Every day, 800 women around the world die for reasons related to pregnancy or childbirth. And some 5.7 million women annually suffer severe disabilities following childbirth.
But there’s another positive side to this story. Maternal mortality has generally decreased by half since 1990 and this includes even in places that are extremely poor. New technologies and health care approaches, better infrastructure, and creative government policies are changing the odds for pregnant women and their families.
Someone dear to me will be traveling to Rwanda soon and that, together with my passion for Maternal, Newborn and Children health ignited me to acquaint myself with the state of maternal and children health in this country of a thousand hills, which my French brothers will call “Pays des Mille Collines”.
I was pleased with the facts that I got. I know you have an idea of this country, Rwanda, but allow me to refresh your mind a little. Between April and June 1994, an estimated 1 million Rwandans were killed, 2 million displace and health systems destroyed in the space of 100 days.
Despite that, Rwanda’s maternal mortality ratio decreased by 77 percent between 2000 and 2013 and currently stands at 320 deaths per 100,000 live births. Under-5 child mortality also reduced by more than 70 percent making it one of the few African countries to meet goal 4 and 5 of the Millennium Development Goals in 2015.
Many factors created this success story:
- Rwandan government subsidizes a national health insurance scheme, which has led to increased use of family planning, prenatal care and health facilities.
- Midwives and other clinical officers are trained in emergency obstetric care.
- Women are fined for giving birth at home, and doctors are financially rewarded for high quality obstetric care.
- Rwandan clinics have focused on improving their quality. Many strive to keep regular clinic hours, well-staffed and supplied clinics, good hygiene practices and respectful staff.
- By 2012, there was one doctor per 16,000 people and one nurse per 1,300 people. Before 1997, Rwanda had no trained midwives, but now there are around 1,000. Rwanda established new standards for quality of care, and in 2010, delivery by a skilled provider was at 69 percent, as was delivery in a health facility
- Rwanda’s government is committed to providing universal health care as part of its Vision 2020 Strategy.
In 1995, most development agencies were ready to give up on Rwanda, then one of the poorest and most vulnerable countries in the world. But now, Rwanda is one of the few countries on track as far as maternal, newborn and children health is concern. Mine is to say kudos Rwanda. Kenya is behind, but i am positive we will get there too…someday!