Surgical site infections (SSIs) following cesarean sections (CS) are a significant global health concern, with varying prevalence rates across regions. At Remera Rukoma Hospital in Rwanda, the CS infection
rate was 2.025% from July to December 2023, prompting a quality improvement project to reduce it to 1% by June 2024. The hospital's target of a 1% surgical site infection rate for cesarean sections aligns
with World Health Organization standards, positioning it as a potential regional leader in infection control while significantly improving patient safety and maternal health outcomes.
The project utilized a comprehensive approach, employing the Fishbone diagram to identify root causes across patient, surgical team, and hospital environment factors. Targeted interventions were implemented, including improved pre-operative cleaning, staff training on infection prevention, and enhanced environmental
hygiene. Progress was monitored monthly using the Plan-Do-Study-Act cycle.
The project successfully reduced the average CS infection rate to 0.45% from January to June 2024, with four months achieving 0% infection rates. Key factors in this success included strengthened aseptic practices, optimized antibiotic prophylaxis, and improved teamwork. Continuous monitoring, regular staff education, and datadriven improvement cycles are recommended to sustain these positive outcomes.
