Rwanda is on an ambitious journey to strengthen its maternal health system and expand its health workforce, guided by the national “4x4 Strategy” to quadruple the number of skilled health professionals within four years. With only one skilled health worker per 1,000 people—far below the WHO-recommended four per 1,000—the country is investing strategically in midwifery education, digital systems, and innovations that improve quality of care for mothers and newborns.

A key driver of this progress is AIM for Change!, a two-year initiative funded by the Government of India through the UN Office for South–South Cooperation and implemented by UNFPA Rwanda. The programme strengthens midwifery training, professional leadership, and regulation, while enabling Rwanda to learn from successful models in other countries through South–South exchanges. In 2025, these exchanges took Rwandan delegations to Ghana in August and India in November, generating invaluable insights to accelerate Rwanda’s maternal health reforms.

Learning from Ghana: Strengthening Midwifery Regulation and Community-Level Innovation

From 18–22 August 2025, representatives from Rwanda’s Ministry of Health, Rwanda Biomedical Centre, UNFPA Rwanda, the Nursing and Midwifery Council, the Rwanda Association of Midwives, and academia visited Ghana to learn from the country’s strong midwifery regulation and maternal health innovations.

In meetings with Ghana’s Ministry of Health, the Ghana Health Service, academic institutions, and midwifery associations, the delegation saw how Ghana maintains high professional standards through mandatory relicensing, integrates Universal Health Coverage principles into midwifery curricula, and cultivates Centres of Excellence for midwifery education.

The group also observed community-level innovations—such as emergency transport systems for pregnant women, Community Scorecards, Safe Motherhood Awards, and strengthened maternal death reviews—supported by partnerships with banks, telecoms, and faith-based organizations.

Reflecting on the exchange, Vivianne Umuhire Niyonkuru, Skills and Career Path Analyst and Delegation Lead, noted:

As Rwanda and Ghana work toward the shared goal of reducing preventable maternal deaths, this visit reflects our commitment to learning from one another to strengthen maternal and newborn health. Ghana’s experience in professionalizing and regulating midwifery offers valuable lessons for Rwanda.

Learning from India: Integrating Digital Health, System Coordination, and Innovative Training

From November 09-18, 2025, a second delegation of nine representatives from the Government of Rwanda, UNFPA Rwanda, and academic institutions completed a nine-day visit to India organized by UNFPA India and the Ministry of Health and Family Welfare. India’s progress—reducing maternal mortality from 103 per 100,000 live births in 2020 to 80 in 2023—demonstrated the impact of long-term investments and coordinated governance.

The delegation examined how India’s maternal health system operates as a connected ecosystem: national guidelines aligned with digital platforms, state-level implementation mechanisms, consistent data use, and dedicated budgets ensuring continuity of care. Initiatives such as fixed antenatal care days, Accredited Social Health Activists (ASHAs), and digital tracking for high-risk pregnancies illustrated structured pathways for follow-up and early intervention.

A standout innovation was UNFPA’s Virtual Reality training for midwives, which enhances competence in managing postpartum haemorrhage, pre-eclampsia, neonatal resuscitation, and respectful maternity care. UNFPA Rwanda Country Representative Dr. Olugbemiga Adelakin emphasized:

As UNFPA supports the government of Rwanda to finalize the revision of its midwifery curriculum to align to global standards, integrating tools like Virtual Reality will be essential. It provides a practical, scalable way for students and midwives to gain real clinical experience and deepen their skills, helping us move closer to our goal of safer births for every woman.

Dr. François Regis Cyiza, Director of the Health Facilities Programs Unit within the Maternal, Child, and Community Health Division at the Rwanda Biomedical Centre/Ministry of Health, who took part in the visit, reflected on the experience:

This learning visit has been truly impressive and will inspire Rwanda’s ongoing digital health reforms, ensuring that digital systems not only generate data, but also support the tracking of high-risk pregnancies and enable their active follow-up across all levels of care, ultimately improving the quality of maternal health services.
 

During both visits, the delegations also met Rwanda’s diplomatic representatives in the host countries, who emphasized the importance of sustained bilateral collaboration and knowledge exchange in advancing maternal health. Rwanda’s High Commissioner to Ghana, Her Excellency Rosemary Mbabazi, and Deputy High Commissioner to India, Mr. Emile Mwepesi, highlighted that while Rwanda’s partnerships have traditionally focused on areas such as trade, education, and security, expanding cooperation into maternal health marks an important step toward leveraging shared experience and innovation to improve outcomes for women and families. They underscored that strong South–South partnerships and long-term engagement are critical to building resilient health systems and accelerating progress toward safer motherhood.

Through continued collaboration with India and Ghana under the AIM for Change! South–South cooperation initiative, UNFPA in partnership with the Rwanda Ministry of Health is charting pathways to translate the learnings into local action—prioritizing stronger digital systems in labour rooms, improved maternal death surveillance and response, seamless RMNCH data flows, and a unified approach to tracking high-risk pregnancies from early antenatal care through postpartum follow-up. Central to this vision is also the empowerment of community health workers, midwives, and nurses with the tools, skills, and reforms needed to deliver quality care at every level of the health system. Building on Rwanda’s integrated health architecture and manageable scale, the initiative will pilot innovations—from VR-enabled clinical training to digital labour-room solutions and strengthened MPCDSR processes—designed to accelerate impact.