Saving the lives of newborns through Perinatal Care improvements at the Gahini Hospital in Rwanda

UNICEF Rwanda works with the Royal College of Paediatrics and Child Health (RCPCH) and the Rwanda Paediatrics Association, to place neonatal doctors and nurses from the UK in Rwandan hospitals for a 6 month residency programme.

Steve Nzaramba
Mother holds her newborn twins
01 September 2021

Every morning, Nurse Jacqueline Mukawiringiye makes her rounds checking on the babies currently in the incubators at the neonatal unit in Gahini Hospital. Since 2019, Nurse Jacqueline has been part of the Perinatal Improvement Program at Gahini Hospital and says she has seen a significant improvement in her work.

Located in the Eastern Province of Rwanda in Kayonza District, Gahini Hospital is one of the 19 selected health facilities, part of the Rwanda Perinatal Improvement program. The Perinatal Improvement program is co-managed by the Rwanda Paediatric Association and the Royal College of Paediatrics and Child Health. UNICEF spearheads this program with funding support from Takeda Pharmaceutical Company Limited.

Jackeline Mukawiringiye, Head Nurse at Gahini Hospital coaches Rachel Murasoni on the "Kangaroo Care" technique.
Jackeline Mukawiringiye, Head Nurse at Gahini Hospital (right), coaches Rachel Murasoni, left, on the "Kangaroo Care" technique. Rachel's daughter was born too early, but the skin-to-skin contact of Kangaroo Care helps regulate her body temperature and promote healthy growth.

Gahini Hospital has been part of the program since March 2019, and the medical staff has to date continued to advance in the knowledge on the improved measures of perinatal care. Currently, 16 staff members from the maternity unit and eight from the neonatology unit have been trained, providing Gahini Hospital with 24 trained staff, which is an excellent achievement for the district and will continue to grow positively, impacting other health facilities in the community. 

Gahini Hospital's achievements from being part of the program extend beyond gaining access to knowledge and skill in improving care for perinatal, to personal achievements in the staff. Staff is more confident in their jobs, which is of great significance because they receive pregnant and nursing mothers who need the assurance that they are in safe hands, more so among low-income communities challenged with inadequate access to proper medical care.

Other achievements include quality care from the medical staff because the mothers expect excellent service. The program goes beyond offering knowledge increase and provides the medical staff with resources in creating systems to keep track of the services provided to the infants and mothers. These systems allow functional working environments where the maternity and neonatology units can co-exist in providing the utmost care to babies and mothers. 

Gahini Hospital has seen a significant improvement in its departments since the training was adopted, with fewer mortality rates reported among mothers and babies due to advanced knowledge and skills handling emergencies during care provision. 

"Learning the ABC method assisted us in learning how to save mothers and their babies quicker because we know what to look for and how to begin the treatment. It's a standard method that all medical staff is now aware of, and it has been of great help with reducing mortality in our patients."

Jacqueline Mukawiringiye

These achievements have not been without challenges, which in most cases are associated with the arrival of expectant mothers in the facility with advanced pregnancies, at times after they had delivered are home or on the way to the facility. Some of the mothers who find themselves in such situations cannot afford medical services; hence, they only visit the hospital for emergency cases, such as home deliveries that affect the health of the mother or the newborns.

Gahini Hospital is trying to educate mothers on seeking medical attention in time and providing them with adequate information on avoiding emergencies. Currently, the Rwandan government offers medical aid in the form of a Community Based Insurance called Mutuelle de Santé to low-income homes. These medical insurances cover a certain percentage of medical bills depending on which defined income categories. For instance, in category 1, the government pays the Rwf 2,000 subsidy to the insurance per year for each individual's treatment. The individual would cover the remaining amounts, which are usually not expensive. However, the balance to be paid can still be a lot for the low-income household, so they end up not applying for medical aid.

The Rwanda Perinatal Improvement program is currently in the second phase, which means the medical staff at Gahini Hospital will continue to receive training on perinatal care, leading to more remarkable improvements for the hospital and the community. 

With funding from Takeda’s Global CSR Program, UNICEF will continue to be a part of the second phase, ensuring that quality health care for mothers and children does not stop in Rwanda.

Jacqueline Mukawiringiye, head nurse at Gahini Hospital, paediatric doctor Evelyn Little attend to a newborn baby, born premature
Jacqueline Mukawiringiye (left) and paediatric doctor Evelyn Little (right) attend to a newborn baby, born premature, in Gahini Hospital's neonatology ward.