INTRODUCTION: Rwanda’s high coverage of facility-based deliveries and strong routine health information systems provide a unique opportunity to examine seasonal patterns in maternal and newborn health service utilization and translate these findings into actionable health system planning.
METHODS: National routine data on health facility deliveries, Bacillus Calmette–Guérin (BCG) vaccination, and first antenatal care visits (“new registrations”) were extracted from the Health Management Information System (DHIS2) for financial years 2012/13–2024/25. Monthly totals were aggregated at the national level and analysed descriptively using visual inspection of trends and calculation of five- and ten-year monthly averages to identify recurring seasonal patterns.
RESULTS: Clear and consistent seasonality was observed in health facility deliveries and BCG vaccination across the thirteen-year period. Deliveries were substantially lower than the monthly average in January (–2,354 deliveries) and markedly higher in May (+2,866 deliveries), with BCG vaccination closely mirroring this pattern. In contrast, first antenatal care visits demonstrated a different seasonal distribution, with higher-than-average registrations in January and lower attendance between July and September, indicating misalignment between early antenatal attendance and subsequent peak delivery periods.
CONCLUSION: The findings support targeted, low-cost interventions, including the strategic scheduling of maternity staff leave and training, adjustments to supply-chain ordering practices, refinements of data quality outlier detection tools, and intensified sensitization for early antenatal care during optimal periods. Routine seasonality analysis should be integrated into evidence-based planning to strengthen maternal and newborn health outcomes.
