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Maintaining Delivery of Evidence-Based Interventions to Reduce Under-5 Mortality During COVID-19 in Rwanda: Lessons

Alemayehu Amberbir1, Felix Sayinzoga2, Kedest Mathewos1

  • 1University of Global Health Equity, Kigali, Rwanda.

Annals of Global Health
|July 29, 2024
PubMed
Summary
This summary is machine-generated.

Rwanda

Keywords:
COVID-19Rwandaessential health servicesimplementation researchunder-5 mortality

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Area of Science:

  • Implementation Science
  • Global Health
  • Public Health

Background:

  • The COVID-19 pandemic disrupted access to essential interventions for reducing under-5 mortality (U5M).
  • Rwanda experienced challenges in maintaining healthcare delivery for these critical services.
  • Previous U5M reduction efforts' role in system resilience was explored.

Purpose of the Study:

  • To identify strategies and factors mitigating drops in evidence-based interventions (EBIs) during the COVID-19 pandemic in Rwanda.
  • To assess the impact of previous U5M reduction initiatives on healthcare delivery resilience.
  • To understand national and subnational responses to maintain EBI access.

Main Methods:

  • Convergent mixed-methods approach integrating implementation science and resiliency frameworks.
  • Triangulation of data from document review, health management information systems, and key informant interviews.
  • Quantitative analysis using interrupted time series and Poisson regression; qualitative analysis using thematic analysis.

Main Results:

  • Moderate drops observed: 4% in pentavalent vaccine, 5% in rotavirus vaccine, and 5% in facility-based deliveries.
  • Barriers included lockdowns, movement restrictions, and fear of COVID-19 among communities and health workers.
  • Effective strategies included community-based delivery, data utilization, mentorship, supervision, and digital platforms.

Conclusions:

  • Rwanda's health system demonstrated resilience by rapidly identifying and responding to EBI drops during the pandemic.
  • Adaptability and a flexible response, informed by data and community engagement, were key to mitigating service disruptions.
  • The ability to learn and adapt facilitated a resilient healthcare system.