Even with the government's promise of a fully fledged hospital in Ndiza area, Ancillah Ayingeneye still has to make a journey of over four hours from Nyabinoni sector to reach Kabgayi hospital in Muhanga district.

Ayingeneye, an expectant woman who left home at 5.30am, first has to wait in the queue. Then, she needs to do several prescribed tests. On this visit, she has been transferred to Kabgayi as a result of having given birth through caesarean section before. Even with the complexity of her case, and arriving at hospital at 11am, she had to wait beyond 1pm in vain.

“I woke up early because of my complications but I have been told that the doctor only handles 15 patients a day. I may have to wait till tomorrow to be examined,” Ayingeneye says swearing that she can even sleep on the street.

Ayingeneye is among thousands of rural women in Rwanda who continue to face challenges of accessing maternal health services despite efforts by government to set up specialised care units for expectant mothers.

And despite a significant drop in maternal and child death, women still have to make long distances to reach district hospitals, and wait longer in queues to get medical treatment.

Statistics indicate that pregnant women in developing countries are 25 times at a risk of death compared with their counterparts in developing countries with main the causes ranging from haemorrhage and hypertensive disorders to abortion.

Rwanda has made significant progress in reducing mother mortality rates from 1,071 women in 2000, to 210 women in 2014-15 according to Demographic Health Survey (DHS).

But statistics indicate the delays in receiving care contributes 50 per cent of the causes of deaths while 12 per cent is as a result of inadequate case management and 11 per cent is due to poor monitoring at hospitals.

Long queues in almost all health services continue to negatively affect the health care delivery. This is partly attributed to a growing population outpacing the number of medical doctors and nurses who are available to provide care.

But poor pay in government hospitals has seen an increase in the number of medical professionals opening private clinics. For instance, a medic in public service earns Rwf300,000 while they can earn close to Rwf1 million in the private sector.

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Residents insist that it’s not just lack of facilities but lack of doctors and specialists that continues to affect general access to healthcare.

According to the 2014 National Human Resources for Health Policy, by the Ministry of Health, there are 678 medical doctors and 9,448 nurses/midwives. Current WHO statistics indicate that Rwanda has one doctor per 100,000 patients while the WHO recommends one doctor per 1,000 patients.

It is government policy and WHO recommended for every pregnant woman to have four antenatal tests at a health centre.

Most Rwandan women continue to seek maternal care services at health centres. National statistics indicate that 90 per cent of Rwandan women give birth at health centres, eight per cent do so at home and only per cent at private clinics.

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In Gisenyi, the district hospital has for the past three years come up with a new mechanism of giving expectant mothers special medical treatment and attention.

This service is totally aimed at giving pregnant women all the services they need. Patients have now known the system and any pregnant woman is giving first priority- in which case we have set up a special wing that takes care of women only,” hospital director, Dr William Kanyankole said.