Midwifery in Rwanda: what you need to know ahead of the Africa and Eastern Mediterranean Regional Conference
As the ICM Regional Conference for Africa and the Eastern Mediterranean approaches, happening from the 24th to the 26th of September in Kigali, Rwanda, it is time to explore and understand the midwifery landscape in this country. Exploring the practices and challenges of midwives in different contexts is crucial for reflecting on and improving the standards of care within our communities. Ahead of this exciting event, the first of four regional conferences that will be hosted this triennium, we had the privilege of speaking with Josephine Murekezi, the President of the Rwanda Association of Midwives (RAM), to gain valuable insights into the state of midwifery in Rwanda.
Tell us about your Midwives Association, when was the association created and how many members does it have?
The Rwanda Association of Midwives (RAM) was established in 2011 with an initial membership of 300. It gained official recognition as a Non-Governmental Organization (NGO) from the Rwanda Governance Board on April 25, 2018. The RAM joined ICM in 2013 and later became a member of the Confederation of African Midwives Association (CONAMA) in 2018. Our Midwife Association serves as the leading professional organization representing midwives and advancing the practice of midwifery in Rwanda. We are dedicated to promoting midwifery through advocacy and by enhancing leadership, management, and governance in our health system . Currently, RAM’s membership stands at 420 active members, while Rwanda has a total of 2600 midwives, with membership numbers fluctuating over time.
What are the educational and training requirements for midwives in Rwanda?
In 1996, the Rwandan government, in collaboration with the Ministry of Education and the Ministry of Health, launched midwifery training programs at the Kigali Health Institute (KHI). These programs catered to both direct intake students and enrolled nurses seeking to transition into midwifery. The three-year training ended with the award of an Advanced Diploma in midwifery.
Over time, KHI expanded its offerings. In 2006, it introduced a four-year degree, now offering two distinct degree options: a Bachelor of Science in midwifery with direct entry, which lasts four years, or and a Bachelor of Midwifery Education program tailored for Advanced Diploma graduates, which lasts two years. Furthermore, midwives can pursue a master’s degree in midwifery after obtaining their bachelor’s degree, provided they have at least two years of experience in clinical practice or teaching at a recognized institution.
What initiatives or programs are in place to support midwives in Rwanda?
In July 2023, the Government of Rwanda launched the 4×4 Reform initiative, aiming to quadruple the number of healthcare workers nationwide, with an emphasis on boosting the midwifery workforce. This strategy has already secured 500 scholarships for midwives in partnership with NGOs.
The Enabel’s Barame project has played a pivotal role in supporting the Rwanda Association of Midwives through mentorship programs focused on enhancing Quality Management of Emergency Obstetrical & Neonatal Care (EmONC). This initiative aims to strengthen the capacity of health professionals to deliver high-quality maternal and neonatal services, thereby reducing morbidity and mortality rates in Rwanda.
UNFPA has also been instrumental in supporting midwifery in Rwanda. This support includes scholarships for Master’s and PhD students in midwifery education, along with simulation-based training for both pre-service and in-service midwives through a mentorship program. Furthermore, UNFPA has contributed to strengthening the Rwanda Association of Midwives and advancing midwifery regulation in the country through the introduction of a midwifery task force sub-Technical Working Group. Their ongoing advocacy efforts continue to promote investments in midwifery programming.
Currently, RAM is collaborating with Jhpiego to enhance its institutional, financial, and programmatic sustainability. This partnership aims to empower RAM to effectively implement awards and initiatives that directly benefit the association and contribute to long-term development.
What are the main challenges facing midwives in Rwanda?
Midwives in Rwanda face several significant challenges. These include a shortage of midwives across the country, which strains healthcare services. Low salaries are a prevalent issue, affecting the morale and retention of midwives. Another challenge is the lack of recognition for midwives’ educational achievements, hindering career advancement. High turnover rates exacerbate these issues, impacting continuity of care. Many midwives also experience unpaid overtime due to heavy workloads, leading to burnout and affecting patient care quality. Moreover, the demanding workload increases the risk of professional malpractice, posing further challenges to delivering effective maternal and neonatal healthcare in Rwanda.
What are your expectations for the upcoming ICM conference in Kigali and why do you think it will be an interesting event for midwives to attend?
We’re excited to host the first-ever ICM conference in Kigali, it is a big honor for us. Conferences like this are important because they bring together a vast network of academic and non-academic professionals to share knowledge and exchange ideas.
Rwandan midwives are eager to learn from others. Our midwives want to compare what they do with what others do and learn new ways to improve care. They’re also looking forward to getting new ideas for their own research projects by seeing how others solve problems.
Overall, attending the ICM conference in Kigali will be a great opportunity for our midwives to learn, collaborate, and contribute to better midwifery care worldwide.
Don’t miss the opportunity to grow, learn, and connect at the Africa and Eastern Mediterranean Regional Conference. Reserve your spot today and join us to learn from each other and build stronger midwife associations.
