Health Financing Sustainability Policy: Republic of Rwanda

The Health Financing sustainability policy is based on the overall health sector policy which is also in compliance with the Vision 2020 of the Government of Rwanda. The health sector has been characterized by successful innovations in health financing such as the Community Based Health Insurance Schemes (CBHIS), the Performance Based Financing (PFP) approach for both health facilities and the Comm unity Health Workers (CHW) cooperatives whose positive impact has been documented. [from forward]

Health Sector Policy: Republic of Rwanda

Rwanda’s Health Sector Policy translates the Government’s overall vision of development in the health sector, as set out in Vision 2020 and the Economic Development and Poverty Reduction Strategy (EDPRS II 2013-2018). Since the adoption of the previous Health Sector Policy in 2005, much has changed in terms of national socio-economic development and more specifically in the health sector.

The Role of Social Service Workforce Development in Care Reforms

This working paper explores the topic of social service workforce strengthening as it relates to child care reform. It is intended to be a useful resource for reform efforts and a practical and accessible overview for use by policy-makers, practitioners, and service providers in contexts that are either considering the implications of care reforms for their social service workforce or are already engaged in the process. The paper illustrates key issues by drawing on the experiences of Indonesia, Moldova, and Rwanda, three countries in the process of reform. [from

Rwanda's Evolving Community Health Worker System: A Qualitative Assessment of Client and Provider Perspectives

Community health workers (CHWs) can play important roles in primary health care delivery, particularly in settings of health workforce shortages. However, little is known about CHWs’ perceptions of barriers and motivations, as well as those of the beneficiaries of CHWs.[from abstract]

Pathways to Progress: A Multi-Level Approach to Strengthening Health Systems

This report synthesises findings from five country case studies from the health dimension of this project, which focus
on maternal and child health (MCH) (Mozambique,Nepal, Rwanda) and neglected tropical diseases (NTDs)(Cambodia, Sierra Leone). MCH was selected given its centrality in two of the Millennium Development Goals (MDGs) and its ability to act as a proxy for strengthened health systems.

Financing Medical Education through the Private Sector

From 2010 through 2013, the SHOPS project implemented a series of pilot activities to explore the feasibility of introducing private sector health education financing mechanisms. SHOPS explored private sector solutions to help meet ambitious targets from the U.S. President’s Emergency Plan for AIDS Relief for training new health care workers. This report shares the project’s work with private pre-service education financing in Malawi, Rwanda, Tanzania, and Zambia.

Plausible Role for CHW Peer Support Groups in Increasing Care-Seeking in an Integrated Community Case Management Project in Rwanda: A Mixed Methods Evaluation

During national scale up of Integrated Community Case Management (iCCM) in Rwanda, greater improvements in care-seeking were found in the districts where Kabeho Mwana implemented its model than in the rest of the country. Success was attributed to an emphasis on routine data review, intensive monitoring, collaborative supervision, community mobilization, and, in particular, CHW peer support groups. [from introduction]

Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review

Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance.

Strategic Human Resources Solutions for Healthcare Systems in Central and Eastern Africa

This article explores the human resources problems along with the health status and services for Kenya, Rwanda and Uganda. Situational analysis on health status and service delivery is presented via a thorough examination of country specific National Health Sector Strategic Plans. Strategic solutions based on improving the Human Resources for Health are explained and World Health
Organization’s Millennium Development Goals are examined. [from abstract]

Systems Approach to Monitoring and Evaluation Guides Scale Up of the Standard Days Method of Family Planning in Rwanda

After providing a brief introduction about the outcomes of the pilot phase as well as goals and outcomes of national scale up, this article provides lessons learned about how to successfully scale up health interventions. [from introduction]

The Human Resources for Health Program in Rwanda — A New Partnership

From 1989 through 1997, Rwanda had the lowest life expectancy of any country in the world. Workforce setbacks further plagued the country as many clinicians fled or were killed. During the last decade, however, Rwanda has rebuilt its health system and registered some of the steepest declines in premature mortality in recent history.[adapted from introduction]

Excellent Clinical Outcomes and High Retention in Care Among Adults in a Community-Based HIV Treatment Program in Rural Rwanda

This artical reports the clinical and programatic outcomes at 24 months for a cohort of patients enrolled in a community-based anti-retroviral treatment (ART) program in southeastern Rwanda which provided additional measures of support at the community level, including community-based psychosocial support and directly observed ART delivered by community health workers. [adapted from author]

Using Performance Incentives to Improve Health Outcomes

This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. [from abstract]

Augmenting Surgical Capacity in Resource-Limited Settings

This article outlines an educational partnership model designed to increase local capacity for postgraduate education at a Rwandan surgical residency program and to reduce dependence on foreign programs for the training of Rwandan surgeons. [adapted from author]

