New innovations lower child deaths in rural areas

Alphonse Mategero, a community-based health worker in Kigufi Health Centre in Nyamyumba Sector, Rubavu District has not seen a child or mother die during birth in the past two years.
A nurse immunises a baby at Police Hospital in Kacyiru. (Timothy Kisambira)
A nurse immunises a baby at Police Hospital in Kacyiru. (Timothy Kisambira)

Alphonse Mategero, a community-based health worker in Kigufi Health Centre in Nyamyumba Sector, Rubavu District has not seen a child or mother die during birth in the past two years.

Previously, this village on the banks of Lake Kivu, suffered high mother and child mortality rates largely due to delays in reaching health facilities.

“Our sector is largely surrounded by this lake, so many times it became difficult to transport  a mother in labour or any sick person to this health facility; and this always  increased their chances of dying,” said Mategero.    

This ended after the government introduced marine ambulance services, as now patients are transported to the facility from any part of the sector within a few minutes upon notification.

Every village has at least two community health workers, each with a rapid SMS system, a phone application that helps monitor maternal and child health.

The method, for instance, automatically notifies a community health worker about the due date of a particular pregnant mother in their area and when she is supposed to report to the health centre for routine check-up.

This has been crucial in reducing maternal and child deaths over the years in the whole country.

A report released by Save the Children recently, states that Rwanda is the only East African country that is experiencing extremely fast rates of reduction in child mortality while virtually eliminating disparities in survival chances between poor and rich children.

The report says Rwanda is among the few sub-Saharan African countries on track to achieve Millennium Development Goals number four and five. Malawi and Ethiopia are also on the list of African countries on the right track.

It also shows that child deaths fell rapidly between 2000 and 2013 from 182 to 52 deaths per 1,000 live births. Maternal mortality also fell from 1,000 deaths per 100,000 live births to 320.

The report says that Impressive improvements have also been made in the coverage of services — with 98 per cent of one-year-olds vaccinated in 2010. In 2000, women in the richest economic group were three times more likely to give birth in the presence of a skilled attendant.

By 2010, this ratio had reduced to 1.4, with coverage among the poorest group rising from 22 per cent to 64 per cent. There is still a long way to go, but this trend is encouraging, the report notes.

Rwanda’s achievements in health outcomes are linked to improvements across a range of sectors and programmes, including the National Social Protection Strategy and significant progress in water, sanitation, education and gender equality.

The country has increased health spending to six per cent of GDP, far beyond the average of two per cent in other sub-Saharan African countries. It is one of just six African countries that allocated more than 15 per cent of its budget to health, meeting the Abuja Declaration of 2001.
Its subscription rate to community based health insurance stood at 73 per cent in the fiscal year 2013/14.

About 45,000 volunteer community health workers deployed countrywide are involved in sensitisation, screening, and sometimes treatment of ailments among its citizens.

And the presence of about 42 public hospitals, five referral hospitals, and over 450 health centres, makes access to health care easier countrywide.

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