Rwanda's Ministry of Health is banking on the planned expansion of health facilities at the Cell level to reduce the high fertility rates, which are driving up population growth.

The trend, which is mostly attributed to weaknesses in family planning campaigns, is linked to an increase in demand for maternal and neonatal services at health facilities nationwide. This calls for an expansion of existing health infrastructure and equipping them accordingly.

Experts are cautioning that the new measures are needed to reduce fertility rates as currently, the country faces the risk of its population tripling in the next 30 years, which might undermine its ambition to become a lower middle-income country by 2020.

Specifically, the fertility rate needs to reduce to at least 2.3 children per woman by 2035 from the current 4.2 children, if the country is to realise its goal of increasing per capita income from $700 to at least $12,000 by 2050.

The government said it will focus on intensifying efforts to increase access to family planning services. This includes addressing geographical barriers by increasing the number of health facilities countrywide.

Diane Gashumba, the Minister of Health told Rwanda Today, that the government plans to set up and operationalise health posts at all the 2,148 Cells nationwide. The drive is expected to reduce the distance covered by residents to access health facilities.

Efforts to reduce the high fertility rates have in the past been hampered by a rise in teen pregnancies, while demand for family planning methods has largely remained unmet due to inefficiencies and hesitation by health facilities associated with the Catholic Church.

Health posts

Figures from the Ministry of Health show that about 150 health posts need to be built over the next seven years. There are currently 501 facilities offering services like curative outpatient care, child immunisations, health education and a few rapid laboratory tests.

While the exact cost of the expansion is yet to be disclosed, officials say it will require multi-sectoral collaboration especially with local districts. The health ministry is also banking on the support of its different partners to safeguard past achievements and keep track of targets.

Rwanda ranks among the few countries that attained the highest declines in maternal deaths and those of children under five years globally over the past 10 years.

However, with an increased life expectancy of 66 years, high fertility rates resulting in population increase, demand for maternal and neonatal services at health facilities is rising, piling pressure on existing infrastructure and equipment.

The United Nations Children’s Fund (Unicef) plans to provide equipment used in the provision of maternal and neonatal services in about 17 hospitals in 12 districts and which are dealing with huge demand and caseloads.

Select facilities

Ted Maly, Unicef Rwanda Representative told this paper that they will select facilities like Muhima hospital, one of Kigali’s busiest District health facility, which doubles up as a maternity hospital.

These facilities will get equipment meant for “both monitoring and treating some of the most common complications babies face during the early stages of birth.”

He added that Unicef will also provide mentorship and training for doctors, nurses and midwives in specialised skills in maternal and neonatal health.

Data carried out in 2015 shows that despite a rapid decline in infant mortality rates in the past 10 years, the number of babies who died in the first 28 days of life was 40 per cent of total child deaths registered.

Heineken Africa foundation committed Rwf600 million ($702,000) for equipping and rehabilitation of Gisenyi and Kacyiru hospitals.

The Ministry of Health said seven maternity wards have been built, expanded and equipped over the past three years.