learning from success : reduction of maternal mortality in rwanda: an integrated approach
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Learning From Success : Reduction of maternal mortality in Rwanda: an integrated approach. Dr. Fidele Ngabo , Maternal Child Health Director . I. Introduction: Map of Health F acilities. I. Introduction (cont.) Administrative and Health S tructures. - PowerPoint PPT PresentationTRANSCRIPT
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Republic of RwandaKivu 2010 Leadership RetreatReporting on progress since the Leadership Retreat, and looking ahead to the next quarter
Learning From Success:
Reduction of maternal mortality in Rwanda: an integrated approach
Dr. Fidele Ngabo, Maternal Child Health Director
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I. Introduction: Map of Health Facilities
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I. Introduction (cont.) Administrative and Health Structures
Levels Admin Structures
Health Infrastructure Numbers
1. Villages / imidugudu 14.837 CHW 44,511
2. Cells / akagari 2.148 Health Posts / FoSaCom 44
3. Sectors / imirenge 416 Health Centres 450
4. Districts 30 District HospitalsDistrict Pharmacies
4030
5. Province (incl Kigali) 4 (DH to be upgraded to ProvH)
later
6. National 1 Nat. Referral Hospitals 5
Referral systems Ambulances / SAMU 154
Registered Private HF 157
Total Public + Agree HF (= in bold, being HC + DH + Nat Ref Hosp 495
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II. Achievements Maternal Mortality Trend
0
200
400
600
800
1000
1200
611
1071
750
476
1990 2000 2005 2010
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II. Achievements (cont.)Trends in Maternal Health
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II. Achievements (cont.)Role of Education in Health Improvement
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II. Achievements (cont.)Use of Modern Contraception
by Education
Percent of married women using any modern method
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II. Achievements (cont.)Current Use of Modern Methods
Percentage of currently married women using any modern method
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II. Achievements (cont.)Fight against Malaria
Decline in incidence, 70% between 2005 & 2010;
Decline in morbidity, 60% decline in out-patient cases between 2005 & 2010;
Decline in mortality, 54% decline in patient deaths between 2005 & 2010;
Increase in percent of pregnant women sleeping under LLINs, from 60 to 73% (2007/8 – 2010)
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II. Achievements (cont.)Trends in malaria prevalence in women by residence
Percent woman age 15-49 classified as having malaria
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III. Contributing Factors to Success
1. Conducive policy environment: (Clear policies & strategies are developed and implemented.)
– Vision 2020
– Economic Development and Poverty Reduction Strategy
– Health Sector Strategic Plan
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III. Contributing Factors to Success (cont.)
– Performance-based contracts (imihigo) at all levels of government
– Women empowerment
2. Strong commitment from highest level to the grass roots
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Political commitment to support health services
HE The President meeting the CHWs in 2010
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High level support to MCH
HE the First Lady leading the HPV vaccination campaign
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Community Participation: Community discussing health
issues in the village
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III. Contributing Factors to Success (cont.)
3. Innovative financing systems– Performance-based financing (health facilities and
community health workers)– Community-based health insurance coverage
(95%)
4. Strong financial support from GOR and from development partners
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III. Contributing Factors to Success (cont.)
5. Good Health Sector Coordination: JHSR: Joint Health Sector Review jointly done
every six months by Ministry of Health (MOH) and Development Partners (DPs)
Health Sector Working Groups which include MOH and DPs: to harmonize implementation of activities and avoid duplication
MCH technical working Group
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III. Contributing Factors to Success (cont.)
6. Accountability at All Levels• Sector-Wide Approach (SWAP): All resources are provided
in the context of a defined Health Sector Strategic Plan under Government leadership and in partnership with DPs
• Mid Term Review Framework: A systematic and effective use of results-focused budget planning, preparation and review approaches over a medium term; it allows an efficient and effective management of public funds and sound stewardship
• Transparency in financial management with regular financial audits
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IV. Sustaining Successes
• Maintain Government commitment• Strengthen health policies, strategies and systems• Strengthen community involvement• Strengthen women empowerment• Increase male involvement in reproductive health • Strengthen partnership for knowledge sharing• Continued support from DPs to strengthen a
sustainable health system
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Murakoze! Thank you!