Innovations in Rwanda's health system: looking to the future

Logie, Dorothy; Rowson, Mike; Ndagije, Felix

doi:10.1016/s0140-6736(08)60962-9

Cited by 128 publications

(112 citation statements)

References 6 publications

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“…In its efforts to improve access, the country has developed a comprehensive health sector strategic plan. A major focus of this plan is the expansion of health insurance to the informal sector through MHI [13].…”

Section: Mutual Health Insurance In Rwandamentioning

confidence: 99%

Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection

et al. 2011

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Section: Mutual Health Insurance In Rwandamentioning

confidence: 99%

Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection

et al. 2011

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“…Rwanda has made rapid progress in economic and social development since the 1994 genocide, when approximately one million people were killed and much of the socio-economic fabric of Rwanda, as well as many health facilities, were destroyed [17]. Rwanda is one of the nine countries that reached the Millennium Development Goal (MDG5) that called for a reduction of 75% in the maternal mortality ratio (MMR) from 1300 per 100,000 live births in 1990 to 290 per 100,000 live births in 2015 [18,19].…”

Section: Introductionmentioning

confidence: 99%

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Holmlund

Ntaganira

Edvardsson

et al. 2017

Global Health Action

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Background: Obstetric ultrasound has become an indispensable part of antenatal care worldwide. Although the use of ultrasound has shown benefits in the reduction of maternal and foetal morbidity and mortality, it has also raised many ethical challenges. Because of insufficient numbers of midwives in Rwanda, uncomplicated pregnancy care is usually provided by nurses in local health centres. Obstetric ultrasound is generally performed by physicians at higher levels of healthcare, where midwives are also more likely to be employed. Objectives: To explore Rwandan midwives’ experiences and views of the role of obstetric ultrasound in relation to clinical management, including ethical aspects. Methods: A qualitative study design was employed. Six focus group discussions were held in 2015 with 23 midwives working in maternity care in rural and urban areas of Rwanda, as part of the CROss Country Ultrasound Study (CROCUS). Results: Obstetric ultrasound was experienced as playing a very important role in clinical management of pregnant women, but participants emphasised that it should not overshadow other clinical examinations. The unequal distribution of ultrasound services throughout Rwanda was considered a challenge, and access was described as low, especially in rural areas. To increase the quality of maternity care, some advocated strongly for midwives to be trained in ultrasound and for physicians to receive additional training. In general, pregnant women were perceived both as requesting more ultrasound examinations than they received, and as not being satisfied with an antenatal consultation if ultrasound was not performed. Conclusions: Obstetric ultrasound plays a significant role in maternity care in Rwanda. Increasing demand for ultrasound examinations from pregnant women needs to be balanced with medical indication and health benefits. Training of midwives to perform obstetric ultrasound and further training for physicians would help to address access to ultrasound for greater numbers of women across Rwanda. RESPONSIBLE EDITOR Virgilio Mariano Salazar Torres, Karolinska Institute, Sweden

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“…Significant investments have been made to improve the infrastructure of primary health centers and to remove financial barriers to access through community health insurance [2]. Nevertheless, reducing Rwanda's maternal mortality ratio, estimated at 750 deaths per 100 000 live births, is encumbered by a high fertility rate of 5.5 children per woman and a population growth rate of 2.8% per year, which is among the highest in Africa [3,4]. In 2008, only 52% of births had skilled attendance.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, attitudes, and practices in safe motherhood care among obstetric providers in Bugesera, Rwanda

Puri¹,

Rulisa²,

Joharifard³

et al. 2011

International Journal of Gynecology & Obstetrics

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Innovations in Rwanda's health system: looking to the future

Cited by 128 publications

References 6 publications

Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection

Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection

Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound

Knowledge, attitudes, and practices in safe motherhood care among obstetric providers in Bugesera, Rwanda

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