Abstract
BackgroundWhile maternal and newborn deaths has been decreasing since 2008 in Rwanda, there is room for improvement to meet its sustainable development goals. The maternal and newborn health care program needs to be monitored to ensure its effective implementation. This study therefore aimed to explore stakeholder’s perceptions of the Rwandan maternal and newborn health care program to identify areas for improvement.MethodsThe convergent, parallel, mixed method study used quantitative and qualitative data in a single phase. The quantitative data was obtained from 79 health care workers, ranging from maternal community health care workers to program supervisors. The 10 areas of the Project Implementation Profile (PIP) instrument checklist with a five-point Likert scale were used to indicate their perceptions (strongly disagree to strongly agree). The qualitative interviews of five nurse managers used a manifest inductive content analysis, directed approach that entailed using existing theory and prior research to develop the initial coding scheme before starting data analyse.ResultsThere was disagreement about the level of top management support, human resources was regarded as an area of concern, with 18.7% (n = 14/79) indicating that they did not agree that this was adequately provided for; urgent solutions for unexpected problems was regarded as an areas of concern by 46.8% (n = 36/79). Top management support weakness were inadequate support training, materials, money for home visits, supervision and leaderships, and training of newly recruited maternity health care workers. For human resources, there were insufficient trained staff to take care of mothers and newborns due to the shortages of health providers. The management of unexpected problems was also an area of concerns and related to getting patients to health facilities during pregnancy emergencies and the lack of qualified birth attendants at health facilities.ConclusionThe study identified three areas for improvement: top management support, human resources and urgent solutions for unexpected problems, as they may be affecting the provision of maternal and newborn health care program services. Using the PIP enable managers to improve the country’s maternal and newborn health care program, and to provide ongoing monitoring and evaluation of with respect to the desired outcomes of reducing maternal and neonatal mortality.
Highlights
While maternal and newborn deaths has been decreasing since 2008 in Rwanda, there is room for improvement to meet its sustainable development goals
Sub-Saharan Africa had the highest neonatal mortality rate in 2018 at 28 deaths per 1000 live births, with a child born in the region being 10 times more likely to die in the first month than one born in a high–income country [1]
Three categories were below the mean value of 4, these being top management support (No 2) (Mean = 3.66, SD = 1.059), human resources (No 5) (Mean = 3.61, SD = 1.064) and urgent solutions for unexpected problems (No 10) (Mean = 2.33, SD = 1.559) (Table 2), these being particular areas of concern (Table 2)
Summary
While maternal and newborn deaths has been decreasing since 2008 in Rwanda, there is room for improvement to meet its sustainable development goals. The number of annual neonatal deaths decreased from 5.0 million in 1990 to 2.5 million in 2018 [1], with efforts being made to implement programs that would enable countries to meet their Sustainable Development Goal (SDGs) targets (adopted in 2016) to reduce mortality to at least 12 deaths per 1000 births by 2030. Sub-Saharan Africa had the highest neonatal mortality rate in 2018 at 28 deaths per 1000 live births, with a child born in the region being 10 times more likely to die in the first month than one born in a high–income country [1]. Reducing maternal deaths globally to less than 70 per 100,000 live births by 2030 is a target of SDG 3, and aims to “ensure healthy lives and promote wellbeing for all at all ages” [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
