Although Rwanda’s maternal mortality rate dropped to 203 per 100,000 live births in the last five years, challenges around the shortage of competent healthcare providers and lack of sufficient continuous professional development opportunities continue to slow down the country’s efforts to achieve the SDG 3 target to reduce these deaths to below 70 by 2030.
To address these challenges, in November, Health Development Initiative (HDI) in partnership with Rwanda Biomedical Centre (RBC) and United Nations Population Fund (UNFPA) launched ‘Mobimenta’, a capacity-building model that aims to improve the capacity of frontline healthcare workers delivering Emergency Obstetric and New-born Care, Comprehensive Abortion Care (CAC) and Family Planning services in all areas of maternal and neonatal health.
The mentorship programme seeks to accelerate the reduction of preventable maternal and neonatal morbidity and mortality, the reduction of unmet needs for family planning, as well as further enhance the improvement of knowledge, skills, and attitudes among healthcare providers.
Delivered by national, district and provincial hospital mentors, these monthly mentorships are being conducted in 48 health facilities, and are benefitting 81 frontline healthcare workers located in Karongi and Nyamasheke districts.
According to the 2021 State of the World’s Midwifery report, when competent and supported by a functional health system, midwives can help prevent over two-thirds of maternal and newborn deaths and comorbidities.
Joyeuse Ngoma, a midwife and head of the maternal health division at Kibuye Hospital, is one of the mentors giving onsite mentorship.
So far, she has mentored a dozen midwives from health centres in the district.
Ngoma explained that before the mentorship, a midwife is required to go through a skills assessment and is only considered if they score at least 85 per cent.
"If they don’t score the minimum, we first equip them with the basics until they reach the minimum required score before they are eligible for the mentorship,” she said.
She added that the skills gaps they are mostly focusing on include emergency techniques in neonatal care and neonatal care. This includes how to handle post-childbirth excessive bleeding, supporting newborns with breathing difficulties, removing a retained placenta, and dealing with high blood pressure during labour.
Louange Gutabarwa, Director of Research at HDI, noted that the mentorship curriculum also includes postpartum family planning, which includes services around the prevention of unintended pregnancy and closely spaced pregnancies through the first 12 months following childbirth.
"It is important to encourage women who have just given birth to start birth control. We chose Karongi and Nyamasheke districts because they are lagging behind when it comes to family planning. With this mentorship, we expect to see a significant improvement,” she added.
Anasthase Hakizimana, a midwife at Mubuka Health Centre in Karongi District, is currently one of the healthcare providers being mentored. He explained that he was keen to learn more about supporting a baby with breathing difficulties and how to handle excessive bleeding after childbirth.
"From this mentorship, I have learnt not to panic when complications arise and how to make quick decisions related to referrals in case a woman or child is facing risks that I may determine are life-threatening,” he said.
Mobile mentorship was adapted to the context of Rwanda, due to the topography as a mountainous country, which makes access to health facilities a challenge. The flexible design of the model allows the tailoring of training packages to the specific individual needs of the targeted health facilities.