DOI: 10.1101/516112Jan 9, 2019Paper

Understanding variation in maternal health service coverage and maternal health outcomes among districts in Rwanda

BioRxiv : the Preprint Server for Biology
Leon BijlmakersJeroen van Dillen

Abstract

Objective: To identify factors that explain variations between districts in maternal health service coverage and maternal health outcomes. Methods: Individual key informant interviews and focus group discussions using structured topic lists were conducted in May 2015 in four purposively selected districts. Results: The solidarity support for poor people and the interconnectedness between local leaders and heads of health facilities were identified as enablers of health service utilization. Geographical factors, in particular location close to borders with mobile populations and migrants, and large populations with sparsely distributed health infrastructure, exacerbated by hilly topography and muddy roads were identified as barriers. Shortages of skilled health providers at the level of district hospitals were cited as contributing to poor maternal health outcomes. Conclusion: There is a need to take into account disparities between districts when allocating staff and financial resources in order to achieve universal coverage for high-quality maternal health services and better outcomes. Local innovations such as the use of SMS and WhatsApp text messages by health workers and financial protection schemes for poor patients improv...Continue Reading

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Community Health Workers
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