Maternal mortality is one of the most heartbreaking and devastating challenges women and families face in the developing world. The leading cause of death for young women ages 15 to 19 in developing countries is complications from pregnancy, especially in sub-Saharan Africa(1). Also in sub-Saharan Africa, 2.2 million young women have unintentional pregnancies every year (2). This crisis is finally being addressed effectively with exciting developments in Rwanda:
• 60,000 rural health workers have been trained to help mothers and children, at least one worker is present in each village in Rwanda
• The government is introducing a large program to give the HPV vaccine to women
• Women are receiving more education about family planning, contraception, and hygiene
• A revolutionary SMS system is being implemented to get trained medical professionals to expecting mothers.
More about each of these initiatives and strategies: (bold emphasis done by me)
Rwanda’s long-term vision and openness to innovation is helping it make great strides towards a brighter future.
Maternal and child survival are certainly top of the list of Rwanda’s health priorities, having been identified as absolutely crucial for the long-term health of the country on its road to development. Healthier mothers mean healthier children, and healthier children mean a healthier, more productive society in the future.
Lack of easy access to care meant that decisions to seek medical help were often delayed, worsening the prognosis. But this problem is being tackled through the training of 60 000 village-based community health workers. Each village has at least one worker trained in maternal health, one in child health, and one in community health, each of whom has been elected by the local community.
Government and GAVI plan to introduce a rotavirus vaccine next year, followed by the human papillomavirus vaccination (HPV)—part of the fourth generation of vaccines to be approved for funding by GAVI. But the immunisation programme is not just about vaccination, it also acts as a gateway to other health services. This is readily apparent at the Musha Health Centre in Rwamagana district, on a hill overlooking Lake Muhazi, east of the capital. By 10 in the morning the bright and airy meeting room is already packed with rows of women cradling infants. Facing the women, a nurse sits at a desk and prepares the vaccinations. Another nurse paces the room, espousing the benefits of giving birth at the health centre instead of at home, answering questions about the vaccination session due to take place, and preparing the women for an education session on family planning. At each vaccination visit women are educated on a different subject, from nutrition and hygiene to contraception.
Meanwhile, Rwanda continues to innovate. The next step in the evolution of its health system will see the widespread introduction of a UNICEF-developed rapid SMS system of communication between community health workers, health centres, and hospitals. The system is primarily designed to improve maternal health, with every woman who becomes pregnant required to report to the local community health worker. These workers are given mobile phones, which they use to record and send details about the woman’s village, language, and weight. 3 months before the woman is due to give birth she is asked to attend prenatal classes, and asked to alert the community health worker as soon as she starts her contractions or experiences any complications. The health worker then messages a central ministry of health server, which dispatches an ambulance from the nearest health centre. In serious cases, the server bypasses the health centre and alerts the nearest regional hospital to intervene.”
These developments are hugely exciting, and I hope that these ideas spread to other parts of the region soon. Even though current economic conditions may not lend to huge amounts of aid to African nations, innovative solutions like this must be implemented quickly. Here are some of the many reasons why we all should support innovative solutions in all parts of sub-Saharan Africa:
• In Uganda, nearly half of young people who have an STI do not seek treatment because they are embarrassed, do not want others to know, do not know where to go, or because they are unable to meet the cost.
• In Madagascar, a recent study shows that only 14 percent of women are using hormonal contraception. Barriers to use include gaps in knowledge about the range of available methods, misinformation and negative perceptions about some methods, and concern about social opposition to contraceptive use, mainly from male partners.
• In Somalia, a woman has a one in twelve lifetime chance of dying from a pregnancy-related cause. In Rwanda and Burundi, the chance is one in sixteen
• In sub-Saharan Africa, one person in two lives in extreme poverty.
I applaud Rwanda’s efforts to improve maternal and children’s health, as surely this will lead to a more productive society. I hope too see programs like this implemented in many more countries in the coming month and years.
Dan Jubelirer is a 2010 Netroots Fellow at Amplify, a youth-driven community dedicated to promoting sexual health and reproductive justice.