Kibungo Hospital and the Fight Against Post-Caesarean Infections

When her daughter was born three months early and had to be delivered by caesarean section, Helen was frightened.

“Giving birth is sometimes scary. It was even scarier for me because I didn’t give birth the natural way that I wanted,” she said.

Thanks to care provided by staff in the maternal unit of Kibungo hospital, a provincial hospital in eastern Rwanda, Helen healed well and her baby was healthy.

Her story might have had a different outcome just a few years ago.

In October 2013, 3.6 percent of mothers who gave birth by caesarean section in Kibungo Hospital suffered post-surgical infections, which can have serious consequences for the mother. These infections were caused by inadequate sterilization and a lack of training for hospital staff on infection prevention methods.

By participating in Rwanda’s hospital accreditation program, Kibungo Hospital decreased its rate of post-caesarean infections to less than 1 percent just two years later. 

Through the national accreditation program, all provincial and district hospitals in Rwanda are assessed twice per year, based on key risk areas. Hospitals then put measures in place to improve services and minimize these risks, improving health care quality across the country.

The accreditation process, which was initiated in 2013 under the USAID-funded, MSH-led Integrated Health Systems Strengthening Project (IHSSP) and receives ongoing support from the Rwanda Health System Strengthening (RHSS) project, has taught Kibungo staff sterilization techniques and other best practices to reduce the risk of infection at every step of service delivery.

Doctors now clean their hands with hand sanitizer kept in their pockets at all times. Mothers are transported to the operating room on a stretcher used only between the maternal ward and the operating room to reduce of the possibility contamination from other parts of the hospital. And before beginning surgery, doctors follow strict clinical guidelines for cleaning the incision site. According to Dr. Xavier Uwimana, the hospital quality improvement trainer, this culture of standard-driven quality has developed as a result of the accreditation process. 

The hospital’s commitment to infection control doesn’t end once the sutures are sewn. Doctors also work with patients to ensure women know how to minimize the risk of post-caesarian infection once they leave the hospital. They encourage women to bathe regularly, gently clean the area around the incision, and change their bedding frequently.

“The medical staff have really supported me just by telling me what I need to do to be safe more often,” said Helen. “They also demonstrate it so that I don’t make any mistakes when I finally go home.”