Innovation summary

In Rwanda, 10 years after the 1994 genocide, an estimated 28% of the population suffers post-traumatic stress disorder, with many risk factors for postnatal depression.1 Postnatal depression is the most common maternal mental health problem and preliminary studies have found rates of postnatal depression to be as high as 60%.2 The goal of this innovation is to reduce the prevalence, severity, and impact of postnatal depression in new mothers and their infants in Rwanda.

The innovation focuses on training community members who ordinarily assist new mothers in Rwanda to detect mental health problems and provide emotional support through active listening.

Impact summary

  • 150 new mothers will receive enhanced maternal care support from trained local women leaders
  • 30 fewer mothers receiving this enhanced maternal care will develop moderate to severe depression, relative to 150 new mothers receiving their regular care
  • $189,000 USD funded over two years

This innovation is funded by Grand Challenges Canada.

Innovation details

The innovation depends on leveraging the capacity of universities in training the next generation of health care professionals, engaging the Ministry of Health to ensure the sustainability of the program, and working with existing community leaders in ways that emphasize undertaking their existing practice differently, rather than adding new tasks. The following activities are being undertaken:


  • Training students in nursing and midwifery in maternal mental health
  • Training community women leaders in maternal mental health and active listening techniques in 30 intervention communities


  • Recent mental health nursing graduates will screen all new mothers in 60 communities (30 intervention, 30 control) for postnatal depression and presence social support both before and after the intervention
  • Mothers with severe depression will be referred for additional care 

Home Visits by Community Women Leaders

  • As part of their regular activities, trained community women leaders will regularly visit all new and expectant mothers in the 30 intervention communities for one month prior to delivery and 12 months following delivery.
  • Community women leaders will provide emotional support through active listening, and identify mothers who may need additional support or care

Engagement of Communities

  • Six community advisory boards will be organized to support community women leaders and to raise community awareness of maternal mental health issues

Engagement of Healthcare Policymakers

  • Collaboration has been established with the Ministry of Health around content of training, design of intervention, and subsequent mobilization of knowledge


  • Rwandan Ministry of Health
  • University of Rwanda
  • York University (Canada)
  • University of Manitoba (Canada)
  • Western University (Canada)
  • Grand Challenges Canada

Evaluation methods

Rates of support and depression will be compared through a pre and post evaluation of the intervention and control villages, and intervention and control sites will be compared.

Cost of implementation

$189,000 USD funding provided over two years.

Impact details

It is expected that there will be an increased awareness of maternal mental health within the Ministry of Health, and thus ultimately in policies for women and children’s health going forward, particularly the inclusion of maternal mental health in training for health workers and community workers.

In addition, there will be a greater increase in support and a decrease in depression, better infant growth outcomes and improved maternal health and mental health in the intervention communities.



  1. Munyandamutsa N et al. (2012) Mental and physical health in Rwanda 14 years after genocide. Social Psychiatry and Psychiatric Epidemiology 47(11):1753-1761.  doi: 10.1007/s00127-012-0494-9
  2. Umuziga MP. (2014) Assessment of common perinatal mental disorders in a selected district hospital of the Eastern province in Rwanda. Master's Thesis. University of Western Cape, South Africa


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