INCLUSIVE EDUCATION GIRLS UP RWANDA

Problem statement.                                                                                       In 2013, the National Institute of Statistics of Rwanda (NISR) announced that there are no available statistics about the rate of teenage pregnancies in the county, but the vice is still a challenge despite various measures in place. Teenage pregnancies are predominant in rural areas due to lack of awareness on risk factors. In schools, sex education is not given enough time. Girls get most of information on sexuality from their peers who are also less informed and from social media networks and television. It finally announced that “the government’s effort in partnership with development partners have significantly reduced the problem. For instance, strengthening of co-curricular sexuality education activities and the number of youth friendly centers to deliver youth- friendly services”.

Unwanted pregnancy among adolescent girls in schools is a problem not only in Masaka Sector but also in the whole country wide. It has been revealed that in schools there were522 unwanted pregnancies among girls aged 10- 18, this was registered last year in several schools country wide, a Gender Based Violence (GBV) in School report. The report released by the Gender Monitoring Office last year, shows most of the cases are being in Karongi (58), Kayonza (53),Gatsibo (52), and Gasabo (50).

It was a culmination of August 2011 meeting between the Ministry of Education and several stakeholders to find out the root causes of existence of GBV in Schools. They found that the biggest perpetrators of sexual violence which leads to unwanted pregnancies are old men, commonly referred to as sugar daddies, fellow students, teachers, and motorcyclists. While releasing the findings, Eugenie Kabageni, the Deputy Chief Gender Monitor in charge of fighting injustice and GBV, said “many teenage girls give in to sexual abuse because of poverty”. She noted that according to the research they carried out in schools, many students claimed that they give in to sexual abuse when they are promised money to meet their needs they cannot get from their parents or guardians. In addition to that, the report cited police statistics which indicate that 1,682 defilement cases were registered in 2012, while in July and February this year 318 defilement cases were recorded and the Ministry of Primary and Secondary Education announced that the 6 report will guide the Ministry and other stakeholders in devising means to curb unwanted pregnancies in schools.

What makes our solution innovative?

Designing our system solutions alongside frontline healthcare workers ensures effective and efficient utilization by the end-user. We begin by assessing the needs of healthcare workers and community members while ensuring relevance to the larger health system. Inclusive Education Girls up Rwanda is standardized to reflect data national requirements and is relevant to any country who has adopted World Health Organization guidelines as their protocols. Our system links to DHIS2, a data-reporting platform used by over 60 countries. How technology is integral to our solution:

Our system Digital Health Record will revolutionize the way in which eHealth solutions are developed and implemented around the globe. The Project and frontline healthcare workers created Our system because no existing digital health records were designed to support nurse workflows at rural health centers or for nurses to utilize real-time data trends to tailor health education to their patients’ needs. Our system utilizes technology to improve the quality and efficiency of care at the local level, while promoting the adoption of national health protocols, compliance with national reporting requirements and achievement of lasting improvements in health outcomes.

Our vision over the next three to five years to grow and
scale our solution to affect the lives of more people:

Over the next five years, our system will expand to support high quality maternal and child healthcare throughout East Africa and beyond. Because our software is designed to support national protocols based upon World Health Organization guidelines, it can be shared with minimal adjustment to other national health programs. We will add modules to improve care of other conditions in rural health centers, such as diabetes, heart disease, HIV and Tuberculosis. 

How we will reach and
retain our customers or beneficiaries:

Our system digital health record customers include national governments, government consortiums, and non-governmental organizations, while Our system beneficiaries include healthcare workers and mothers.

To support customer needs, Our system supports interoperability and has the capacity to interact with other data reporting systems such as DHIS2 and OpenMRS. To respond to beneficiary needs, Our system is designed to support work flows common in many resource-limited settings and has the flexibility to be adapted to new contexts. 

How many people we will be serving with our solution in the 12 months and the next 3 years:

Expansion of INCLUSIVE Education Girls up Rwanda throughout Rwanda will begin mid-October 2023. This will allow us to improve the quality of care to 480,000 mothers and babies in 20224.We aim to increase the quality of care provided to mothers and children by at least 50% one year after implementation, leading to significant improvements in maternal and child morbidity and mortality. During this time, The Inclusive Education Girls up Rwanda Project will work closely with the East African Health Research Commission to prepare for the expansion throughout their member countries, thus improving the quality of care to over 6.8 million mothers and children by 2023. 

Alongside front-line health care workers and the Rwanda Ministry of Health, The Inclusive Education Girls up RwandaProject is creating Rwanda’s first point-of-care digital health record. This digital health record,  will dramatically improve maternal and child health outcomes by giving nurses the tools they need to adopt evidence-based clinical care protocols, provide high quality care and utilize real-time data trends to both tailor health education to individual family needs and to improve the health care delivery system while simultaneously satisfying Rwanda Ministry of Health data reporting requirements

Existing solutions are not adequate to support the needs of rural health centers, where most antenatal and childhood care is provided throughout Africa. Current digital health records were designed for simplicity of technology and national data reporting requirements. Our user-centered design approach avoids the traditional barriers to adoption of new eHealth strategies by engaging nurses and mothers in the entire design process to ensure that Inclusive Education Girls up Rwanda maximizes their ability to interact and simplifies national data reporting requirements. Inclusive Education Girls up builds upon nurses' existing workflows, provides real-time individualized data trends to tailor health education, and supports the data requirements of national governments. Nurses can enter individual data and track both individual and family health trends over time. Users can shift between individual and group health assessments depending upon the work flow of the health facility. Inclusive Education Girls up makes complicated z-score calculations used by nurses to diagnose malnutrition. A mother can track her family's health status through periodic 'health reports' that include photographs of her child over time that can be printed and taken home.

