Khurmi Manpreet Singh, Sayinzoga Felix, Berhe Atakilt, Bucyana Tatien, Mwali Assumpta Kayinamura, Manzi Emmanuel, Muthu Maharajan
UNICEF Office for Rwanda, Kigali, Rwanda.
Rwanda Ministry of Health/Rwanda Biomedical Centre, Kigali, Rwanda.
Int J MCH AIDS. 2017;6(2):93-108. doi: 10.21106/ijma.214.
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.
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.
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.
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.
卢旺达新生儿生存案例研究分析了该国新生儿健康与生存状况。该研究回顾了该国已实施的循证干预措施及覆盖水平；确定了服务提供以及社区/受益者接受服务方面的关键问题与瓶颈，并提出了旨在更快降低新生儿死亡率的关键建议。
本研究采用混合方法研究，包括对该国实施的各种孕产妇和新生儿健康项目进行定性和定量分析。这包括采访各级关键利益相关者、实地考察以及采访受益者以评估服务的接受情况。对诸如卫生管理信息系统（HMIS）、孕产妇和新生儿死亡审计等监测系统进行了审查并分析数据以辅助这些分析。
政策、规程、各种监测指南和工具已经到位，然而，这些的实施仍然是一项挑战，例如减少败血症导致死亡的感染控制措施。尽管现有工作人员知识相当丰富且积极性很高，然而，卫生人员短缺尤其是医生短缺是一个问题。新设施正在投入使用，例如在吉塞尼，但现有设施需要扩建。
实施具有高影响力的循证干预措施至关重要，但覆盖水平需要显著提高，以便在降低新生儿死亡率方面取得更大成效。在规划中应考虑公平方法，以便更好地实施服务，使穷人和有需要的人能够受益于公共卫生项目。
