Rwanda

Rwanda—the most densely populated country in Africa—is still recovering from a devastating civil war that ended in 1994 with the genocide of an estimated 800,000 people. The government faces several challenges in rebuilding the country’s health system. With 65 years of experience focused on building quality reproductive health care that lasts, EngenderHealth is uniquely suited to assist Rwanda’s government as it rebuilds health networks and facilities. As Rwanda’s Ministry of Health develops national family planning policies and strategies, EngenderHealth is assisting with efforts to:

• Expand contraceptive choice;
• Prevent the spread of HIV and AIDS;
• Make motherhood safer.

 
Expanding Contraceptive Options
A shortage of skilled providers, inadequate supplies, and lack of accurate information about methods hinder men’s and women’s access to modern contraception in Rwanda. Through the ACQUIRE Project, funded by USAID, EngenderHealth collaborates with Rwanda's Ministry of Health, Pathfinder International, and other agencies to promote a full range of contraceptive methods, especially long-acting and permanent methods like Norplant and the IUD. At the community level, we assist with programs to increase knowledge of modern contraception, particularly among youth. We also advocate for men’s involvement in reproductive health and family planning.

 
Advancing Services for HIV and AIDS
EngenderHealth’s innovative training and quality improvement approaches help eliminate the stigma surrounding HIV and AIDS in health care settings. We improve the quality of HIV services by:

• Supporting voluntary counseling and testing for HIV;
• Preventing mother-to-child HIV transmission;
• Promoting sound infection control practices at health clinics;
• Encouraging men to prevent HIV and educate their peers about sexual and reproductive health.

 
Making Motherhood Safer
About 60% of Rwandan women deliver their babies at home, and only 38% of births take place with a skilled birth attendant. Over the last several years, the country has made concerted efforts to decrease maternal mortality, increase the number of hospitals, and place skilled health personnel in remote areas. Despite these great strides, a large number of women still die in childbirth or suffer debilitating injuries.

One common—and preventable—injury is obstetric fistula, a vaginal tear resulting from prolonged obstructed labor that can lead to incontinence, nerve damage, and severe social stigma. Several hundred new fistula cases occur each year in Rwanda. By training health care workers in prenatal and emergency obstetric services, EngenderHealth helps prevent fistulas; we also train social workers in fistula counseling. To ensure the most efficient use of resources—and to extend the reach of education efforts—we established the Fistula Working Group in Rwanda, which includes all agencies and nongovernmental organizations working on fistula in the country.