Progressive web application technology addresses internet latency by allowing storage of data on individual electronic devices until the internet is available. Once internet is available, the application will connect directly to the Rwanda Ministry of Health’s District Health Information System 2 (DHIS2) reporting platform. The system will minimize delays, remove redundancy, and improve quality and efficiency of reporting. Data will be accessible from any device, thus laying the foundation for a robust national health record that provides facility-independent access to individual health information.

The concept of Project and Rwanda Ministry of Health's desire to sustain and replicate our successful quality improvement program initially created to improve the quality of care for HIV-positive pregnant women and their children. Quality of care improved by 120% in three years, leading to elimination of mother-to-child HIV transmission and a 60% drop in new cases of malnutrition. Nurses and mothers became actively engaged in collecting, analyzing and responding to health data. Nurses are now empowered with skills to improve their systems of care and mothers are inspired to adopt and sustain healthy behaviors.

The Project is working with the Rwanda Ministry of Health to scale our locally-developed digital health record throughout Rwanda. The East Africa Health Research Commission, facilitator of the East Africa Digital REACH Initiative, considers it to be an essential tool for rural health centers throughout East Africa.  

Our team is comprised of a diverse and complementary group of experts in, sexual reproductive health, clinical care, public health, health informatics, and human-centered design that provides expert viewpoints from a wide array of fields. Our Rwandan leadership has expertise in rural health needs and national health requirements, while our Executive Director’s extensive experience as an end-user of electronic health records in the imbuto foundation allows our team to draw upon the successes and failures of US-based digital health records. The Inclusive education girls up Rwanda works closely with the Rwanda Ministry of Health to guide or national scale strategy.

Before starting my initiative, one day I was just moving around in our community and I met with mother who gave birth in the way, where I asked her whether she was going to the hospital, and she answered no, she was not aware of her period. So, by this I observed that there is greatest gap in the global market. where 24 pregnancy women had died before 2019 due to the long journey they took as 6 hour per day from Gikundamvura sector to Muganza sector and there is no road there. people cross or travel in Bugarama swamp where it is very difficult especially for pregnant women. And lack of information on sexual reproductive health.

AROUND 6O 000 PEOPLE AND ABOVE BECAUSE WE WORK ACROSS THE COUNTRY

Designing our system solutions alongside frontline healthcare workers ensures effective and efficient utilization by the end-user. We begin by assessing the needs of healthcare workers and community members while ensuring relevance to the larger health system. Inclusive Education Girls up Rwanda is standardized to reflect data national requirements and is relevant to any country who has adopted World Health Organization guidelines as their protocols. Our system links to DHIS2, a data-reporting platform used by over 60 countries. The result is an innovative digital health record that strengthens healthcare workers’ ability to provide high quality healthcare, delivers essential information to national governments, and supports global scale.

Over the next five years, our system will expand to support high quality maternal and child healthcare throughout East Africa and beyond. Because our software is designed to support national protocols based upon World Health Organization guidelines, it can be shared with minimal adjustment to other national health programs. We will add modules to improve care of other conditions in rural health centers, such as diabetes, heart disease, HIV and Tuberculosis. Our vision is for our system to serve as the primary care digital health record utilized in rural health centers serving millions of people across Africa.

The Rwanda Ministry of Health recognizes the importance of a digital health record designed by and for health care workers that also satisfies Ministry of Health needs, and has requested expansion of Our system to health centers across Rwanda by mid-2020. Over the next nine months, our team will expand our system from nine health centers to all twenty-one health centers in Gakenke District, link the database to DHIS2, and refine our implementation strategy based upon our experience with the initial 21 health centers. We will deploy fifteen implementation teams and work with local partners to expand our system throughout Rwanda by mid-2023

government consortiums, and non-governmental organizations, while Our system beneficiaries include healthcare workers and mothers.

To support customer needs, Our system supports interoperability and has the capacity to interact with other data reporting systems such as DHIS2 and OpenMRS. To respond to beneficiary needs, Our system is designed to support work flows common in many resource-limited settings and has the flexibility to be adapted to new contexts. Our Our system digital health record customers include national governments implementation strategy is user-centered, and our experience in Rwanda will inform our ability to scale at national levels while maintaining our focus on healthcare worker needs.

14. where by 9 of them are females and 5 are men

1Year up to 2years

Our team is comprised of a diverse and complementary group of experts in clinical care, public health, health informatics, and human-centered design that provides expert viewpoints from a wide array of fields. Our Rwandan leadership has expertise in rural health needs and national health requirements, while our Executive Director’s extensive experience as an end-user of electronic health records in ENGLAND allows our team to draw upon the successes and failures of US-based digital health records. The Project works closely with the Rwanda Ministry of Health to guide or national scale strategy

Inclusive education girls up Rwanda will be made available through an Open Source software platform, and this source code is being requested by non-government organizations and inclusive Education girls up leaders. Rwanda will continue to maintain the software and implementation strategies. Our team will be well positioned to generate revenue to sustain our work through the provision of code support and support contracts, implementation and design expertise, and creation of new modules and integrations for clients.