Serving 50 villages and 29,000 people, our community-based efforts are centered in Kibogora, Rwanda, a rural village in the Western Province of the country. These efforts include a new maternity center, opened at the lowest level of the healthcare infrastructure, and a mobile reproductive healthcare service. In the first 18 months of operation, these new services provided 3200 family planning visits, 1200 prenatal care visits, 530 screenings of pregnant women for HIV, and 133 deliveries. Additionally, capacity building efforts are ongoing at the health centers and district hospital, which serve the larger region within which this population resides. Healthcare providers are receiving didactic training, as well as hands-on clinical and simulation based training. Patient safety initiatives, including checklists and protocols, have also been implemented on the maternity ward. All of these efforts are aimed at assuring safe, high-quality reproductive healthcare services for the women of this community and research efforts are underway to evaluate the effectiveness of each of these programs.
Physician Exchange Program
In 2010, we began intensive training of two physicians from Kibogora District Hospital at the Weiler Hospital of the Albert Einstein College of Medicine. Training included use of simulation technology in the management of life-threatening complications of pregnancy, obstetric ultrasound, didactic one-on-one teaching, and clinical observership in the outpatient setting and on labor and delivery.
This on-going training is strengthened by employing a long-term mentoring approach between Einstein faculty and the medical staff of Kibogora District Hospital. Management skills, systems concepts, and leadership are reinforced through direct mentorship by Einstein staff on the maternity ward in Kibogora as well as through medical teleconsultation and support. Patient safety initiatives are incorporated into these efforts, with protocols and checklists being implemented by local staff with facilitation by Einstein faculty.
Adolescent Sexual Health Program
In March 2011, we conducted a needs assessment at two neighboring schools in Kibogora, Rwanda. Our goal was to determine the perceived needs of the students and utilize the results of this assessment in the design and implementation of a youth-friendly adolescent sexual health program. In January, 2012, the adolescent sexual health program began at the first of these schools. The foundation of this unique program is the new partnership between the medical and educational infrastructure in the community fostered by this program. Students receive didactic lectures in the classroom by staff from their school that were trained by Einstein faculty. A reproductive health library at the school then complements these lectures, organized field-trips to the local health centers (where nurses have received adolescent friendly reproductive health training), and anonymous question and answer forums.
Cervical Cancer Prevention
In collaboration with WE-ACTx, Women's Equity in Access to Care & Treatment, Einstein faculty have been actively engaged training Rwandan providers in cervical cancer screening and treatment, as well as providing technical support for the establishment these services. In 2009, Division faculty led the first training in Visual Inspection with Acetic Acid (VIA) and cryotherapy in Rwanda. In 2011, in collaboration with Partners in Health, our faculty led a month-long workshop, which resulted in the establishment of the first group of Rwandan National Trainers in cervical cancer screening. This team will now be responsible for leading the training efforts in establishing the Rwandan National Cervical Cancer Screening Program, which is scheduled to begin in 2012. Division faculty will continue to be involved in the implementation, monitoring and evaluation of the national screening program.
The HRH program
Under Dr Irwin R Merkatz’s leadership, Einstein has continued to show its commitment to Global Women’s Health, most recently by joining a consortium of major US academic institutions that are partnering with the Rwandan government in the Human Resources for Health Program (HRH) The Rwandan government partnered with the Clinton Health Access Initiative (CHAI) for support and advice in creating the program – the goal is to strengthen the cadre of skilled health care professionals in the country. CHAI serves as an advisor to several countries in the developing world to assist in health access.
The HRH Program is an 8 year program that pairs US and Rwandan institutions of medical and nursing training to augment and strengthen the Rwandan healthcare infrastructure, specifically the lack of skilled/trained health care professionals. The Department of Obstetrics & Gynecology and Women’s Health at Einstein is participating in the program and has been assigned to the teaching hospital at the medical university in Butare. We are working one-on-one with faculty to strengthen their curriculum and training materials. In addition, we are assisting in the direct training of medical students and residents in OBGYN.
This year we are focusing on obstetrics mainly. In the coming years we will send sub-specialists in all areas of obstetrics and gynecology.
The Maternal Fetal Medicine Specialists who will participate over the 2012-2013 year include the following:
- Dr. Diana Wolfe
- Dr. Rodney Wright
- Dr. Pamela Tropper
- Dr. Cynthia Chazotte
- Dr. Nancy Judge