The mortality rate for children under five is 50 per 1,000 live births, and out of the deaths that occur at health facilities, 65% are preventable, according to a 2016 report by the Rwandan Ministry of Health. The top causes of death include respiratory tract infections, sepsis, malaria, and malnutrition-related complications.
These deaths can be attributed to a range of issues, from inadequate or non-existent emergency triage, a lack of proper assessment and treatment of the severely ill, poor monitoring of patients during and incomplete investigation of disease. At the community level, most children are treated by community health workers, most of whom do not have medical training and have critical gaps in knowledge that prevents them from providing proper treatment and diagnosis.
Last October, we launched a one-year program aimed at building the capacity of nurses and community health workers to improve their knowledge and skills so that children under five can receive an acceptable standard of care. The program targeted 21 health centers and the surrounding areas in Rulindo, a rural district in the Northern province of Rwanda.
So far, we have been able to accomplish a number of significant outcomes:
- We trained 41 nurses on Integrated Management of Childhood Illnesses protocols and guidelines to treat common illnesses, including pneumonia, diarrhea, malaria and malnutrition.
- We trained 42 educators who will teach 988 community health workers on how to recognize signs and symptoms of childhood illnesses, how to manage the cases and when to refer children to the health center.
- We printed and distributed 42 copies of national protocols booklets on how to treat childhood illnesses to our 21 health centers and are mentoring nurses on their use.
- We are working with 121 nurses to improve knowledge and competency to accurately diagnose and treat these childhood illnesses as well as contributing factors such as malnutrition, following the National Treatment Guidelines and evidence-based protocols.
- Our training and programming led to 42,499 children under the age of five being assessed and treated for respiratory infections, malaria, diarrhea and malnutrition in October 2019 - March 2020.
- We helped create and conduct two community campaigns that educated 46,743 mothers on malaria prevention, child nutrition and hygiene. As part of these campaigns, children were screened for malnutrition and vaccinated against childhood illnesses.
- We are now getting ready to launch the program in the Nyabihu District, where we estimate we will be able to reach 16 health centers, 140 nurses and 1,407 community health workers.