One in four pregnant women now complete the recommended eight antenatal care visits, according to the Rwanda Biomedical Centre (RBC), with health officials saying the programme is improving early detection of pregnancy complications and increasing attendance at prenatal care services. The eight-contact antenatal care model was introduced at the end of 2023, replacing the previous recommendation of four visits in line with the World Health Organisation (WHO) guidelines. The revised schedule is designed to improve the early detection and management of pregnancy-related complications, particularly those that develop during the later stages of pregnancy. Antenatal, or prenatal, care refers to the health services provided by skilled professionals during pregnancy to safeguard the wellbeing of both the mother and baby. ALSO READ: How routine prenatal visits are preventing emergencies that used to kill mothers Awareness remains high Dr. François Regis Cyiza, Head of Maternal and Child Health Programmes at RBC, said awareness of antenatal care is generally high, although not all expectant mothers know they are now expected to attend eight visits. Even when some women do not know the exact number of recommended contacts, they understand the importance of seeking antenatal care, he said. Chantal Uwera, who gave birth to a healthy baby boy five months ago, said she attended monthly antenatal appointments as advised by her gynaecologist. The reminders before each appointment were helpful because a lot can change in a month. Regular check-ups reassured me that my baby was developing well and eased my anxiety throughout the pregnancy, said the Kiyovu resident, whose son weighed 3.5 kilograms at birth. Cyiza said women are informed about the eight-contact schedule during their first antenatal visit. Healthcare providers and community health workers explain the purpose of each appointment and encourage mothers to complete all recommended visits to improve outcomes for both mother and baby. Steady progress RBC began tracking completion of all eight antenatal visits during the 2024/25 financial year, about a year after the new guideline took effect. National data shows that about 25 percent of pregnant women completed all eight visits between July 2024 and June 2025. The figure increased to around 27 percent during the 2025/26 financial year. Although progress has been gradual, Cyiza said the programme is still in its early stages and several factors affect completion rates. One challenge is that the eighth visit is scheduled between 38 and 40 weeks of pregnancy, yet some women deliver before reaching that appointment. Late initiation of antenatal care also affects completion because women who begin care after the first trimester have less time to complete all eight contacts before delivery, he said. Why some women miss appointments Cyiza said work commitments and other personal responsibilities cause some women to miss scheduled visits. It is largely a behaviour change issue rather than a problem of service availability, he said. Geographical barriers also remain a challenge. While many communities are within a 30-minute walk of a health centre, hilly terrain and difficult travel conditions can make attending appointments more difficult for some mothers. Improving maternal health Despite these challenges, the programme has contributed to higher utilisation of antenatal care services. According to the 2025 Rwanda Demographic and Health Survey, about 78 percent of pregnant women now attend at least four antenatal care visits. Cyiza said the expanded schedule was introduced because evidence shows that many pregnancy complications emerge during the second and third trimesters. These include pregnancy-induced hypertension, pre-eclampsia, gestational hypertension and gestational diabetes.He noted that many stillbirths also occur during the final months of pregnancy, making close monitoring during this period essential. For that reason, five of the eight antenatal contacts are scheduled during the third trimester. This allows healthcare providers to detect complications early and manage them promptly to prevent maternal or newborn deaths, he said. The programme, alongside broader investments in maternal healthcare, has contributed to improved outcomes. Maternal mortality has fallen from 203 to 149 deaths per 100,000 live births over the past five years. Annual maternal deaths have also declined from between 300 and 320 before the end of 2023 to about 270 by June 2025 and around 240 by the end of the following year. We cannot deny that this programme has played an important role. It has contributed significantly to the reduction, Cyiza said. He attributed the gains to expanded antenatal care, a larger health workforce and the deployment of more obstetricians and gynaecologists to district hospitals. Previously, specialists were largely concentrated in tertiary hospitals, with only a few district hospitals having them. Today, many district hospitals have obstetricians and gynaecologists, improving access to specialised maternal healthcare, he said.
