Limited specialists, facilities spell doom for premature babies

Sunday February 2 2020


To minimise the risk of death, pregnant mothers who face complications need to access a well equipped referral hospital. Photo | Cyril NDEGEYA 

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Rwandan women face the risk of losing their babies born prematurely as the country stares at shortage of neonatal specialists and Neonatal Intensive are Unit (NICU) nurses.

Women based in rural areas are the worst hit as the majority of specialists are based in urban areas.

Risks associated with premature births  in Rwanda include high blood pressure, diabetes and infections such as urinary tract and amniotic membrane. To minimise the risk of deaths, pregnant women who face complications need to access a well-equipped referral hospital.

there are 27 neonatal nurses and two neonatologists, according to the Rwanda Paediatrics Association.

Mothers requiring neonatal care for their foetus to survive an only access sch services at King Faisal Hospital (KFH) and University Teaching Hospital of igali (CHUK).

According to experts, women who fail to access such facilities on time increase their risks of suffering from miscarriage or stillbirth.


“The number of nurses and specialists is still very low almost nothing compared with he population of people that need these services but there is hope in five years to have more in the field,” said Jean Baptiste Nkuranga, neonatologist and president of the Rwanda Paediatrics Association.

“We have made progress because 10 years ago, we didn’t ave these facilities but now our hospitals can offer neonatal care in the country. Mostly our work s to advise all other hospitals on phone calls once they encounter difficulties to help patients. If the case seems complex we advise them to transfer the patient to CHUK or KFH,” said Dr Nkuranga adding that there is a need to maintain public awareness to ensure that mothers attend antenatal clinics.

"We want to encourage mothers to adhere to antenatal clinic check-up to help reduce maternally and child mortality," said Dr Nkuranga. Most public hospitals also have a limited supply of specialized equipment to handle such cases.

Yet for a baby born prematurely to survive, it requires not only highly specialised care but also equipment such as an incubator to survive.

While definite figures of the number of public hospitals with specialised equipment and neonatal intensive care units and nurses to cater for preterm and postern births are not readily available, Rwanda Today has learnt a few hospitals including King Faisal, Kigali University Teaching Hospital (CHUK), Kirehe, and Kanombe Military hospital are equipped with equipment that include neonatal intensive care units, specialists and nurses to cater for preterm and postern births.

Other provincial and district hospitals have nurseries to support children born with health complications but not preterm births.

There are 47 referral hospitals and district hospitals spread across the country. According to the National Institute of Statistics of Rwanda (NISR), Mortality Assessment Survey 2015 report, July 2018, at national level, neonatal mortality rate was estimated at 11.1 infant deaths per 1,000 live births.

Male neonatal mortality rate is higher at 11.7 per cent than that of female, which stands at .6 per cent.

The government has increased investments in programmes addressing maternal and neonatal morbidity and mortality. This has significantly reduced maternal mortality and child mortality over the past decade.

Maternal mortality ratio is estimated at 64.5 per 100,000 live births while under five mortality rate is estimated as of 27.2 per 1,000 live births.

Recently, King Faisal Hospital recorded significant progress with quadruplets born prematurely. The youngest and oldest born weigh 850g and 1880 kilogrammes respectively, and after 45 days in the ICU incubators they have gained over 800gm each.

A month ago, a Congolese mother through successful caesarean delivery gave birth to our children with low weight. Happily, one pair has gained normal weight and discharged from the hospital and the remaining two are on oxygen in the neonatal intensive care unit, Rwanda Today witnessed.

The high rate of infant deaths is blamed on a lack of skilled neonatologists where the whole country has two local specialized neonatologists who are expected to handle all complex neonatal cases.