Maternal and Perinatal Outcomes among Maternity Waiting Home Users and Non-Users in Rural Rwanda

Most maternal and perinatal deaths could be prevented through timely access to skilled birth attendants. Women should access appropriate obstetric care during pregnancy, labor, and puerperium. Maternity waiting homes (MWHs) permit access to emergency obstetric care when labor starts. This study compared maternal and perinatal outcomes among MWH users and non-users through a retrospective cohort study. Data were collected through obstetric chart reviews and analyzed using STATA version 15. Of the 8144 deliveries reported between 2015 and 2019, 1305 women had high-risk pregnancies and were included in the study. MWH users had more spontaneous vaginal deliveries compared to non-users (38.6% versus 16.8%) and less cesarean sections (57.7% versus 76.7%). Maternal morbidities such as postpartum hemorrhage occurred less frequently among users than non-users (2.13% versus 5.64%). Four women died among non-users while there was no death among users. Non-users had more stillbirths than users (7.68% versus 0.91%). The MWH may have contributed to the observed differences in outcomes. However, many women with high risk pregnancies did not use the MWH, indicating a probable gap in awareness, usefulness, or their inability to stay due to other responsibilities at home. Use of MWHs at scale could improve maternal and perinatal outcomes in Rwanda

Effect of neonatal nurse mentorship in improving neonatal care competencies among neonatal nurses in Rwandan hospitals

Abstract Background Despite healthcare improvements in Rwanda, newborn mortality remains high. This study assesses the impact of neonatal mentorship on enhancing nurses’ competencies within neonatal units, aiming to address this mortality concern and strengthen healthcare providers’ abilities. Methods The prospective cohort study included 25 health facilities supported by Ingobyi Activity in Rwanda, which were beneficiaries of a monthly mentorship program focusing on five critical neonatal competencies. These included adopt manipulation of neonatal equipment, effective management of small and sick newborns, stringent infection prevention and control (IPC), kangaroo mother care (KMC) implementation, and family‐centered care provision. We employed an observation checklist to measure neonatal practice competencies, comparing practices at the time point of the baseline, at the 6th mentorship session, and finally at the 12th mentorship session. Results The program engaged 188 neonatal nurse mentees. Data analysis highlighted a substantial increase in overall neonatal practice competencies from a baseline of 42.7%–75.4% after 12 mentorship sessions. Specific competency enhancements included family‐centered care (40.3%–70.3%), IPC (43.2%–84.2%), KMC (56.9%–73.3%), management of small and sick newborns (38.5%–77.6%), and manipulation of neonatal equipment (42.7%–75.4%). Conclusions This neonatal mentorship program was effective in enhancing nursing competencies, leading to significant improvements in neonatal care practices. Future work should evaluate the program's cost‐effectiveness and explore its potential to positively impact neonatal health outcomes, thus ensuring sustainable healthcare advancements