Project Brief: Training, Support and Access Model for Maternal Newborn and Child Health in Rwanda (TSAM): Community Health

The Project

The Training, Support, & Access Model (TSAM) for Maternal, Newborn and Child Health (MNCH) in Rwanda is a 4-year international development partnership project with funding provided to the University of Western Ontario (Western) by Global Affairs Canada (GAC) at the Government of Canada. The main mission of the TSAM project is to improve maternal, newborn and child health (MNCH) in Rwanda by working with local partners to improve health service access and delivery. The project is regulated by a Contribution Agreement (CA) between Western University and GAC.


The TSAM project has three (3) primary goals:

  • To work with health practitioners and health workers in Rwanda to practice safe, evidence-based, gender sensitive, culturally appropriate and inter-professional emergency MNCH care.
  • To improve specialized care for mothers and children provided by nurses, midwives and physicians, and reinforce MNCH district training and mentoring.
  • To advise the partners and the Ministries of Health and Education, as well other organizations with a vested interest in MNCH care, on the results of the TSAM project in order to align strategic plans and policies with gender sensitive MNCH service delivery.


The TSAM project partners in Rwanda include:

  • Rwanda Medical and Dental Council (RMDC); College of Medicine & Health Sciences (CMHS) at the University of Rwanda (UR); Nursing Council of Nursing and (NCNM)


Training of Community Health Workers

  • Issue

Although health decentralization of care delivery system has been established in past years, still Rwanda is having infant and maternal mortalities in the community, and even at health facilities. These mortalities might be caused by the delay of the mothers in accessing of health service. Capacity building that includes continuous training and mentorship for community health workers has been identified by Ministry of Health as an effective way to promote health of mothers, newborns and children under five.

  • Background
  • Training and mentorship for CHWs is a priority as per the MoU with the MOH.
  • The primary goal in TSAM is to build the capacity of CHWs through training and mentorship model with a view to contribute in reduction of deaths and promotion of health and wellbeing among mothers, neonates, and children.
  • The community health model in TSAM is based on the integration new concepts, including cross cutting themes (CCT) of gender, ethics and interprofessional collaboration (IPC) as well as maternal mental health and gender based violence.
  • ToT for health professionals from the health centers will first take place, followed by the training of the CHWs using established curriculum with the addition of the CCT concepts.


  • Current Status
    • Revision of existing CBMNH training modules and development of related content for new concepts to be integrated. (CCT, MMH and GBV).
    • Training of 240 trainers on CBMNH with CCT, MMH and GBV integration for all 5 hospitals in Northern province: Rutongo, Kinihira, Byumba, Nemba and Ruli as well as 101 trainers from Kibirizi, Gakoma and Muhanga in the Southern province.
    • Seventeen CCT (gender, ethics, IPC, MMH & GBV) Master Trainers have been trained on the CBMNH program for 4 days.
    • Training completed for 2,595 ASM and 5,158 Binome CHWs on CBMNH in the catchment area of the 5 Northern hospitals and the 3 Southern hospitals.
    • Awareness meetings held with local leaders on PPH/CBMNH Program for each district in the Northern province as well as Gisagara and Muhanga districts in Southern province.


  • Next Steps
    • Complete ToT and CHW training for Ruhango and Gitwe hospital catchment areas.
    • Conduct an evaluation of the CHW training for Rulindo and Gicumbi Districts in the Northern province.
    • Develop CHW mentorship training manual incorporating the CCT themes of gender, ethics, IPC, MMH and GBV.
    • Deliver training on CH mentorship approach for selected CH_HcBM in Northern and Southern provinces.
    • Develop an evaluation strategy for the community health mentorship program, including process evaluation, formative evaluation and outcome evaluation.
    • Hold awareness meeting on PPH/CBMNH with local leaders in Ruhango District.



February 6, 2019



Professor David Cechetto

Director, TSAM for MNCH in Rwanda