Country on course to reduce infant deaths, but huge task ahead

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One of the United Nations Millennium Develop­ment Goals is to reduce child mortality by ensuring that the number of children who die under the age of five is reduced by two-third, come 2015. So, how much progress has Rwanda made?

maternity

The care that a newborn baby receives determines if he dies or lives. (file photo)

According to a report by the Ministry of Health, in 2000 the infant mortality rate was of 107 deaths per 1,000 live births, while the under-five mortality rate was of 196 per 1,000 live births – an indication that most deaths oc­curred during the first year of life.

“In Rwanda the main causes of child deaths have proven to be diarrhea, malaria and pneu­monia,” says Dr Anniseth Nza­bonimpa, coordinator of the family planning, HIV, maternal and child integration unit in the Health Ministry.

Therefore, the ministry has been putting in place strategies to prevent them.

Efforts have focused on im­munization of children. “In re­cent years, new vaccines like the pneumococcal vaccine were introduced.  New ones will con­tinue to be introduced as they be­come available,” said Nzabonim­pa.

According to the 2010 demo­graphic and health survey, 90% of the children aged 12-23 months were vaccinated – a significant increase from 75% and 80% of 2005 and 2008 respectively.

Other strategies are pro­vision of clean water and good sanitary conditions. “We give to the families ‘Sur’eau’, a product used to purify the water they drink and urge them to increase measures of hy­giene in their homes,” said Dr Ferdinand Bikorimana, of the maternal and child health de­partment in the health ministry. “The community health workers are instrumental in the campaign as they are constantly on the ground. So we provided them with whatever is needed to help the commu­nity attain the above.”

To fight against malaria, a lead­ing cause of death among chil­dren, mosquito nets have been distributed to the community.

Neonatology services, which specifically take care of all new­born babies with problems, have also been introduced and there is a plan to have them in every hospital. “In general, the care that a newborn baby receives de­termines if he dies or lives,” ex­plained Nzabonimpa.

mother and baby

When it comes to mother and child health, Rwanda has made significant progress. (file photo)

New methods like the kangaroo mother care, used to keep new born ba­bies warm, have been introduced and encouraged.  “A mother’s health, especially when preg­nant, is key to the health of the new born, which is why antenatal care is impor­tant,” explained Bikorimana. Parents are taught how to take care of their baby’s health, nutri­tion and hygiene. As it is easier to teach younger people, this is also taught to the youth. “It’s better to know how to handle a situa­tion before it rises,” Bikorimana added.

The percentage of babies deliv­ered by health professionals has increased from 52% in the 2007-08 to 69% in 2010. The proportion of babies delivered at a health fa­cility increased substantially dur­ing the same period, from 45% in 2007-08 to 69% in 2010.

To make health care for chil­dren easier for parents, the Min­istry of Health is implement­ing an integration of different services. “If a mother comes to get immunization for the child, we want to also have a general checkup for the child and give him/her the treatment needed,” explained Nzabonimpa. If pos­sible, the mother will also be treated. “Some of them have to travel a long distance to get to the hospital, so it will be easing their burden.”

With all these strategies and programs, the country has man­aged to reduce child mortality rates recording an infant mortal­ity rate of 50 per 1.000 live births and under-five mortality rate of 76 per 1,000 live births in 2010.

Considering all the improve­ments made against both malaria and pneumococcal disease, and the efforts to take better care of new born babies and under five children, Rwanda is on track to meet the 2015 target of reducing the mortality rates to 28 for in­fants and 50 for under-five chil­dren.