Research Abroad in Rwanda: Fevi Rose Paro Seeks to Advance Maternal Health Through Community Insight
What does it take to ensure safer pregnancies in some of the world’s most geographically isolated communities? For Fevi Rose Paro, a PhD candidate in Environmental and Global Health and a participant in the University of Florida’s Research Abroad for Doctoral Students (RAD) program, the answer begins on the ground—listening, observing, and learning directly from the communities most affected.
Through the RAD program, Fevi spent five weeks in Rwanda’s Nyagatare District exploring a critical global health challenge: why many women in geographically isolated and disadvantaged areas are unable to access or fully utilize antenatal care (ANC). While ANC plays a vital role in monitoring pregnancies and preventing complications, only 47.2% of women in Rwanda receive the recommended visits. In 2016, the WHO moved from a recommendation of 4 to 8 ANC visits, but maternal mortality rates in the country remain higher than the global average. These numbers reveal an important truth: access alone does not guarantee utilization.
Using a socio-ecological approach, Fevi’s research examines how environmental, cultural, and social factors intersect to shape maternal health behaviors. Her work examines how distance, terrain, and climate influence access, as well as how beliefs, traditions, and community dynamics shape decision-making. Through participatory mapping and focus group discussions, community members shared insights that go far beyond what data alone can show.
Her time in Rwanda was not only productive but deeply meaningful. “Rwandans are very kind, warm, and helpful—especially in the villages. When you ask for directions, they don’t just point the way; they walk with you to your destination,” she reflected. She observed strong community values, including deep respect for elders, a culture of shared caregiving among mothers, and women who confidently voice their perspectives. Faith also plays a central role in daily life, shaping both routines and decisions.
Initial findings reveal a complex mix of factors influencing ANC utilization. Community support, women’s autonomy, partner involvement, and existing health policies can encourage care-seeking. At the same time, significant barriers remain, including long distances, poor road conditions worsened by seasonal rains, high transportation costs, food insecurity, and competing household responsibilities. Health system challenges, which can lead to long wait times and inconsistent scheduling, also play a role. In some cases, religious beliefs may discourage women from attending visits. As Fevi notes, “Understanding these barriers is crucial to addressing the low uptake of antenatal care—because even when services exist or are offered, it does not automatically imply utilization of these services.”
As she moves forward, Fevi will integrate both quantitative and qualitative findings to better understand the full picture of ANC utilization in Rwanda. By combining environmental, spatial, and socio-cultural perspectives—an approach rarely applied in geographically isolated settings—her work aims to inform more effective strategies to improve maternal health outcomes.
At its core, this research is about equity: ensuring that where a woman lives does not determine the care she receives. By grounding global health solutions in lived experience, this work brings us one step closer to more inclusive and responsive maternal health systems worldwide.
Learn more about UF’s Research Abroad for Doctoral Students (RAD) program.