The lack of enough information and failure to pay health insurance on time continue to be the main hindrance for expectant mothers to access antenatal services.

The number of births happening at home reduced to 9 per cent in 2015, down from 31 per cent in 2010, according to the Demographic Health Survey (DHS).

Dr Felix Sayinzoga, the Division Manager of the Maternal and Child Health Division at Rwanda Biomedical Center (RBC), told The New Times in a telephone interview that some expectant mothers have refused to heed the advice to seek antenatal care from the health centres.

"Some mothers lack information on where to go for antenatal care while others don’t pay their health insurance on time. This, in the end, makes them fear the charges imposed by health centres. There are some mothers who give birth from their homes because of their mindset. They think (that) if one birth at home was successful, another will also be,” he said.

Expectant mothers are normally expected to visit the doctor four times during the duration of their pregnancy and should thus secure health insurance as well as transport to and from the hospital on time.

Sayinzoga says that every village has four health counsellors. Of these, one is dedicated to following up on pregnant mothers, advising them and escorting them to the hospital when they are in labour.

Among the policies that have been implemented to help expectant mothers are building and renovating maternity wards in all health centres and hospitals, increasing the number of ambulances, antenatal care throughout the pregnancy, public lectures on pregnancy and paying for health insurance among others.

Government’s target is to have 100 per cent of women giving birth from hospitals.

In Rwamagana District, 16 per cent of births still happen at homes.

Jeanne Umutoni, Rwamagana District Vice Mayor in charge of Social Development, told The New Times that this mainly due to the poor mindset.

"Sometimes people think they have no problem, so they don’t go to the health centres to give birth. Some of these mothers do it in hiding because they know it is not encouraged,” she said.

Umutoni says the district seeks to tackle the problem by making it compulsory for mothers to go for antenatal care, paying for health insurance through advice given by health counsellors.

The district has four ambulances help in times of emergency, she said.

Addressing the issue is part of a campaign for National Integrated Maternal and Child health that was launched on Monday by the Ministry of Health.

Launched in Karongi District, the campaign runs until October 18.

The campaign also aims at fighting malnutrition in children, family planning, malaria and Human Intestinal Parasites prevention, among others.

editor@newtimesrwanda.com