Identifying Characteristics Associated with Performing Recommended Practices in Maternal and Newborn Care among Health Facilities in Rwanda: A Cross-Sectional Study

This study examined the quality of facility-based maternal and newborn health care by describing the implementation of recommended practices for maternal and newborn care among health care facilities to determine whether increased training, supervision, and incentives for health workers were associated with implementing these recommended practices. [adapted from author]

District Health System Reorganization Guideline from a Managerial Perspective

These guidelines are Rwanda’s official guide to the management of a functional district health system and were designed as a daily guide for the duties of the district health team. It traces key roles and responsibilities of each team member. [adapted from foreward]

Synthesis of Focus Group Discussions with Health Workers in Rwanda

This report summarizes the findings of a qualitative study on health workers’ performance and career in Rwanda to identify bottlenecks, strengths and shortcomings for human resources in the health sector, as perceived by both health workers and users of health services. [adapted from summary]

Institutions for Health Care Delivery: A Formal Exploration of What Matters to Health Workers

Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers. [adapted from introduction]

Where, Why and for How Much: Diversity In Career Preferences Of Future Health Workers In Rwanda

The government of Rwanda has identified human resources for health as one of its policy priorities. This study aims to contribute to building a better understanding of health worker choice and behaviour, and to improve evidence based polcies. [from summary]

Study on the Readiness of the Political, Legal, Health and Community Systems to Respond to Gender-Based Violence in Three Districts of the City of Kigali

This study examines the ability of political, legal, health, and communities to respond to gender-based violence in Kigali, Rwanda. [from publisher]

Human Resources for Health Strategic Plan 2011-2016

The overall aim of the plan is to increase the number of appropriately skilled, motivated and equitably distributed health service providers for Rwanda. The main strategic objectives of the plan are: a coordinated approach to planning across the sector based on the best available data; increased number of trained and equitably distributed staff; improved productivity and performance of health workers; and strengthened human resource planning, management and development systems at all levels. [from summary]

Workplace Violence and Gender Discrimination in Rwanda's Health Workforce: Increasing Safety and Gender Equality

This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda, and examines the subsequent impact of the study on Rwanda’s policy environment. [from abstract]

Fostering Public-Private Partnerships to Improve Access to Family Planning in Rwanda

Through public-private partnerships, the government of Rwanda can make more efficient use of public resources by targeting and meeting the needs of specific populations and thus help ensure family planning services and products will be available to all Rwandans in the long term. This report aims to inform stakeholders working to strengthen family planning through multisectoral partnerships about Rwanda’s family market.

HRH Country Profiles

The HRH country profiles serve as a tool for systematically presenting the HRH situation, policies and management. They are expected to help to monitor trends, generate regional HRH overviews, provide comparable data between countries and identify points for focused action in countries. They will also serve for a comparison of countries’ responses to similar HRH challenges.

Who Wants to Work in a Rural Health Post? The Role of Intrinsic Motivation, Rural Background and Faith-Based Institutions in Ethiopia and Rwanda

This paper examines the extent to which health workers differ in their willingness to work in rural areas and the reasons for these differences, based on the data collected in Rwanda analysed individually and in combination with data from Ethiopia. [from introduction]

Paying Primary Health Care Centers for Performance in Rwanda

Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. [from abstract]

Implementation of the Learning for Performance Approach in Rwanda: Final Report

The Capacity Project used the Learning for Performance (LFP) approach to develop the family planning (FP), HIV/AIDS and gender components included in the competency-based A1 nursing and midwifery pre-service curricula. LFP was also used to adapt the Rwanda national FP curriculum to an on-the-job training approach. This study documents the implementation of the and the lessons learned from its application in preservice education and in-service training in Rwanda. [from summary]

Final Feasibility Evaluation for No-Scalpel Vasectomy in Rwanda

In direct response to the country’s human resources for health needs, the Capacity Project helped to develop the capacity of the district hospital clinical workforce to expand access to a full range of quality family planning methods through a pilot vasectomy in-service training program for physicians and nurses at two district hospitals. [adapted from introduction]

Evaluation of the Capacity Project's Human Resources Information Systems (HRIS) Strengthening Process in Swaziland, Uganda and Rwanda

The Capacity Project worked to strengthen HRIS in several low-resource countries to assist decision-makers and human resources managers in identifying and responding to critical gaps in HRH. The findings and recommendations in this report cover the Capacity Project’s implementation of HRIS in Swaziland, Rwanda and Uganda. [from summary]

Task Shifting for Scale-up of HIV Care: Evaluation of Nurse-Centered Antiretroviral Treatment at Rural Health Centers in Rwanda

In September 2005, a pilot program of nurse-centered antiretroviral treatment (ART) prescription was launched in three rural primary health centers in Rwanda. We retrospectively evaluated the feasibility and effectiveness of this task-shifting model using descriptive data. [from abstract]