By Dias Nyesiga
In a weekly market in Nyabimata sector, Nyaruguru district, women are enchanting their promotional offers to whomever wishes to hear, reducing a kilo of Irish potatoes from Rwf 180 to Rwf 160.
Behind a group of women near the weighing scale stands Marie José Muhawenimana, dressed in a kitenge with her baby curled in the back. She feels out of place and despite the smiles and laughter of other women, she seems to just smile with her glowing face alone.
“My smile is forbidden, I can’t laugh in public or lest I will bring bad omen to people because of my stained teeth and bad breath,” said Muhawenimana, a mother of two as she struggles to hold back tears.
“When I want to laugh, I make sure I cover my mouth with my hand or look down, she adds. To local folks, having stained teeth is regarded as a hereditary bad omen.
For Illdephonse Nizeyimana from Mishungero cell, Nyabimata sector his crowded teeth make him a laughing stock among his peers at school, “I feel inferior and uncomfortable, I always wanted to go for treatment but a health facility is far from my home.”
Like Muhawenimana and Nizeyimana, most people in Nyabimata sector, Nyaruguru district are grappling with oral health issues such as stained teeth, halitosis, crowded and decaying teeth which to most have forced them carry the forbidden smile.
But in Mishungero cell, Nyabimata sector, an improved health post with a state of the art ultrasonic dental cleaner comes to restore the hopes of people; to smile again.
“All these oral health issues are treatable, with this machine we are able to clean teeth and restore their whiteness and provide oral health care information to help people avoid oral health diseases,” said Marie Claire Nyirakanyana, who oversees Mishungero health post.
Again, the partnership agreement signed mid this month between Embassy of Japan in Rwanda and Society for Family Health (SFH Rwanda) to construct an improved health post in Ruhinga cell, Nyabimata sector with dental care services will see people accessing oral health services closer to them.
The two health posts are part of the second generation health posts constructed by Society for Family Health Rwanda across the country to support Rwanda’s efforts to increase equitable distribution of health facilities at grassroots.
Unlike other health posts, these improved health posts have a maternity ward, fully equipped laboratory, dentistry and ophthalmology, services that are provided at a health centre and hospital levels.
“From our previous experience where we placed second generation health posts, we have seen mothers able to go for antenatal care and giving birth from a health facility,” said Manasseh Gihana Wandera, Executive Director, SFH Rwanda.
The Second Generation Health Posts-SGHPs have been constructed by Society for Family Health, in partnership with the Ministry of health across the country in a bid to bring health services closer to people.
Experts say the Second Generation Health Posts serve as a link between community health workers and health centers and have greatly contributed to cutting the travel distance for Rwanda’s population thus easing access to essential healthcare services.
Through its Social behavior Change communications and Social marketing of health products and services, SFH Rwanda works with districts to construct health facilities in remote areas of the country thus easing access to health services.
“With the support of different partners, 1,117 Health Hosts (HPs) have been established in underserved communities (remote areas) in Rwanda,” Gihana said.
Among these, SFH Rwanda with its partners has constructed and equipped 179 health posts countrywide, 21 of these health posts were upgraded to Second-Generation Health Posts (SGHPs) and other 15 Second Generation Health Posts are under construction.
In Bugesera and Nyagatare districts which are prone to water scarcity has been facing a challenge of increasing rate of poor hygiene related diseases, malaria and improved health posts are playing a critical role.
“We always sensitize people who come here about sanitation and hygiene. So apart from treating diseases, the health post plays an important role in creating awareness among the communities it serves,” she added.
Further, SFH Rwanda supports Ministries of Health and Local Government to strengthen the functionality of these health posts and improve quality of healthcare using Public Private Community Partnership (PPP) model.
Evette Niyonziza, head of Musove health centre says that there has been upsurge of people coming for treatment with numbers rising from 900 to 2,000 patients monthly.
“Most people tell you that they have not been going for treatment and checkups because the health facility was far from them which affected them financially and socially and opt for self treatment,” she said.
The move is part of the country’s efforts to attain Universal Health Coverage (UHC) by availing healthcare services for all through financial protection mechanisms and equitable distribution of health facilities at grassroots.
“…..To improve equity in access, Rwanda set a target that the walk to the nearest health facility should be no more than 25 minutes. Half the country now meets this standard, and the work continues,” President Kagame said during a High-Level Meeting on Universal Health Coverage in 2019.
Moreover, the increased Second Generation Health Posts at cell level has seen the country edge closer to achieving Sustainable Development Goals, surpassing some of the Universal Health Access targets.
Currently, the country has 1,700 health posts, 500 health centers, 42 district hospitals, and five national referral hospitals, which call for more efforts to increase health posts to cover all the 2,148 cells across the country, something SFH Rwanda says are committed to further support the government.
The United Nations Inter-agency Group for Child Mortality Estimation indicates that the country’s Child mortality rate dropped to 26 deaths per 1000 live births in 2019 from 54 deaths per 1000 live births in 2013 and 221.3 deaths per 1,000 live births in 1970 which has already surpassed the 52 deaths per1000 live births 2015 country threshold.
Rwanda’s fourth health sector strategic plan (HSSP4) indicate Prevalence rate of Stunting dropped to 38 percent from 44 percent, Births attended in health facilities to 91 percent from 69 percent, Birth control and Family Planning rising to 42 percent from 31 percent .
While full child immunization increased to 90.1 percent from 69.8 percent with exclusive breastfeeding rate rising to 85 percent.
Experts attribute the decline in maternal mortality to improvements in the contraceptive prevalence rate and skilled birth attendance as more women access health services mainly antenatal services at cell level through Second Generation health Posts.
