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Improving availability of EmOC services in Rwanda — CARE's experiences and lessons learned at Kabgayi Referral Hospital
Author(s) -
Kayongo M.,
Butera J.,
Mboninyibuka D.,
Nyiransabimana B.,
Ntezimana A.,
Mukangamuje V.
Publication year - 2006
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2005.10.030
Subject(s) - medicine , referral , preparedness , psychological intervention , case fatality rate , health care , medical emergency , quality management , nursing , operations management , environmental health , population , management system , political science , law , economics , economic growth
Objective CARE's work in Rwanda was designed to improve the functional capacity of health facilities for the delivery of EmOC services. Objective The project supported a comprehensive package of focused interventions that included hospital renovations, provision of essential equipment, training of staff and improvement of management systems at the Kabgayi regional referral hospital. Results There was an increased level of preparedness for emergencies and ability to manage common obstetric complications according to evidence‐based practices. These changes ultimately led to increased availability, quality and use of services as demonstrated by an increase in the demand for care of obstetric complications at the facility. The met need increased from 16% at the start of the project (2001) to 25% in 2004, while the cesarean rate remained essentially the same (1.9% and 3.2%) over the same time period. There were progressive declines in the case fatality rates from 2.2% in 2001 to 1.2% in 2004. Conclusion CARE's experience indicates that progress towards reducing maternal mortality requires specific efforts that support and strengthen existing health systems to provide skilled care that can save women's lives.