All Babies Count (ABC): Eliminating Preventable Neonatal Deaths in Rwanda

Partners In Health
Organization Location: 
Boston, Massachusetts

WHO estimates that two-thirds of newborn deaths could be prevented if effective health measures were provided during birth and in the first week of life. In Rwanda, 69% of births are facility-based, yet 46% of neonatal deaths still occur in the first day of life. To increase health-system capacity to prevent newborn deaths using evidence-based measures, Partners In Health has developed the All Babies Count (ABC) model, an intensive 18-month change acceleration process. The ABC model—instead of focusing on a single change strategy—creates sustainable impact by re-orienting the culture of the health system to continuous quality improvement (QI). The ABC model: (i) equips health workers with essential supplies; (ii) provides on-site, regular clinical mentorship to improve delivery of evidence-based interventions; and (iii) launches learning collaboratives to promote data utilization for continuous improvement. Built with input from end-users, ABC is an integrated, low-cost approach that boosts demand by improving patient satisfaction through patient-centered care and incorporates use of scientific advancements from high-income settings. During a successful pilot of the ABC model in two districts in Rwanda, the neonatal mortality rate dropped by 40%. Building on this success, PIH proposes a 3-year transition-to-scale project to apply the ABC model to 7 districts. ABC will train 546 health workers, increase facility-based delivery to 75%, reach 57,475 women, and save 638 newborns.

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