ArticleBMJ global health2018
Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005-2010.
Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed.
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- Changes in child mortality and population health following 10 years of health systems strengthening in rural Madagascar: A longitudinal cohort study.PLoS medicine · 2025Article
- Analyzing the usage of theories of change for routine immunization programs -- a review of impact evaluations from LMICs.Journal of health, population, and nutrition · 2024Review
- Interventions addressing routine childhood immunization and its behavioral and social drivers.Frontiers in public health · 2024Review
- Heterogeneity in health funding and disparities in health outcome: a comparison between high focus and non-high focus states in India.Cost effectiveness and resource allocation : C/E · 2023Article
- Towards a positive postnatal experience in Sub-Saharan African countries: the receipt of adequate services during the immediate postpartum period: a multilevel analysis.Frontiers in public health · 2023Article
- Protocol-driven primary care and community linkage to reduce all-cause mortality in rural Zambia: a stepped-wedge cluster randomized trial.Frontiers in public health · 2023Article
- Interventions to increase facility births and provision of postpartum care in sub-Saharan Africa: a scoping review.Reproductive health · 2021Article
- District-level health system strengthening for universal health coverage: evidence from a longitudinal cohort study in rural Madagascar, 2014-2018.BMJ global health · 2020Article
- The All Babies Count Initiative: Impact of a Health System Improvement Approach on Neonatal Care and Outcomes in Rwanda.Global health, science and practice · 2020Article
- Do memories of the Ebola virus disease outbreak influence post-Ebola health seeking behaviour in Guéckédou district (epicentre) in Guinea? A cross-sectional study of children with febrile illness.BMC public health · 2020Article
- Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo.AIDS care · 2020Article
- Assessing trends in the content of maternal and child care following a health system strengthening initiative in rural Madagascar: A longitudinal cohort study.PLoS medicine · 2019Article
- Lowering hospital walls to achieve health equity.BMJ (Clinical research ed.) · 2018Article
- Integrated health system strengthening can generate rapid population impacts that can be replicated: lessons from Rwanda to Madagascar.BMJ global health · 2018Article
- Early changes in intervention coverage and mortality rates following the implementation of an integrated health system intervention in Madagascar.BMJ global health · 2018Article
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17 authors.
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Abstract
introductionAlthough Rwanda's health system underwent major reforms and improvements after the 1994 Genocide, the health system and population health in the southeast lagged behind other areas. In 2005, Partners In Health and the Rwandan Ministry of Health began a health system strengthening intervention in this region. We evaluate potential impacts of the intervention on maternal and child health indicators.
methodsCombining results from the 2005 and 2010 Demographic and Health Surveys with those from a supplemental 2010 survey, we compared changes in health system output indicators and population health outcomes between 2005 and 2010 as reported by women living in the intervention area with those reported by the pooled population of women from all other rural areas of the country, controlling for potential confounding by economic and demographic variables.
resultsOverall health system coverage improved similarly in the comparison groups between 2005 and 2010, with an indicator of composite coverage of child health interventions increasing from 57.9% to 75.0% in the intervention area and from 58.7% to 73.8% in the other rural areas. Under-five mortality declined by an annual rate of 12.8% in the intervention area, from 229.8 to 83.2 deaths per 1000 live births, and by 8.9% in other rural areas, from 157.7 to 75.8 deaths per 1000 live births. Improvements were most marked among the poorest households.
conclusionWe observed dramatic improvements in population health outcomes including under-five mortality between 2005 and 2010 in rural Rwanda generally and in the intervention area specifically.
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