Improving survival and wellbeing of newborns in Rwanda
UNICEF is working with partners to reduce newborn mortality by improving the quality of maternal and newborn care in Rwanda through training of nurses and doctors and equipping health facilities with equipment vital for child survival
“As a midwife or nurse, you have to be artistic and precise in everything you do,” says Sophia Nyame, a Ghanaian nurse, while working at Kacyiru Hospital in Rwanda's capital, Kigali.
“This is important because it helps reassure the patient that they are in good hands, and they will be taken care of, whatever the issue may be,” she adds.
Sophia is part of an international outreach team of nurses, doctors, and midwives currently in Rwanda to impart their skills and knowledge to Rwandan doctors and nurses as part of the Integrated Rwandan Perinatal Improvement Programme (RPIP), a UNICEF-supported neonatal clinical mentorship project.
The team spends a total of six months in-country, imparting mentorship and training to doctors and nurses in various hospitals across the country on a rotational basis.
Implemented in collaboration with the Royal College of Paediatrics and Child Health (RCPCH) and the Rwanda Paediatric Association (RPA), and thanks to the generous financial support from Takeda Pharmaceuticals, RPIP currently covers 10 Hospitals and 75 catchment Health Centers countrywide. The RPIP involves training and mentoring hospital nurses and doctors in the care of newborns, including the use of life-saving equipment.
From April 2021 to March 2022, a total of 233 nurses and doctors were trained and mentored.
The project serves to remedy one of the major barriers identified to further reduce newborn mortality in Rwanda: inadequate quality of care provided during labour, management of sick newborns, and shortage of human resources and basic equipment.
“In our line of work, any error – big or small – can lead to the loss of a life.”
“Lack of preparation for childbirth is among the leading causes of newborn mortality,” Sophia continues. “In our line of work, any error – big or small – can lead to the loss of a life,” she says.
“Therefore, it is especially important that doctors and nurses are receiving this training, and it will hopefully lead to improved healthcare and lowered rates of deaths during childbirth,” she added.
The first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival. Statistics show that within the first month, 19 neonates out of 1,000 live births die each year in Rwanda. This is higher than the average global rate of 17 deaths per 1,000 live births in 2020.
Countless deaths in the first month of life and among children under five are due to diseases and conditions that are readily preventable or treatable with proven and cost-effective interventions.
“The quality of new-born and intrapartum care has significantly improved since this mentorship programme began.”
“The quality of new-born and intrapartum care has significantly improved since this mentorship programme began,” says Noella Uwera, a neonatal nurse working at Kacyiru Hospital who is among those benefitting from Sophia’s training.
“It is incredible how seemingly minor adjustments or tweaks to the management of newborn babies can make a huge difference. We learnt, for example, the importance of having shawls on hand to cover up prematurely born babies while transporting them to the Neonatal Intensive Care Unit (NICU). This helps protect them from the cold and preempts complications related to hypothermia. This has made a big difference,” she narrated.
“As a result of this mentorship programme, our overall management and care for newborns has markedly improved. We use data much more often now to track how the baby is faring, and this has helped highlight of concern before they develop into a full-blown condition,” Noella added.
"If there is any emergency c-section, if there is any high-risk newborn, the maternity team know they have great support from the neonatology team and that is due to the support we received via the Quality Improvement (QI) Plan," says Dr. Ariane Nina Ndayikeje, Consultant Paediatrician and Head of the Pediatrics and Neonatology Department at Kacyiru Hospital.
The Integrated Rwandan Perinatal Improvement Programme, currently in its second phase, ensures that doctors, nurses and midwives continuously have their capacity built up, which in turn leads to quality health care for mothers and children in Rwanda.