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Rwanda’s fourth health sector strategic plan (HSSP4) is meant to provide the health sector with a Strategic Plan that will highlight its commitments and priorities for the coming 6 years. It will be fully integrated in the overall economic development plan of the Government. HSSP4 will fulfill the
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country’s commitment expressed in the national constitution, National Strategy for Transformation (NST) and the aspirations of the Health Sector Policy 2015. The strategies herein adhere to the Universal Health Coverage (UHC) principles towards realisation of the Sustainable Development Goals (SDGs). HSSP4 therefore lays a foundation for Vision 2050 (“The Rwanda We Want”), which will transform Rwanda into a high-income country by 2050. HSSP4 anticipates the epidemiological transition of the country, the increase in population and life expectancy and the expected increase of the health needs of the elderly, notably in Non Communicable Diseases (NCDs). HSSP4 also anticipates a decrease in external financial inflows, hence it is imperative to build secure / resilient health systems.
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In recent years, Rwanda has been on the fast track to achieve major health improvements for its entire population. With the support of government agencies and various non-governmental partners, the Ministry of Health (MoH) has endeavored to decentralize Rwanda’s health system and bring health serv
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ices closer to the people. Guided by multitude of national and international development frameworks, Rwanda’s healthcare successes include the establishment of a community health insurance scheme (mutuelle de santé), a system of cooperative-financed community health workers in every village, and interventions for researching, preventing, and treating diseases like HIV/AIDS, TB, and malaria.
As the MoH continues to design innovative means to reach and surpass its prescribed health outcome targets, it will hold as core principles the integration of service provision, the increase in healthcare capacity, and the attainment of sustainable funding sources. Rwanda is committed to achieving the Millennium Development Goals by 2015 and has declared Family Planning (FP) a national priority for poverty reduction and socioeconomic development of the country. Modern contraceptive use has more than quadrupled from 2005 to 2010, rising from 10% to 45%, but the government’s Economic Development and Poverty Reduction Strategy calls for an increase the modern contraceptive prevalence to 70% by 2016. While structural changes in health care and supply chains have led to noteworthy improvements in FP and other services, there are still many challenges that must be overcome. As such, a strategic plan is needed to coordinate FP efforts around a well-defined set of objectives and responsibilities.
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The Early Childhood Development Policy and its Strategic Plan seek to provide a framework to ensure such a holistic and integrated approach to the development of young children. International research has demonstrated the high economic returns on ECD investment and its positive impact on health and
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education outcomes as well as the overall economic development of a nation. The implementation of the ECD Policy will thus provide Rwanda with the basis for achieving the objectives and goals of the EDPRS and Vision 2020.
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The target audience for this guideline is primarily for health care providers nurses, doctors, social workers and other people involved in HIV response in Rwanda so that they are capable of offering quality care services to patients over a long time. The new National Guidelines for Prevention and Ma
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nagement of HIV and STIs are articulated in accordance to treat all HIV+ patients regardless of CD4 count and a new service delivery model to support its implementation.
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Attraction and Retention of Rural Primary Health-care Workers in the Asia Pacific Region
Liu Xiaoyun; Zhu, Anna; Tang, Shenglan
World Health Organization, Regional Office for South-East Asia
(2018)
C_WHO
The Asia Pacific Observatory on Health Systems and Policies is a collaborative partnership which supports and promotes evidence-based health policy making in the Asia Pacific Region. Based in WHO’s Regional Office for South-East Asia, it brings together governments, international agencies, foundat
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ions, civil society and the research community with the aim of linking systematic and scientific analysis of health systems in the Asia Pacific Region with the decision-makers who shape policy and practice.
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The purpose of this strategy is to guide the planning, management and development of human resources for health in Rwanda for the period 2011 - 2016. The overall aim of the plan is to increase the number of appropriately skilled, motivated and equitably distributed health service providers for Rwand
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a.
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Pathways to progress: a multi-level approach to strengthening health systems
Samuels, F., Amaya, A.B., Rodríguez Pose, R. and Balabanova, D.
Overseas Development Institute
(2014)
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Findings on maternal and child health in Nepal, Mozambique and
Rwanda, and neglected tropical diseases in Cambodia and Sierra Leone | 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
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,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. NTDs, while until recently relatively neglected in global policy debates, are now attracting more interest, not least because they are viewed as diseases of the poor whose treatment could positively impact on most of the other MDGs.
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Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review
Maurice Bucagu, Jean M. Kagubare, Paulin Basinga, Fidèle Ngabo, Barbara K Timmons & Angela C Lee
Reproductive Health Matters
(2012)
CC
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit
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erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. 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. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | 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. The authors find that the incentives had a large and significant effec
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t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo
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r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see
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page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
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The mandate of the National Tuberculosis Control Programme is to provide leadership and stewardship to accelerate intense and coordinated efforts to reduce the adult TB burden of 290 per 100,000 population recently established in the 2013 National TB Prevalence Survey. Other key challenges are low T
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B case notification, unacceptably high TB death rates, low antiretroviral therapy (ART) coverage among TB/HIV patients and low drug-resistant notification and treatment.
