Brushing Off the Past: How a toothbrush kit is inspiring maternal health policy change in Rwanda
As a result of RISA Fund-supported activities in clinics across the Southern Province of Rwanda, oral hygiene long sidelined in antenatal care is now at the centre of a growing movement to improve pregnancy outcomes in Rwanda.
Dr. Peace Uwambuye, a 2021 Mawazo Fellow and the Acting Deputy Dean of the School of Dentistry at the University of Rwanda, saw a gap in antenatal care that few doctors had considered: oral health. Her subsequent project, funded by the Mawazo Connects Fund through RISA Fund, set out to raise awareness of periodontal disease among health professionals and pregnant mothers. What began as a community engagement initiative has since evolved into a catalyst for systemic change in primary healthcare delivery.
As a RISA Fund-supported Mawazo Fellow, Peace partnered with the University of Rwanda and local health authorities to deliver workshops, stakeholder meetings, and educational talks across three health centres: Kabgayi, Nyanza, and Remera Rukoma. Nurses, midwives, and pregnant women were introduced to the importance of oral health both during and after pregnancy, supported by the distribution of oral hygiene kits.
From Awareness to Action
The immediate response to these trainings and workshops has been hugely positive: health workers have started voluntarily incorporating oral health screenings into routine antenatal care. A nurse from Kabgayi Health Center noted that as a result of RISA-funded trainings, ‘we now understand how oral health can affect the baby; this information should be part of our routine care’.
Pregnant women who attended the awareness workshops also reported changes in behaviour, including first-time dental visits and improved daily brushing habits.
“No one had ever told me that gum bleeding could affect my baby. I will definitely go for dental checkup.”
– Pregnant woman, Nyanza Health Center
“The toothbrush and toothpaste you gave me helped me to start brushing every day.”
– Pregnant woman, Remera Rukoma Health Center
These testimonials reflect an individual health transformation for pregnant mothers but also signal the potential for a wider shift in how maternal health is understood, and proper care is delivered, across rural Rwandan medical centres. Prioritisation of proper dental care amongst mothers to be is especially important because in Rwanda, women with periodontitis a gum disease commonly acquired during pregnancy are 6 times more likely to give birth to premature babies.
Scaling Impact Through Advocacy
Peace’s advocacy workshops and trainings have extended beyond the Southern Province to Kigali, where a public roadshow attracted attendees from district hospitals, dental associations, academia, and the Rwanda Biomedical Center. The event offered free oral health screenings for pregnant and nursing mothers and created a platform for dialogue on integrating oral hygiene into broader public health agendas.
The message conveyed to mothers, healthcare workers, and hospitals alike is clear: oral health must be prioritised by African governments to prevent a looming health crisis. With 44% of the Rwandan population already affected by oral diseases, the stakes are high.1 Peace’s work is helping to position oral hygiene not as a niche concern, but as a cornerstone of maternal and public health.
Building for the Future
The project’s impact didn’t end with the toothbrush kits distributed and workshops held across the Southern Province. Health facilities across the region have since begun institutionalising oral health referrals into antenatal care, and discussions are currently underway to incorporate oral health training into pre-service education for nurses and midwives. The Ministry of Health has started collaborating with the University of Rwanda to develop training modules and monitoring systems, ultimately aiming to integrate oral health into national antenatal care guidelines.
This layered approach; community engagement, professional training, and policy dialogue has laid a foundation for sustained change that will lead for better outcomes for pregnant women across Rwanda. By working to embed oral health into maternal care, Peace is not only improving outcomes for mothers and babies but also redefining what comprehensive care looks like at a national level within Rwanda.
A Model for Systemic Innovation
Peace’s work exemplifies the kind of innovation the RISA Fund seeks to support, i.e. locally led, evidence-based, and scalable. It demonstrates how small interventions as small as a toothbrush can unlock big shifts in health systems. And it underscores the importance of listening to communities, equipping professionals, and bridging gaps between research and policy.
As Rwanda continues to explore new ways to strengthen its healthcare system, this project offers a compelling blueprint for change – one that starts with awareness, grows through collaboration, and endures through institutional reform.
The RISA Fund is funded by UK International Development from the UK government. This content is produced in partnership with the Foreign, Commonwealth and Development Office.