Optimizing Nursing and Midwifery Practice in Rwanda

Abstract

Following the 1994 genocide in Rwanda, the number of nurses remaining in practice in Rwanda was critically low. Since that time the leaders of Rwanda have worked diligently to increase both the number of nurses in Rwanda and their level of education. They have also set goals for the number of healthcare workers that should be in each facility according to the population in the catchment area. In 2015, a cross sectional, descriptive study was done to evaluate the gaps between the targeted number of the nurses and midwives in the health centers and district hospitals in Rwanda and the actual numbers in these facilities. Results indicated that in health centers staffing levels were at 55% of recommended levels, and in district hospitals 80.5% of recommended staffing levels. Looking to the future, Rwanda must focus not only on staffing numbers but also evaluate the practice environment, healthcare system, and the roles and responsibility of nurses and midwives. Education systems must also prioritize ensuring that entry-level nurses and midwives enter into the profession with essential competencies for safe practice, that interdisciplinary team practice is a part of the curriculum, and that nurses and midwives are educated beyond the associate nurse level.

Keywords: Rwanda, nursing practice, midwifery practice, nurse staffing, East Africa