REPUBLIC OF RWANDA

MINISTRY OF HEALTH

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THE RWANDA HEALTH SYSTEM STRENGTHENING PROJECT

Over the past 20 years, Rwanda has re-alized impressive declines in infant, child, and maternal mortality through innova-tive health system reforms. Management Sciences for Health (MSH) has been a steadfast partner to the Government of Rwanda in these efforts. The Rwanda Health System Strengthening (RHSS) project (2014 - 2019) builds on work initiated under the Integrated Health Systems Strengthening Project (IHSSP, 2009 – 2014) and the HIV Perfor-mance-Based Financing project (HIV/PBF, 2005 - 2009), all funded by the US Agency for International Development (USAID) and led by MSH.

RHSS supports the continued growth and improvement of Rwanda’s health sector by strengthening systems that support sustainable financing, governance and leadership, human resource management, quality improvement, and data manage-ment, and increasing the private sector’s support for sustainable health care.

RHSS works with national institutions and public and private health care providers and facilities to provide all Rwandans access to cost-effective, quality health services.

MSH Rwanda KK 341 Street, Plot No 22, Kicukiro Area

P.O. Box 371 Kigali - RwandaTel: (250) 0788 308 081/2

www.msh.org

This brochure is made possible by the support of the American People through the United States Agency for International Development (USAID). The contents of this brochure are the sole responsibility of the Rwanda Health System Strengthening project and do not necessarily reflect the views of USAID or the United States Government.

OUR PARTNERS:

Management Sciences for Health (MSH)

Banyan Global

Jembi Health Systems

Tulane University School of Public Health and Tropical Medicine

The University of Rwanda School of Public Health

RHSS is helping move the Rwandan health system toward financial independence by mobilizing domestic resources and supporting effective decentralization of management and service delivery. These efforts, combined with innovative quality improvement initiatives, support Rwanda’s continued progress toward a healthier population.

Project support for improved quality of care has led to impressive improvements in patient outcomes. For instance, in just 21 months, post-caesarian section infection rates fell from 3.7 to 0.9% in Kibungo hospital, a facility participating in the accreditation process.

3.7% to

0.9%

Kibungo hospital post-caesarian infection rate

2013 - 2015

QUALITY IMPROVEMENTInitiated in five district hospitals under the Integrated Health Systems Strengthening Project, Rwanda’s inno-vative country-owned hospital accreditation system has driven impressive improvements in quality of care. (See center panel.) RHSS continues to train and mentor staff from these hospitals and will support expansion of the accreditation system to all health facilities in the country over time. The project is working with the Ministry of Health to establish a national steering committee and accreditation oversight body.

ENGAGING THE PRIVATE SECTORRHSS is building the capacity of the Ministry of Health and the Rwanda Biomedical Center to develop private sector engagement activities and public-private partner-ships. Innovative initiatives, such as creating private wings within public health facilities, will decrease the burden on the public health sector and create revenue. The project is also identifying specialized services that can be delivered more cost effectively by the private sector, such as technology support and some clinical support services. RHSS will work with the proposed Devel-opment Credit Authority to incentivize local financial institutions to lend money for private sector health initiatives.

HEALTH FINANCING RHSS ensures availability of comprehensive, effective financial management systems at all facility levels in the private and public sectors and within community health worker cooperatives. Through analyses of the true cost of facility-based care, the project is building the evi-dence base to set service fees.

RHSS is bolstering sustainability of the Rwandan com-munity-based health insurance (CBHI) system by sup-porting the transition of the system’s management from the Ministry of Health to the Rwandan Social Security Board. Through promotion of innovative business plan-ning and income generation strategies, RHSS is helping address gaps between revenues and costs in health facilities, CHW cooperatives, and the CBHI system.

DATA USE, RESEARCH, AND KNOWLEDGE MANAGEMENTRwanda has made great progress in harmonizing data collection in the health sector. However, routine use of data to make strategic, evidence-based decisions is not yet institutionalized. RHSS is helping develop a culture of data use by harmonizing monitoring and evaluation frameworks at the decentralized level to maximize use of available data; supporting strategic and operational planning in eHealth and mHealth; continuing to support existing information management systems—especially those developed using DHIS 2 and OpenMRS—and developing a broad base of local capacity to manage those systems; and establishing mechanisms to facilitate and promote operations research at all levels of the health system.

LEADERSHIP AND GOVERNANCERHSS identifies barriers to effective decision making, implementation of policies, and gaps in institutional and individual capacities, proposes solutions, and supports their implementation. The project strengthens human resources for health at the central and decentralized levels and trains and mentors staff at all levels of the health system to improve policies, planning, and coordi-nation of health interventions.

Ruhengeri hospital neonatal death rate

1.4%

4.3%

2013

2015