The government has launched a new model that recommends expectant mothers to have at least eight antenatal contacts with their healthcare providers within the course of their pregnancy.

The new guidelines, also by the World Health Organisation (WHO), replace those introduced in 2016 that initially recommended at least four visits.

The guidelines, which were tailored to the Rwandan context, will respond to identified areas of antenatal care that are critical to saving lives, improving quality of care.

Speaking at the launch, the Permanent Secretary in the Ministry of Health, Zachee Iyakaremye, said that the new guidelines present a more comprehensive opportunity to respond and address antenatal areas that are critical to saving lives.

He pointed out that the process of developing the new recommendations highlighted the value of communicating effectively and addressing physiological family planning misconceptions and socio-cultural issues in a respectful manner.

“Research has shown that by implementing timely and appropriate evidence-based practices, antenatal care can save lives. Crucially, it is also an opportunity to communicate with and support women at a critical time of their lives,” he said.

He reminded that the government has scaled up high impact maternal and neonatal interventions to significantly decrease maternal and new-born mortality.

“These efforts integrate family planning services into antenatal, delivery and postnatal care. As part of increasing contraception uptake, we expanded contraception services to the lowest community level to increase accessibility and use for young people and people with disability,” he said.

He touched on family planning where he said that with contraceptive use, around 425,000 unintended pregnancies were prevented while approximately 780 maternal deaths were averted in 2021.

He called on all healthcare providers including obstetricians, general medical practitioners, midwives, and nurses who are responsible for providing antenatal care and family planning services at all levels to contribute to improving maternal and neonatal healthcare outcomes in Rwanda.

The UNFPA Adolescent and Youth Unit Team Leader, Therese Karugwiza reminded that over 600 women die from pregnancy or delivery related complications while around 5,700 new-born children die every year in Rwanda.

She reminded that these deaths can be avoided with antenatal care contact where most risks in pregnancies can be found and treated in a timely manner.

Karugwiza added that with the expansion from four to eight antenatal visits, some of the services will be brought closer to the women and will be performed by community health workers.

“Integrating family planning services into maternal health services can be an effective strategy for reducing unmet need, especially in situations where maternity care is a woman’s primary contact with the healthcare system,” she said.

Call for inclusion

Alliance Stella Ishimwe, a Rwandan youth representative working with Health Development Initiative (HDI) who moderated a panel under the theme, “No Woman Should Die While Giving Life,” welcomed the new recommendations and called for these guidelines to be inclusive of young people.

“These new guidelines are commendable and timely. What we would like to see next is their dissemination countrywide in such a manner that healthcare providers deliver these services to expectant adolescents in a stigma-free environment,” she said.

Additionally, Ishimwe called for a review of the laws and policies that continue to frustrate many young people’s quest for contraception methods.

The Executive Director of the Umbrella of Organisations of Persons with Disabilities in the fight against HIV&AIDS and for Health Promotion (UPHLS), Francois Xavier Karangwa, also touched on the challenges that people with disabilities still face in relation to access to Sexual Reproductive Health and Rights services.

“We are still facing challenges in accessing health facilities as well as equipment and materials like those used in communication. Most of these materials still don’t favour people with visual and hearing impairment and frustrate their efforts to enjoy family planning services,” he said.

He called for more efforts to be put in ensuring that all information and services are inclusive so that no Rwandan is left behind.

A Family Planning Business Case report developed in Rwanda in 2019 indicates that, on average, between 2015 and 2050, every Rwf 1,000 invested in family planning will yield Rwf 112,000 in returns. - Nasra Bishumba, The New Times