Girimpundu, Candide Mugeni
Kalisa, Richard
Mwiseneza, Marie Josée
Gashaija, Absolomon
Ishimwe, Japhet
Gasurira, Sylvestre
Musengimana, Denise
Uzayisenga, Josephine
Niyigaba, Jean Paul
Mpinganzima, Ornella
Rugema, Lawrence
Moreland, Patricia
Nsereko, Etienne
Article History
Received: 10 July 2026
Accepted: 9 September 2026
First Online: 14 September 2026
Declarations
Ethics approval and consent to participate: This study used a retrospective, de-identified dataset derived from facility delivery registers. All patient identifiers were removed or hashed prior to analysis. All methods were performed in accordance with the ethical principles of the Declaration of Helsinki and with the relevant national and institutional guidelines and regulations. Ethics approval was obtained from the University of Rwanda College of Medicine and Health Sciences Institutional Review Board and the Emory University Institutional Review Board (reference N0440/CMHSIRB2023; 22 September 2023). Because the study used pre-existing de-identified records with no direct patient contact, the requirement for individual informed consent was waived by both Institutional Review Boards.
Consent for publication: Not applicable.
Competing interests: The authors declare no competing interests.