
More Information:	Posters on display throughout the conference.
Location:	Kigali Convention Center Foyer 1A
Presenter(s):	Olivia Velez

Side Events

Plenary 6: Africa Women In Digital Health

Date(s):	December 12, 2022 05:00pm CAT (10:00am EST)
More Information:	This session will focus on removing barriers for African women to fully participate in the digital space including digital health.
Location:	Room MH4
Presenter(s):	Olivia Velez

Participants

Egide Freddy Muragijimana

District Health Data Analyst

Redempta Sagiza

Yves Sangwa

Community Health Advisor

Cheick Toure

Mali Country Director and Chief Technical Officer (Interim)

Olivia Velez

Chief Digital Health Officer

Rwanda Ingobyi Infectious Diseases Policy & Advocacy

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Kigali Convention Center

Kigali, Rwanda

Rwanda Focuses on Health Workers to Strengthen COVID-Related Services in 20 Districts

kseaton — Fri, 08 Jul 2022 16:08:43 +0000

Rwanda Focuses on Health Workers to Strengthen COVID-Related Services in 20 Districts kseaton July 08, 2022 July 08, 2022

Health workers in 20 districts throughout Rwanda are making higher-quality health services related to COVID-19 available to more people in their communities, thanks to training through IntraHealth’s USAID-funded Ingobyi project. Together with the Rwanda Ministry of Health, we are improving the quality and accessibility of services related to family planning, maternal and newborn health, as well as malaria prevention and treatment.

“When COVID-19 began to spread in 2020, we had to pivot our preexisting plans and implementation strategies to make sure health workers had the right supplies and training they needed to keep communities safe,” says Samson Radeny, IntraHealth’s country director in Rwanda. “We used a variety of approaches to focus on both health worker response and community sensitization.”

And while the Rwandan government had solid outbreak-response structures in place to protect against the spread of Ebola from neighboring Democratic Republic of the Congo, they needed to quickly bolster and tailor these systems for the COVID-19 pandemic. So the Ingobyi team advised and provided technical assistance to the government to train the country’s health workers, build needed infrastructure, and communicate effectively about COVID-19. Together, we:

Trained 280 health workers on COVID-19 case management and care in 26 hospitals.
Partnered with 10 radio stations to disseminate messages about COVID-19, malaria, and maternal, newborn, and child health.
Trained 514 health workers at 25 supported district hospitals to accurately screen clients for noncommunicable diseases and link positive COVID-19 individuals to the national vaccination program.
Provided the Rwanda Ministry of Health with advisors during nationwide mass COVID-19 vaccination campaigns to help plan, coordinate, and supervise the national vaccination activities.
Renovated eight COVID-19 isolation facilities and equipped them with the needed items to support management of critically ill patients.
Repurposed the Ebola call center to serve as an emergency hotline for COVID-19 information and staffed the call center to provide information for the 84,000 calls per week during the first nationwide lockdown.
Procured 500+ pieces of equipment needed by health facilities including digital blood pressure machines, ICU beds, oxygen cylinders, and infusion pumps.
Trained 859 hospital staff on infection prevention and control. Of these, five clinical staff from each hospital were validated as mentors and in turn cascaded the same trainings to 325 health center managers, who in turn trained 3,378 health center staff.

Read: Supporting Rwanda’s COVID-19 Response and Mitigating Its Impact on Maternal, Newborn, and Child Health and Malaria Service Delivery

Early Intervention Among Women Getting Cesareans in Rwanda Is Saving Lives

kseaton — Fri, 10 Jun 2022 14:47:38 +0000

Early Intervention Among Women Getting Cesareans in Rwanda Is Saving Lives kseaton June 10, 2022

June 10, 2022

Cesarean deliveries have become increasingly safe in Rwanda thanks to the efforts of the government and its partners to train and prepare health providers to perform these surgeries.

This blog post was originally published on the USAID MOMENTUM website on June 7, 2022. Read it here.

Cesarean deliveries have become increasingly safe in Rwanda thanks to the efforts of the government and its partners to train and prepare health providers to perform these surgeries. However, pregnant women with previous cesareans are at higher risk of pregnancy complications, including uterine rupture, if not closely monitored in health facilities.

Preliminary results of the Confidential Enquiry into Maternal Deaths (CEMD) in 2019 ranked cesareans as the highest maternal mortality risk factor in Rwanda. Confidential inquiries into maternal deaths are one type of maternal death surveillance and response. They are intended to go beyond counting numbers of deaths for statistical purposes, to provide insight into possible factors that may be addressed to reduce future deaths. The inquiry revealed existing gaps in follow-up of women with obstetrical complications during pregnancy in antenatal care, leading to an increased risk of maternal death in mothers with previous cesarean procedures.

Mukankotanyi Yvette is a 27-year-old mother of three from Ngoma District in Rwanda’s Eastern Province who experienced these gaps in care. When she was due to deliver her youngest child, she was unaware that she needed to be closely monitored at a health facility due to cesarean scars linked to her previous deliveries. This was despite regularly attending antenatal care appointments at her local health center.

MOMENTUM Safe Surgery in Family Planning and Obstetrics Rwanda is working in all 20 USAID Ingobyi-supported districts, including 26 hospitals and 325 health centers to actively provide follow-up care to pregnant women with previous cesarean surgeries. Some 1,307 pregnant women have been identified and referred to hospitals to prevent the risks of developing complications.

