It is morally wrong to make a mother choose between treatment for herself and treatment for her newborn. It is morally wrong that people should be dying of AIDS when treatment is available.
It is morally wrong that babies are still being born with HIV when we know how to prevent it. It is morally wrong that children are still growing up as AIDS orphans.
To be a partner for women and girls against violence and injustice, you do not have to be experts on human rights or gender. You do have to be committed to always asking in your daily work: 'How can I better engage women and girls to understand what they need'
A society that cuts itself off from its youth severs its lifeline; it is condemned to bleed to death.
When the history of our times is written, will we be remembered as the generation that turned our backs in a moment of global crisis or will it be recorded that we did the right thing?
No disease group is as vast and complex in scope as the noncommunicable diseases (NCDs). Incorporating social determinants such as income and education, the NCDs call for an equally massive and comprehensive response
There are 1.2 billion adolescents across the world, 9 out of 10 of these young people live in developing countries. Millions are denied their basic rights to quality education, health care, protection and exposed to abuse and exploitation.
Of all the forms of inequality, injustice in health care is the most shocking and inhumane.
“The early years in a child’s life—when the human brain is forming—represent a critically important window of opportunity to develop a child’s full potential and shape key academic, social, and cognitive skills that determine a child’s success in school and in life.”—President Barack Obama
“If art is to nourish the roots of our culture, society must set the artist free to follow his vision wherever it takes him.”—President JF Kennedy
"The true character of a society is revealed in how it treats its children. History will judge us by the difference we make in the everyday lives of children."—President Nelson Mandela

Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST)

Manpreet Singh Khurmi, MBBS, MPH, Felix Sayinzoga, MD, MSc, Atakilt Berhe, MD, MPH, Tatien Bucyana MD, MPH, Assumpta Kayinamura Mwali, MD, MPH, MMed, Emmanuel Manzi, MD, MPH, Maharajan Muthu, MBBS, MD

Abstract


Background and Objective: The Newborn Survival Case study in Rwanda provides an analysis of the newborn health and survival situation in the country. It reviews evidence-based interventions and coverage levels already implemented in the country; identifies key issues and bottlenecks in service delivery and uptake of services by community/beneficiaries, and provides key recommendations aimed at faster reduction in newborn mortality rate.

Methods: This study utilized mixed method research including qualitative and quantitative analyses of various maternal and newborn health programs implemented in the country. This included interviewing key stakeholders at each level, field visits and also interviewing beneficiaries for assessment of uptake of services. Monitoring systems such as Health Management Information Systems (HMIS), maternal and newborn death audits were reviewed and data analyzed to aid these analyses.

Results: Policies, protocols, various guidelines and tools for monitoring are already in place however, implementation of these remains a challenge e.g. infection control practices to reduce deaths due to sepsis. Although existing staff are quite knowledgeable and are highly motivated, however, shortage of health personnel especially doctors in an issue. New facilities are being operationalized e.g. at Gisenyi, however, the existing facilities needs expansion.

Conclusion and Global Health Implications: It is essential to implement high impact evidence based interventions but coverage levels need to be significantly high in order to achieve higher reduction in newborn mortality rate. Equity approach should be considered in planning so that the services are better implemented and the poor and needy can get the benefits of public health programs.

Key words: Bottleneck Analysis • Lives Saved Tool • Rwanda • Maternal and Newborn Health • Neonatal Mortality

Copyright © 2017 Khurmi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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DOI: http://dx.doi.org/10.21106/ijma.214

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