The United Nations Population Fund (UNFPA) and the Rwanda Association of Midwives (RAM), on Thursday, March 23, initiated a new agreement intended to ensure that mothers and infants do not lose their lives due to preventable deaths.
The United Nations sexual and reproductive health agency’s mission is to deliver a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled.
Speaking during the signing of the memorandum of understanding, in Kigali, the UNFPA country representative, Kwabena Asante-Ntiamoah, said: "Rwanda made great progress in reducing maternal mortality over the last decade, from 487 to 203 deaths per 100,000 live births.”
"Unfortunately, around one to two women still die every day in Rwanda during pregnancy, childbirth or post-partum. So, we still have a long way to go, together, to fulfil our goal. But we are confident that with a strengthened midwifery association, Rwanda will see a major reduction in maternal and neonatal mortality.”
He said the MoU will lead to a stronger collaboration between UNFPA and RAM in addition to a stronger association with strong influence, high visibility and high influence to work towards zero preventable maternal deaths, zero unmet need for family planning, and zero gender based violence and harmful practices.
The President of Rwanda Association of Midwives, Josephine Murekezi, indicated that there are about 2,300 midwives in the country but only 400 of them are members of the association.
The association, Ntiamoah indicated, works to strengthen the midwifery profession through education, support and advocacy in order to improve reproductive, maternal, neonatal child and adolescents’ health through the delivery of evidence-based, quality midwifery services.
"The association's mandate is closely linked to UNFPA’s and in order to reduce maternal and neonatal mortality we need to scale up the investment in midwifery education, regulation and association,” he observed.
He pointed out that they will help the association in terms of research to provide the evidence and impact in regards to reducing maternal mortality.
Tackling 98 per cent of preventable maternal deaths
Murekezi said that most maternal deaths are preventable, if there were enough midwives, necessary equipment and a conducive environment in general.
"I am on the committee for maternal mortality and morbidity at national level. Every time we check our data, we find that 98 percent of deaths could be prevented. So, I think, if we put much effort in our midwifery association, education and regulation, we shall be able to reduce the mortality even further than what we have now,” she said.
She indicated that the preventable deaths result, largely, from the inadequate number of midwives.
"There are cases where you find that 40 mothers are in a maternity ward, waiting to give birth. About four can be in the state of giving birth, yet there are only two midwives,” she said, pointing out that, as a result, a mother or her child might, "unfortunately, die,” because there was no midwife to take care of her during that period.
A midwifery centre of excellence
Under its new strategic plan 2023-2027, the Rwanda Association of Midwives has goals including the establishment of a midwifery center of excellence. The aim is to provide advanced skills and training in line with continuous professional development for medical personnel.
Ntiamoah promised that UNFPA will support the association to set up the midwifery center of excellence.
"That is a big vision that we are going to see and explore and work with RAM to see how we have a centre of excellence in midwifery,” he said.
"There is a unique opportunity especially in Rwanda. So, such a centre will become a hub, not only for Rwanda, but [also] for the region and beyond in terms of South-South cooperation for others to come and learn about the good work that RAM is doing.”