Mothers waiting to have their babies vaccinated listen attentively to the health education sessions delivered by nurses at the health centre. Source: Doune Porter/GAVI/2010.
Musha, east Rwanda, 8 March 2011 - At the Musha health centre, Prosper Mahinga's third patient of the morning waits in a small consultation room, a couple of steps down the hall from where her baby boy has just received vaccinations to protect him against an array of childhood diseases.
The baby is sleeping again now, nestled in her lap.
Like many of the mothers here, she is taking advantage of a routine vaccination visit for a consultation on family planning.
For local mothers, bringing a baby to the Musha heath centre for immunisation is an important opportunity for contact with health professionals. The centre serves a local population of almost 15,000, with 26 staff. It has facilities for basic treatment, maternity, and preventative medicine, as well as a small laboratory.
Every vaccination session at the Musha health centre - and hundreds like it around the country - begins with a learning opportunity. While the mothers are assembled before the vaccination begins, health workers talk to them about ways they can promote their own health and that of their families.
Family planning is an important topic. The assembled women are informed about contraceptive methods available to them and told that they can access family planning services immediately after their babies are vaccinated.
Mothers are taught about the importance of exclusive breast feeding for the first six months of life and about ways to improve nutrition for themselves and their families.
The education sessions also cover ways to protect themselves and their families against malaria, HIV awareness, and hygiene, among other essential basics.
The nurses make these sessions as interactive as possible, asking questions and calling on mothers for the answers. Posters on the walls, with clear graphics (many of the women who attend cannot read) reinforce the messages on maintaining good health.
After the health education session, all the babies are weighed and their growth rate is recorded before they get their vaccinations.
For the mothers who wish it, their own weight is also monitored, and they can ask the health workers at the centre about their own health.
In the family planning consulting room, Prosper's patient listens to the options: contraceptive pills are available, injections that will cover her for three months, an implant that will last for five years, or a coil, estimated to work for up to 10 years, she is told.
A female nurse takes her blood pressure. All is well and she makes her choice, opting for the injection, which the nurse gives her on the spot.
Rwanda has a very high childhood immunisation coverage rate - more than 90%- which means a major proportion of mothers in Rwanda are also being reached with health education and family planning consultations.