Uwiringiyimana Marie Assumpta is a district-based mentor with the Ingobyi Activity, a USAID project that partners with MOMENTUM in Rwanda, assigned to Rukoma Sake Health Center. She conducts regular mentorship for the Antenatal Care Unit (ANC) and maternity staff. During her visits to the ANC unit, she monitors the active follow-up of women with a history of cesareans and hypertension during pregnancy. She also selects and contacts a few mothers in the ANC follow-up register to discover how they are doing. She reached out to Mukankotanyi Yvette to learn if she had contacted the hospital for a delivery plan as recommended. In response, Yvette said she was at home and was starting to feel abdominal pains. Immediately Marie Assumpta called the head of the health center and the community health worker (CHW) to arrange to bring her to the health center.

On March 22, 2022, Yvette delivered a healthy 7.2-pound (3.3 kg) baby boy through cesarean section. “I am really happy that we were able to save Yvette from potential danger. This is all thanks to the active follow-up of mothers, which we didn’t do previously,” says Marie Assumpta.

The Ingobyi Activity in Rwanda is led by IntraHealth International and funded by the US Agency for International Development.

By MOMENTUM

USAID suite of awards

Ingobyi Health Workers Community Health Workers Midwives Rwanda

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Betty Murerwa

kseaton — Fri, 13 May 2022 19:33:34 +0000

Betty Murerwa Community health engagement specialist kseaton May 13, 2022

Betty was a community health engagement specialist for IntraHealth's Ingobyi project in Rwanda.

Rwanda

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Engaging Communities to Improve Health Care Quality through the Citizen Voice and Action Approach

kseaton — Fri, 13 May 2022 19:32:12 +0000

Engaging Communities to Improve Health Care Quality through the Citizen Voice and Action Approach 2022 kseaton May 13, 2022

Read about how IntraHealth International's Ingobyi project applies the Patient Voice Program-Citizen Voice and Action approach to enhance non-confrontational dialogue, accountability, and citizen participation and engagement in the process of improving services. The approach enables joint action planning to address structural, policy, and service delivery gaps.

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Supporting Rwanda’s COVID-19 Response and Mitigating Its Impact on Maternal, Newborn, and Child Health and Malaria Service Delivery

Topics Community Health Health Workers

By Betty Murerwa, Assumpta Kayinamura Mwali

Rwanda

Samson Radeny

Community Advocacy Leads to New Maternity Unit at Rwanda Health Center

More than a maternity unit

How Can We See More Smiling Babies in Rwanda and Around the World?

1. What motivated you to become a pediatrician?

2. Why did you decide to go from clinical practice to working in public health, and focusing on maternal and child health?

3. Rwanda has made great strides in improving maternal and child health through its commitment to universal health coverage. What are some of the remaining challenges?

4. What studies or interventions are you most excited about for further improving maternal and newborn health in Rwanda?

5. What more do you think needs to happen to improve the health of mothers and newborns in Rwanda and around the world?

International Maternal Newborn Health Conference

Our Participation

Panel Discussions

New research and program learning from Rwanda

Every woman everywhere has a right to quality care: Addressing quality gaps in humanitarian settings

Comment améliorer l’accès et l’adhésion aux soins pour une expérience positive de la grossesse (en français)

Expanding maternal and perinatal death surveillance and response (MPDSR) as a holistic quality improvement (QI) approach to accelerate saving maternal and newborn lives

Poster Presentation

To what extent are maternal and child health, family planning, and nutrition services integrated in the national-level policies in Burkina Faso, Cote d’Ivoire, and Niger?

Participants

Robert Bambara

Isabelle Bicaba

Kathryn Mimno

Assumpta Kayinamura Mwali

Marguerite Ndour

Onikepe Owolabi

Fatoumata Tounkara

These New Pediatric Development Clinics in Rwanda Save Lives

Photos

International Conference on Public Health in Africa

Our Participation

Presentations

The effect of e-Learning on retention of maternal and neonatal health knowledge among community health workers in Rwanda

Poster Presentation

Factors influencing completeness of the recommend package for first antenatal care visits in Rwanda

Knowledge, attitude, and practice of youth toward adolescent sexual reproductive health in Rwanda

Fighting COVID with health workforce data: Findings from the early COVID-19 response in Mali and Kenya

Side Events

Plenary 6: Africa Women In Digital Health

Participants

Egide Freddy Muragijimana

Redempta Sagiza

Yves Sangwa

Cheick Toure

Olivia Velez

Rwanda Focuses on Health Workers to Strengthen COVID-Related Services in 20 Districts

Read more about the Ingobyi team’s most effective approaches and key results in Rwanda:

Early Intervention Among Women Getting Cesareans in Rwanda Is Saving Lives

Betty Murerwa

Engaging Communities to Improve Health Care Quality through the Citizen Voice and Action Approach

Supporting Rwanda’s COVID-19 Response and Mitigating Its Impact on Maternal, Newborn, and Child Health and Malaria Service Delivery

Piloting an eLearning Course for Community Health Worker Training

Strategies to Improve Infection Prevention and Control in Health Facilities

Enhancing Provider Competencies through the Low-Dose, High-Frequency Training Approach

Strengthening Health Provider Competencies through Clinical Mentorship

Preventing and Managing Obstetric Fistula in Rwanda

Engaging Communities and Promoting Health-Seeking Behavior through Strategic Social and Behavior Change

Building Capacity of Health Workers through Supportive Supervision