Neonatal resuscitation needs in Rwanda
by Waleed Fatth (GEI Global Programs Manager, Berlin)
Jeanne Musabende lives in Nyamata, a town in Bugesera district some 40 minutes from Kigali, Rwanda’s capital. She recently became famous when a Rwandan online journal used her success story to showcase progress in infant and maternal healthcare in the country. Jeanne was due to have a complicated birth late in the evening, traditionally a worrying event in many developing countries with their notoriously weak rural health infrastructure. But Rwanda has come a long way and is rightfully praised for its progress. Jeanne was able to call a community health worker for help who, in turn, organized an ambulance and also took notes for Jeanne’s situation to facilitate the work of the nurses at the hospital. Few hours later, Jeanne delivered a beautiful healthy baby under the supervision of qualified and skilled professionals.
While success stories like Jeanne’s have become commonplace in Rwanda, the country still bears a heavy burden of high neonatal mortality. And, sadly, it is estimated that more than half of the deaths would be preventable if all birth attendants were trained to manage complications during childbirth, such as birth asphyxia, the inability to breathe at birth.
The United States Agency for International Development (USAID) recently reported a study of 42 cases of neonatal asphyxia in Rwanda where birth attendants with neonatal resuscitation training were present to provide initial stimulation (resuscitation). 22 newborn babies responded immediately to the measures and started to breathe spontaneously. The other 20 were treated with a bag and mask, and 3 of them were ventilated with oxygen. The wonderful result of these measures was that 33 babies (79%) survived without the need of any elaborate interventions which are usually not accessible in rural communities. And of the 9 neonatal deaths, 6 were diagnosed to have been caused by other factors, relating to prematurity and very low birth weight.
These numbers show how fundamentally important training in neonatal resuscitation is for birth attendants. And there are simple and effective evidence-based curricula available, also for resource-limited environments such as those in rural Rwanda. If you are interested to learn more, you can do so by reading about our Helping Babies Breathe (HBB) delegations who train Rwandan birth attendants. The results are life-saving!