Goal 5. Rwanda

Goal 5: RwandaJason DePecol, Siham Elhamoumi, Kate Mooney, Kelsey Morse and Amanda Rohdenburg

Photo Credit: Jason DePecol

           Rwanda is largely viewed as a success story for MDG Goal Five of reducing maternal mortality rates (MMR’s). MMR’s increased in 2000, spiking from 500 to 1,071, due largely to the genocide (Hogan et. al 2010). However, by 2005 the MMR declined sufficiently to 750 per one hundred thousand births, a reduction of almost 30% (UNDP 2007). And later studies show that in 2010 the MMR was 487 per 100,000 births. This ratio is much closer to what the MDGs hoped to achieve. Rwanda is making strides in this goal due largely to the current increase of assisted mothers during delivery from 26% in 1992 to 39% in 2005 and there was a slight increase in birth delivery at the health facilities from 25% in 1992 to 28% in 2005 (WHO 2012). There has been a significant decrease in maternal mortality rates over the last eight years and studies show that they are continuing on a decline (Hogan et al., 2010). If facilities and access to birth attendants continue to improve than the MMR can drop even lower.

            Factors that affect the probability of a woman being assisted by a trained attendant during delivery are education, wealth, and the number of prior deliveries. The percentage of mothers assisted during delivery is proportional to their level of education, the rank of the birth and the greater the number of prior deliveries a woman had; the less likely she needs antenatal care (WHO 2012).

             The interrelated nature of the MDGs is especially noted in the relationship between Goal One and Goal Five. Here it can be seen that Goal One needs to be addressed before adequate strides are made in improving the MMR of Rwanda. In essence, until the serious problem of poverty is addressed in Rwanda, there will not be improved facilities for birth or trained birthing attendants at the side of the mother (Hogan et al. 2010). Sixty-six percent of the wealthiest quintile of women were attended to during birth while only 27% of the poorest quintile were attended (Kanyarukiga 2006). This disparity shows that until poverty is more aggressively addressed, MMR will continue to be higher than they should be, and the poorest of the poor will continue to lack the services that those in urban areas are provided with.

             Challenges affecting the achievement of Goal Five include reducing a number of women who deliver at home, encouraging pre-natal and post-natal consultation services, providing health services to all, increasing the number of skilled birth attendants, and health services access and utilization for the entire population that are not concentrated by wealth.

             Some of the priorities that need to be addressed in order to successfully reach this goal include strengthening national policies on health by decentralizing and enhancing aid coordination, increasing budget allocated to the health sector, decentralizing the treatment of, and care for people living with HIV/AIDS and malaria, increasing decentralization and community involvement in providing maternal health services, and involve women associations in reproductive health and family planning programs.