MGHD 2024

Background: Preterm birth affects 13,4 million cases globally, presenting significant health and socioeconomic challenges. Addressing preterm birth’s underlying risk factors and causes, such as Preterm Premature Rupture of Membranes (PPROM) and Cervical Insufficiency (CI), is important. Although these conditions are manageable, they still contribute to high rate of preterm birth, especially in developing countries like Rwanda, where limited resources alter effective management. Studies on the lived experience of Skilled Birth Attendants (SBAs) are needed to understand how these conditions are managed. Objective: To explore skilled birth attendants’ lived experience in the management of PPROM and CI as risk factors for preterm birth in Rwanda. Methods: A qualitative study using phenomenological approach was conducted in five health facilities in Rwanda. Participants were SBAs working in gynaecology and obstetrics departments. After obtaining informed consent, 24 in-depth interviews were conducted using semi-structured interview guide. The interviews were recorded, transcribed, and translated into English. The transcripts were openly read, manually coded inductively and analysed thematically into codes and themes using Dedoose. Results: Result of the study underscores the lived experience of SBAs while managing PPROM and CI including the challenges they face and the foundational anchors of the management. Five major themes were identified, which were: “Effective Management requires collaborative care”, “Improved practice impacts patients’ outcomes and SBA’s emotions”, “Management guidance through knowledge and protocols”, “Lack of resources and patients’ factors challenge the management” and “Empowering communities and SBAs”. Conclusion: Interventions aiming to improve PPROM and CI management should focus on equipping healthcare facilities with adequate resources, up-to-date management protocols and providing continuous education and emotional support to SBAs.