Rwanda

Drawing on previous research in the US that shows group care can reduce preterm birth rates, our work in Rwanda focuses on group antenatal and postnatal care (referred to as prenatal and postpartum in the US). Partnering with the University of Rwanda’s Dr. Sabine Musange and the Rwanda Biomedical Center, we are performing the largest cluster randomized control trial of group antenatal and postnatal care in the world. 10,000 women across 36 government health centers in five districts will participate.

Our work in 2016 focused on the assessment of facility readiness, qualitative work on attitudes toward antenatal care, and development of a model for group care that would meet the specific needs of Rwandan women. A technical working group of stakeholders met several times during the year to develop and refine the model. Towards the end of 2016, we began training Rwandan midwives as master trainers, who will in turn train the midwives, nurses, and community health workers charged with delivering group care.

The trial launched in May 2017. Our results will provide the global maternal-child health community with long-awaited information about the feasibility and effectiveness of group antenatal care in low- and middle-income countries. With positive findings from this trial, we hope to provide a model of group care that can be adapted to other low- and middle-income countries, ultimately curbing preterm birth. In 2019, with results from nearly 11,000 women and newborns, we will report on whether this innovative model of antenatal care is able to reduce the preterm birth rate in Rwanda.