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Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005–2010
  1. Dana R Thomson1,2,
  2. Cheryl Amoroso3,
  3. Sidney Atwood4,
  4. Matthew H Bonds1,5,
  5. Felix Cyamatare Rwabukwisi3,
  6. Peter Drobac3,4,6,
  7. Karen E Finnegan7,
  8. Didi Bertrand Farmer3,
  9. Paul E Farmer1,3,4,
  10. Antoinette Habinshuti3,
  11. Lisa R Hirschhorn8,
  12. Anatole Manzi3,
  13. Peter Niyigena3,
  14. Michael L Rich3,4,
  15. Sara Stulac1,3,4,
  16. Megan B Murray1,4,9,
  17. Agnes Binagwaho1,10
  1. 1 Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
  2. 2 College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
  3. 3 Partners In Health/Inshuti Mu Buzima, Rwinkwavu, Rwanda
  4. 4 Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, USA
  5. 5 Woods Institute, Stanford University, Stanford, California, USA
  6. 6 Global Health Delivery, University of Global Health Equity, Kigali, Rwanda
  7. 7 Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
  8. 8 Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
  9. 9 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
  10. 10 Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
  1. Correspondence to Dana R Thomson; dana.r.thomson{at}gmail.com

Footnotes

  • Handling editor Seye Abimbola

  • Contributors The following people were involved with the design and/or implementation of the health system intervention in K/SK: CA, FCR, PD, KEF, DBF, PEF, AH, AM, PN, MLR, SS and AB. MHB, LRH and MBM helped to conceive of the evaluation design. DRT and SA conducted the analysis. DRT, MHB and MBM drafted the paper. All coauthors closely reviewed the paper, contributed additional interpretations and approved the final version to be published.

  • Funding This study was funded by Doris Duke Charitable Foundation (Population Health Implementation & Training (PHIT)).

  • Disclaimer The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the institutions to which the authors are affiliated.

  • Competing interests Past and current employees of PIH and RMOH contributed to the study design and writing of this manuscript because they had knowledge of the programme under evaluation and of Rwanda’s health system and context. No PIH or RMOH affiliated coauthors were involved with statistical analysis and interpretation.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Protocols for the 2010 supplemental survey were reviewed and approved by the Partners HealthCare Internal Review Board (protocol #: 2009 P-001941/8) and the Rwanda National Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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Footnotes

  • Handling editor Seye Abimbola

  • Contributors The following people were involved with the design and/or implementation of the health system intervention in K/SK: CA, FCR, PD, KEF, DBF, PEF, AH, AM, PN, MLR, SS and AB. MHB, LRH and MBM helped to conceive of the evaluation design. DRT and SA conducted the analysis. DRT, MHB and MBM drafted the paper. All coauthors closely reviewed the paper, contributed additional interpretations and approved the final version to be published.

  • Funding This study was funded by Doris Duke Charitable Foundation (Population Health Implementation & Training (PHIT)).

  • Disclaimer The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the institutions to which the authors are affiliated.

  • Competing interests Past and current employees of PIH and RMOH contributed to the study design and writing of this manuscript because they had knowledge of the programme under evaluation and of Rwanda’s health system and context. No PIH or RMOH affiliated coauthors were involved with statistical analysis and interpretation.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Protocols for the 2010 supplemental survey were reviewed and approved by the Partners HealthCare Internal Review Board (protocol #: 2009 P-001941/8) and the Rwanda National Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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