Neonates

Difficult choices mothers make when their newborns are admitted to a neonatal unit of a teaching hospital in Rwanda.

In Rwanda 48.8% of the population in Rwanda are estimated as multidimensionally poor while an additional 22.7% is classified as vulnerable to multidimensional poverty. Around 95% population are covered by health insurance. Within the basic benefits package for the Community Based Health Insurance are services for sick newborn infants. CHUB is a teaching hospital in the south of Rwanda that accepts referrals, including sick newborn babies, from 14 hospitals in the south of the country. We tried to better understand the challenges faced by mothers of neonates admitted to CHUB in order to advise policy and practice.

We talked to mothers whose newborn babies were admitted on the neonatal unit at the hospital. We found that difficult choices had to be made on a daily basis, balancing available financial resources, family needs against inputs required for survival of the newborn and the health and well-being of the mother. The unpredictable extended period living away from home and related costs exacerbated challenges mothers faced. The lack of a support system near the hospital increased the financial burden of the hospitalisation of the newborn. Choices between adequate nutrition for the mother to provide vital breastmilk and using scarce family resources to purchase prescribed, life saving medicines were described.

We concluded that changes in National and hospital policies and infrastructure are
required to address the challenges faced by families, particularly mothers, whose sick newborns are admitted to hospital. These policy changes should aim to improve economic security of families, survival of the newborn and health of the mother.