Inside USAID Tubeho’s drive to improve maternal and child healthcare services

Rwanda has made significant progress in improving maternal, new-born, child, and adolescent health, as well as family planning, reproductive health services, and malaria prevention and treatment. These achievements have been made possible through investments from the Ministry of Health and its partners. ALSO READ: US’s $85m projects expected to enhance healthcare in Rwanda However, statistics from the Rwanda Demographic and Health Survey 2019-2020 show stagnations in key maternal, new-born, child, and adolescent health. The study notes significant gaps in progress since 2015. For instance, age and geographic inconsistencies regarding access to relevant services, thus highlighting health inequities and the importance of future collaborative and country-driven investments. For this reason, ‘USAID Tubeho’ (Let’s Live), a USAID-funded project implemented by Jhpiego, was launched to strengthen service delivery, support health programme implementation across maternal, new-born, child, and adolescent health, family planning, reproductive health, malaria services and global health security areas of intervention. Jhpiego is a non-profit global organisation that creates and delivers transformative healthcare solutions that save lives. ‘USAID Tubeho’ aims to contribute to improving the capacity of both health providers and institutions. According to Dr Stephen Mutwiwa, the chief party of ‘USAID Tubeho’, the programme started in August 2023 and is already operating in 20 out of 30 districts that include Gasabo, Nyaruguru, Rubavu, Nyagatare, Ngororero and others. “The programme includes planning and prioritisation with the Ministry of Health, Rwanda Biomedical Center (RBC) and district leaders in the 20 districts. Some key approaches of USAID Tubeho are: supporting training, supervision and mentorship of health providers in the hospitals and health centers including community health workers. Mutwiwa said the programme anticipates increasing access, availability and utilisation of evidence-based, quality, and respectful maternal, new-born, child, and adolescent health services, family planning and reproductive health services, as well as malaria services. “We look forward to boosting the capacity of institutions, local organisations, and providers to respond to emerging global health threats,” Mutwiwa said. ‘USAID Tubeho' also strives to increase the use of evidence and adaptive learning in maternal, new-born, child, and adolescent health, family planning, reproductive health, and malaria programming. Jhpiego is implementing this project with various local organizations for instance, Society for Family Health (SFH) Rwanda, Rwanda Paediatric Association, Rwanda Association of Midwives, and Rwanda Society of Obstetricians and Gynaecologists (RSOG) that offer different types of capacity building for the hospitals and health centers. Jhpiego collaborates with RBC in implementing malaria prevention, control and management interventions. “We support review and development of policies and guidelines to ensure the services providers are evidence based.” “We support relevant division managers and experts to go out in the field to supervise and mentor CHWs at the hospitals and health centers. Additionally, we facilitate community action and mobilisation through messages on malaria prevention and seeking treatment,” Mutwiwa said. USAID Tubeho avails information about family planning and promotes health and access to services that young people need. Through youth corners, youngsters can access any services, especially during weekend and other convenient hours. Family planning services are also available to women to make choices of their preferred family planning methods. Moreover, USAID Tubeho supports global health security by equipping through knowledge and skills for emergency-response to detect any outbreaks in the country. Although the ‘USAID Tubeho’ project is still in its early stages, one of its challenges is the low ratio of health workers to patients. However, the 4x4 Reform approved by the government in July 2023 will improve the situation. It aims to quadruple the number of healthcare workers in the country within the next four years to meet the World Health Organization (WHO) recommendation of at least four healthcare professionals per 1,000 population density. On Friday, August 26, during the 8th Pan-African Malaria Conference held at the Kigali Convention Center, Jhpiego organized an event under the theme “Transforming Pregnant Women’s Access to Malaria in Pregnancy Prevention: Tools and Experiences to Support Scaling Intermittent Preventive Treatment in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP).” WHO has developed a field guide that draws upon best practices and lessons learned from pilot implementation experiences in eight African countries, including Burkina Faso, DRC, Madagascar, Malawi, Mozambique, Nigeria, Senegal, and Sierra Leone. During his opening remarks, Dr Daniel Ngamije the Director of WHO Global Malaria Program said that scaling up access to IPTP is an important strategy of preventing malaria related illness and death among both the pregnant woman and the newborn child, as low birth weight is a strong risk factor of neonatal child mortality, averting a substantial number of low birthweights would save many lives According to the latest World Malaria Report, globally 58 per cent of pregnant women are still not benefiting from this protective intervention, hence the need for a field guide that focuses on minimising missed opportunities by increasing IPTp coverage using a community-based delivery approach through trained community health workers, complementing deployment of IPTp-SP at antenatal care clinics. The approach aligns with the updated IPTp recommendations published in the WHO guidelines for malaria on June 3, 2022. The majority of malaria cases in the country are diagnosed and managed by CHWs, unlike in many other countries.

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Inside USAID Tubeho’s drive to improve maternal and child healthcare services