Safe childbirths is the norm in Rwanda

Gaudance Mukyeshimana is a happy mother because she securely brought into the world a bouncing baby boy. Six months after her labour pangs, Community Health Mobilisers (abajanama bubuzima) have not stopped their routine check-up visits to Mukyeshimana and her baby, Derrick. Though her baby is healthy, the community health mobilisers cannot take chances especially that Mukyeshimana miscarried during her first pregnancy due to high blood pressure. Since 2005, the number of Rusizi district women who give birth at the hospital has dramatically risen. Infact, delivering by traditional means is no longer popular. “Owing to the past ten month statistics, 90 percent of women give birth at the hospital. There are a few cases of women who give birth while on their way to a healthy centre,” says Dr.Theophile Duyishime, the Medical Director of Gihundwe hospital. Factors supporting safe birthsMany factors are hailed for promoting safe childbirth in Rwanda. Every community cell has at least two Community Health Mobilisers in charge of following up on pregnant women. The Mutuelle de sante (Public Health Insurance) is yet another magic carpet that has encouraged mothers to give birth at hospitals. “Community Health Mobilisers have educated us about why it’s safe to give birth at the hospital,” says Mukyeshimana.The Government of Rwanda has also availed ambulances and built a couple of Health Centers in the rural areas which has stopped women from delivering at home. “It’s relieving when women get all the maternity care they need, and they almost pay nothing for it,” said Dr. Duyishime. Meanwhile, former traditional midwives have become significant Community Health Mobilisers, and a tool to educate mothers about the dangers that come with traditional births. The penaltyIf a woman never reports a pregnancy until its three months, she is usually penalized depending on which Health Centre she goes to. It has become imperative that Rwandan mothers go for prenatal checkups during the first three months of their pregnancy. These tests tell the condition of both the mother and baby. “Mothers must test for HIV, high blood pressure and the amount of blood they have. Tests help in the counseling process of pregnant women, on feeding and best exercises they should do,” said Yamini Nkurunziza, a Health Counselor at Kamashangi sector, Rusizi District. Statistics show that 48 percent of women in Rwanda give birth at home in the absence of a professional midwife. However, women have been required to pay a fine of Rwf5000 when they do not deliver at a Health Centre. It’s now mandatory that all authorities get involved in reducing the number of women who give birth while at home. In Rwanda, when cases of mothers delivering at home exceed two, it is the Community Health Mobilisers and the local authorities that get blamed for not doing their job. Still a few hindrancesThe biggest challenge to safe childbirth in remote areas is the use of local medicinal herbs. This issue has been blamed on people’s traditional beliefs. “Some women come to the hospital with local herbs or their relatives bring the herbs later for them to drink. Local herbs endanger the life of both baby and mother yet many continue using these herbs in secret,” says Dr. Duyisenge. Health Centers are now teaching and sensitizing mothers against the use of local herbs. Safe births have thrivedSafe birth through prenatal and post natal care is regarded as the healthy solution to both mother and child health.“Prenatal care lessens the chances of delivering babies with abnormalities,” said Mariam Mukakayijuka, a Community Health Mobiliser, at Kamembe sector, Rusizi District. “Giving birth at the hospital helped me to heal quickly, with no infections,” said Salima Mahoro, another mother. In 2004, Mahoro said that she got complications after giving birth in the hands of a traditional midwife. Luckily she survived and has never repeated the same mistake. As Rwandan women talk on about the dynamics of giving birth at Health Centres as opposed to their homes with a traditional midwife, they have quickly learnt that safe childbirth literally means good health for both mother and child. Lillianean@yahoo.com