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The purpose of Volume 2 is to provide a full set of reference data showing performance over the period of the previous National Health Plan 2001–2010, to provide a baseline against which performance over the next ten years can be measured, and to highlight in greater detail some of the contex
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t against which the policies and strategies described in Volume 1 can be understood.
This Part A of Volume 2 provides data and context from a whole-of-country perspective. The data will be useful for provinces and national-level program staff within the National Department of Health to establish benchmarks and targets in the Five-year Strategic Implementation Plans to be developed to support implementation of this Plan. Additionally, this Volume will serve as a reference manual for all health sector stakeholders.
Original file: 77 MB more
This Part A of Volume 2 provides data and context from a whole-of-country perspective. The data will be useful for provinces and national-level program staff within the National Department of Health to establish benchmarks and targets in the Five-year Strategic Implementation Plans to be developed to support implementation of this Plan. Additionally, this Volume will serve as a reference manual for all health sector stakeholders.
Original file: 77 MB more
USAID/KENYA Evaluation Services and Program Support (ESPS)
The United States Agency for International Development (USAID) has a solid track record of supporting health and development initiatives in Kenya. AIDS, Population, and Health Integrated Assistance (APHIA) is the agency’s flagship hea ... lth initiative in the country. APHIA is currently in its third iteration, APHIAPlus, which began in January 2011 and is slated to end in December 2015. APHIAPlus was designed to contribute to Result 3 (“Increased use of quality health services, products, and information”) and Result 4 (“Social determinants of health”) of USAID/Kenya’s implementation framework. The main technical areas of focus are HIV/AIDS; malaria; family planning (FP); tuberculosis (TB); maternal, newborn, and child health (MNCH); and water, sanitation, and hygiene (WASH). more
The United States Agency for International Development (USAID) has a solid track record of supporting health and development initiatives in Kenya. AIDS, Population, and Health Integrated Assistance (APHIA) is the agency’s flagship hea ... lth initiative in the country. APHIA is currently in its third iteration, APHIAPlus, which began in January 2011 and is slated to end in December 2015. APHIAPlus was designed to contribute to Result 3 (“Increased use of quality health services, products, and information”) and Result 4 (“Social determinants of health”) of USAID/Kenya’s implementation framework. The main technical areas of focus are HIV/AIDS; malaria; family planning (FP); tuberculosis (TB); maternal, newborn, and child health (MNCH); and water, sanitation, and hygiene (WASH). more
Journal of the International AIDS Society 2016, 19:20926
There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low‐ and middle‐income settings. This article describes a public–private partnership ... that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community‐based non‐governmental organization (International HIV/AIDS Alliance).
https://doi.org/10.7448/IAS.19.1.20926 more
There is a growing interest in the potential contribution the private sector can make towards increasing access to antiretroviral therapy (ART) in low‐ and middle‐income settings. This article describes a public–private partnership ... that was developed to expand HIV care capacity in Yangon, Myanmar. The partnership was between private sector general practitioners (GPs) and a community‐based non‐governmental organization (International HIV/AIDS Alliance).
https://doi.org/10.7448/IAS.19.1.20926 more
The Ministry of Health conducted STEPS surveys on adult risk factors surveillance in Myanmar in 2003, 2009 and 2014. Amongst these three surveys, the 2014 one is the most comprehensive, providing an analysis of all States and Regions within Myanmar through not only questionnaires and physical measur
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ements – STEPs 1 and 2 of the survey – but also with data obtained through biochemical measurements (STEP 3).
The STEPS survey was initiated by the Ministry of Health in December 2014 with the technical support of WHO Headquarters, regional and country offices. more
The STEPS survey was initiated by the Ministry of Health in December 2014 with the technical support of WHO Headquarters, regional and country offices. more
Census data shows that Myanmar can harness a double dividend – both youth and gender. This year’s annual report provides many facets of the journey to gender equality. It tells a story of widening horizons for women and girls who are capable in their own right. It is also a story of women fulfil
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ling their reproductive rights, and of couples having access to family planning choices.
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Policy note: Cambodia Health Systems in Transition.
The health system includes a mix of public and private providers. The use of private providers is much greater among the wealthy, while the use of informal-sector health providers is greater among the poor. Due to these circumstances there is ... considerable scope to establish appropriate public-private cooperation and to reinforce the regulatory mandate of the Ministry of Health (MOH). more
The health system includes a mix of public and private providers. The use of private providers is much greater among the wealthy, while the use of informal-sector health providers is greater among the poor. Due to these circumstances there is ... considerable scope to establish appropriate public-private cooperation and to reinforce the regulatory mandate of the Ministry of Health (MOH). more
Policy Note #4: Myanmar Health Systems in Transition Policy Notes Series
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ... revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
Protecting people from financial hardship when they fall ill is one of the two key elements of universal health coverage (UHC). In practice, this means that the majority of health care costs have to be met from government ... revenues so that services are provided free or with a small affordable co-payment. The alternative is to rely on pre-payment through some form of insurance, where risks are pooled across all contributors.
The challenge in Myanmar is that at present neither approach is functioning. Government spending is too low to meet people’s health needs and the proportion of the population covered by insurance is negligible. As a result, families face a stark choice in the event of serious illness: either defer treatment and face the consequences, or incur what can amount to catastrophic expenses and a downward spiral of disinvestment and poverty. more
