How Rwanda has managed to reduce maternal, child deaths

About two months from now, the country will host the 10th annual International Conference on Kangaroo Mother Care (KMC), a technique which offers affordable and effective alternative to incubator care, where by the mother places her newborn — usually premature — on her chest, between her breasts and ties a cloth around it. The baby is wrapped in a gown, tailored to resemble a kangaroo’s pouch every day until it is in good health and size. The method which enables skin-to-skin contact between mother and baby has shown to save preterm and low birth weight babies in high and low-income settings alike. The system which provides ready access to breastfeeding, originated from Colombia in 1978, and has since been proven successful in countries such as Haiti, Vietnam, and Rwanda. The system now approved by the World Health Organisation was first introduced here in 2008, seeing a successful roll out in 27 district hospitals country wide as of March 2013. And clearly, the success of the programme here may have convinced the organisers to select Rwanda as the next host of the three-day meet. Benefits of programme Away from the meet, KMC has not been the only successful maternal and child health project here; there have been a string of similar ones in recent years that have impacted lives differently. For instance just late last year, the 1,000-days campaign, a project geared at wiping out malnutrition was hatched, seeking to improve feeding among children under five years, pregnant and lactating mothers, as well as school going children, in an effort to reduce morbidity and mortality. The programme, a joint venture between the ministries of health, agriculture, education, local government, gender and family promotion, among others, for example saw a push for the introduction of projects like kitchen and cell garden gain momentum countrywide. And 91% of children between the ages of 1-5, and women who had freshly given birth get vitamin A drugs, while 94 percent of children in the same age bracket got deworming drugs and other nutrition supplements such as zinc, iron and folic acid, in March this year alone. And this without doubt has played part in bringing down acute malnutrition which stood at 3% in 2010, to 0.8% as of April 2014. More about efforts to improve mother and child health, today 45,000 community based health workers (CBHWs) are deployed by the ministry of health in different parts of the country (at least two in every village) with a motive of monitoring and reminding pregnant women to go for routine checkups, and this has seen more pregnant women receive health facility- based care. And this perhaps explains why the number of babies delivered in health facilities has been increasing overtime, for instance the percentage of babies delivered in conventional health facilities substantially increased from 52% in 2007-2008 to 69% in 2010. The CBHWs can also diagnose, treat malaria, diarrhea and administer some family planning methods on patients. They also help with HIV related sensitisation and vaccination outreaches. Efforts like those for instance helped the country mid this year, meet the United Nations Millennium Development Goal (MDG 5) of reducing the number of women who die during pregnancy, or shortly after giving birth, by three-quarters, beating the 2015 deadline. This came 3 years barely after the country hit the MDG 4 target on child mortality too , by reducing deaths from 156 deaths per 1000 children in the last 20 years to 54 in 2011, reflecting a two-thirds decline. The government has also been at the fore front of fighting Malaria, a common cause of mortality among infants below the age of 5, and this has been possible through massive roll out of mosquito nets country wide, for example, according to the 2010 Demographic Health Survey (DHS) results, 82 per cent of the population had at least one long lasting, insecticide-treated mosquito net, and 72 per cent of pregnant women and 70 per cent of children under-five years were using bed nets. There is more, all pregnant women have to undergo HIV counselling and testing during prenatal visits. Receiving treatment in the event of testing positive, so as to prevent transmission of the virus from the mother to child. In a related development, a lot has been invested in selling the idea of family planning, so as to enable people have smaller families they can support easily. And this for instance led to the rise in the rate of married or cohabiting women using a modern method of contraception; from just 4% in 2000 to 44% in 2010. To wrap up, there are all indications that the country is on a steady path to becoming a global center of excellence for maternal and child health.