RWANDA: More Women Deliver in Hospitals

About 70 per cent of Rwandan women deliver under the supervision of a professional medical practitioner, an official has said.

In 2000, only 10 per cent women delivered from proper health facilities, according to Dr Fidel Ngabo, the Coordinator of Maternal and Child Health in the Ministry of Health.

The 2010 Rwanda Demographic and Health Survey (RDHS) indicates that the percentage of babies delivered in conventional health facilities has substantially increased to 69 per cent from 52 per cent in 2007-2008.

Dr Ngabo said that the increase is attributed to the role of Community Health Workers (CHW's) at the grassroots level that monitor and encourage women to deliver from health facilities.

"CHW's have played a big role in the increase of this number as they follow up and make sure that women don't give birth at home but in health facilities. They have also been given phones so they can call in case there's need for an ambulance or further medical assistance," he said.

CHWs also encourage women to go for antenatal care and deliver with the help of professionals.

He added that healthcare charges have drastically reduced through health insurance schemes such as mutuelle de sante, which has encouraged many women, including those who cannot afford medical services during pregnancy.

Traditional Birth Attendants (TBAs) who facilitate women to deliver from health facilities are also being offered incentives to encourage professional child birth.

Agatha Mutamba, a midwife at the Rwanda Military Hospital added that most women now prefer to deliver from health facilities though the remaining challenge is poor attendance of antenatal care that ought to be monitored by a health professional.

"Very few women still give birth with the help of TBA's because of all the sensitisation in the media and the role played by Community Health Workers. However, women should also attend antenatal care at least four times during pregnancy so as to detect any complications early enough and also have a health pregnancy," she said.

In an earlier interview, the Chairperson of the Rwanda Midwives Association, Josephine Murekezi, attributed the success to the increase in the number of professional health workers, including doctors, nurses and midwives.

She said this signified that more women can be attended to thus improving maternal healthcare.

According to the 2010 Demographic Health Survey (DHS), 10 per cent of women giving birth received no assistance, 21 per cent were assisted by untrained persons (two per cent by nonqualified health workers, three percent by traditional birth attendants and 16 per cent by relatives or other persons).

Dr Ngabo noted that the distance to health facilities among some rural women is long, compelling them to seek the nearest option such as TBAs or other untrained persons.

Some women also still prefer to use traditional birth attendants to help them during child delivery.

Diana Umulisa, a shop owner in Kabeza told The New Times that some rural women usually feel comfortable with traditional birth attendants.

"There are traditional birth attendants who know how to assist women during childbirth; so these women find it pointless to go for the same services at a health facility. However, this is due to ignorance of some of these women because in case of complications, a TBA might not be helpful at all," she said.