Abstract
BackgroundIn Rwanda, maternal community health workers (M-CHWs) are involved in the country’s overall health system. In maternal health, their role includes the provision of preventive and promotional health services at the community level. They provide services such as health education on maternal health wellbeing, advice and information on access and timely utilization of health facilities for prenatal, delivery and postpartum care. The contribution of M-CHWs in the health sector combined with other government initiatives led the country to achieving the fifth Millennium Development Goal (MDG) - target 5A- that aimed to improve maternal health through the reduction of maternal mortality ratio by 75% between 1990 and 2015). The objective of this study was to explore M-CHWs’ perceptions and experiences on access and provision of maternal health services.MethodsWe used a case study methodology, a qualitative research approach to explore M-CHWs’ experiences and perceptions on access and provision of maternal health services at the community level in Rwanda. For the period of June–August 2014, in-depth interviews were conducted with sixteen M-CHWs who had been providing maternal health services in the Eastern Province of Rwanda. Participants shared their experiences and perceptions on access and provision of maternal health service in their communities.ResultsThe results of this research highlight the role of M-CHWs in promoting the use of health facilities for prenatal care and delivery and the ways they use to reach out to women. Several challenges prohibit M-CHWs to deliver adequate maternal health services and these are related to the poor resources settings in which they operate.ConclusionThe results of this study highlight the experiences and perceptions of M-CHWs on the provision and access to maternal health services in their communities. The fact that M-CHWs are volunteers operating in limited resources settings with no formal training in maternal health and with considerable workloads translates into challenges regarding the quality and quantity of services they provide in their communities. Such challenges create an impact on M-CHWs service provision, satisfaction and retention. The voices of M-CHWs and the communities they serve are needed to explore areas that are specific to each community context that would contribute to making the M-CHW program sustainable to achieve equitable access to maternal health services.
Highlights
In Rwanda, maternal community health workers (M-Community Health Worker (CHW)) are involved in the country’s overall health system
We used a semi-structured interview guide that included open ended questions to elicit views from Maternal Community Health Worker (M-CHW) about: 1) their understanding of maternal health; 2) the types of maternal health services provided at the community level by M-CHWs; 3) the factors that contribute to the use of maternal health services; 4) gaps and barriers in the provision of maternal health services in the community; and 5) suggestions to improve service provision
The following section groups the study results into three themes that emerged from the analysis: (1) promoting access to maternal health services in communities; (2) reaching out to women and (3) empowering MCHWs: Motivation, mentorship and training
Summary
In Rwanda, maternal community health workers (M-CHWs) are involved in the country’s overall health system In maternal health, their role includes the provision of preventive and promotional health services at the community level. M-CHWs’ roles involve educating the community on timely and adequate utilization of health facilities [7] and they play a direct role within their communities where they are in close contact with women who need maternal health services [2]. They provide education and information on overall health and wellbeing during pregnancy and after delivery [1]
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
