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Reflections on a global partnership for perinatal quality improvement in Rwanda

Lisine Tuyisenge1, Jean-Petit Habonimana1, Alexis Nsengiyumva1

  • 1Rwanda Pediatric Association, Kigali, Rwanda.

BMJ Paediatrics Open
|June 7, 2026
PubMed

Insights

A six-year perinatal program in Rwanda improved care quality and clinical outcomes. However, preventable newborn mortality persists, indicating deeper systemic and community health issues require further attention.

Area of Science:

  • Global Health
  • Health Services Research
  • Perinatal Medicine

Background:

  • A collaborative perinatal program was implemented in Rwanda from 2017-2023.
  • The program involved the Royal College of Paediatrics and Child Health, Rwanda Pediatric Association, UNICEF, Rwandan Ministry of Health, and Rwanda Biomedical Center.
  • It aimed to enhance clinical care and outcomes in hospitals and primary health centers.

Purpose of the Study:

  • To assess the impact of a multi-facility perinatal quality improvement program.
  • To identify systemic and community-level factors influencing care quality and clinical outcomes.
  • To understand how professional partnerships facilitate the translation of interventions into effective care systems.

Main Methods:

  • A collaborative quality improvement program delivered over six years.
  • Partnership between international and Rwandan healthcare professionals and institutions.
  • Qualitative analysis of structural factors mediating intervention effectiveness.

Main Results:

  • Measurable improvements in the quality of care and clinical outcomes were observed.
  • Persistent preventable mortality, especially among newborns, highlights underlying systemic constraints.
  • The program revealed structural factors influencing the effectiveness of clinical interventions.

Conclusions:

  • While the program demonstrated positive impacts, systemic and community-level factors significantly affect perinatal outcomes.
  • Qualitative insights are crucial for understanding the success and limitations of quality improvement initiatives.
  • Addressing deeper structural issues is essential for further reducing preventable mortality in perinatal care.

Keywords:
Child HealthHealth PolicyHealth services researchLow and Middle Income CountriesNeonatology

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