Rwanda

Rwanda HIV/PBF Project

2005–2008

Rwanda's HIV/PBF (Performance-Based Financing) Project is designed to increase the delivery of specific HIV & AIDS and primary health care services through an innovative financing project that provides monetary and other incentives through a national output incentive payment program. The approach is designed to promote and reward effective innovation and efficient management in the delivery of quality services. The HIV & AIDS component is to be implemented in a manner that assures that primary care health services are not depleted or weakened by diversion of basic health resources into HIV & AIDS service delivery.

Basic Support for Institutionalizing Child Survival (BASICS)

1999–2009

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As a technical assistance partner for newborn and child health to the USAID Bureau for Global Health, the Basic Support for Institutionalizing Child Survival (BASICS) Project develops and implements strategies to reduce preventable infant and childhood deaths in the developing world. MSH works as a partner in BASICS, which began its third phase in October 2004. Under this indefinite quantity contract (IQC), BASICS assists USAID/Washington Bureaus, USAID field missions, host-country governments, donor agencies, NGOs, PVOs, research institutions, and the private sector to scale up and increase the use of newborn and child health and nutrition interventions by families, communities, and health systems.

Since 1993, BASICS has worked to achieve substantial improvements in coverage and to expand effective newborn and child health interventions. BASICS focus areas include newborn health, essential nutrition actions like vitamin A supplementation, immunization, integrated management of childhood illness, treatment of diarrhea and pneumonia, and malaria control. In addition to strengthening the delivery of basic newborn and child health services, BASICS has expanded its technical scope to include pediatric HIV & AIDS, birth spacing, and child survival and nutrition in complex humanitarian crises. BASICS areas of expertise include assistance to countries on comprehensive strategies or selected interventions for newborn and child health, building partnerships, delivery of quality newborn and child health services, community-based treatment and private sector approaches to expand access to services, and capacity building and training.

Today, BASICS work in Rwanda focuses on expanding effective child health interventions in areas such as newborn health, nutrition, immunization, pediatric AIDS, the treatment of diarrhea and pneumonia, and malaria control. MSH is one of nine consortium members of the BASICS Project.

Rational Pharmaceutical Management Plus Program

2000–2008

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RPM Plus works in more than 40 developing countries to provide technical assistance to strengthen pharmaceutical and health commodity management systems. The program works to improve the availability and use of quality medicines, supplies, and basic medical equipment in the public and private sectors and to promote practical, sustainable changes in pharmaceuticals management by developing capacity within cooperating countries and fostering collaboration between countries.

RPM Plus staff and consultants work within developing countries as well as with regional and global initiatives to provide technical leadership and to develop and apply tools for improving drug management at all levels. The program also disseminates best practices and approaches in commodity management. In response to an urgent request from Centrale d'Achat de Médicaments Essentiels du Rwanda (CAMERWA) to USAID/Rwanda for technical assistance in the quantification of antiretroviral drugs, the RPM Plus Program conducted a general assessment of Rwanda's pharmaceutical and laboratory systems. Following this assessment, in collaboration with USAID/Rwanda and supported by the President's Emergency Plan for AIDS Relief, RPM Plus provided technical assistance to the Ministry of Health and CAMERWA to strengthen Rwanda's pharmaceutical and laboratory sectors.

Advance Africa

2002–2004

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Advance Africa was a family planning/reproductive health service delivery project designed to increase access to and improve the quality of clinical and nonclinical programs in sub-Saharan Africa. The project worked to increase capacity for informed decision-making by clients and communities, and for the public sector to sustain quality family planning/reproductive health service delivery programs. Advance Africa also worked with USAID missions to scale up existing efforts by closing gaps in service delivery, and building partnerships among public and private health and nonhealth organizations. The project implemented innovative approaches to revitalize family planning programs within the broad context of Africa’s HIV/AIDS pandemic. MSH was the prime of a consortium of six international organizations that managed implementation of the Advance Africa project.

IMPACT

1998–2002

The IMPACT program focused on two areas of development: capacity building from 1998 through 2000 and financial management from 2001 to 2002. MSH developed, tested, and revised a capacity building assessment tool for the IMPACT/Rwanda country office and provided ongoing, long-distance technical assistance, training, and coaching on how to implement the capacity-building plan. In the second phase of the IMPACT project, MSH provided support for pharmaceutical management policy and logistics, as well as technical assistance and materials to Family Health International (FHI) in development of FHI projects.

Norplant Cost Study

1993

The Norplant Cost Study — coordinated by the FPMD Project — provided information to assist decision makers in implementing cost-effective strategies to improve access to Norplant (a hormonal contraceptive) in developing countries. It examined unit cost of contraceptive methods in the Centre Universitaire de la Santé Publique (CUSP) in Butare, a large outpatient health center. The study results helped managers evaluate the cost implications of different program decisions and to plan and budget effectively for the future.

International Network for Rational Use of Drugs Initiative on Adherence to Antiretrovirals (INRUD-IAA)

2006–2011

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The International Network for Rational Use of Drugs (INRUD) was established in 1989 to design, test, and disseminate effective strategies to improve the way drugs are prescribed, dispensed, and used, with a particular emphasis on resource poor countries.

Launched in September 2006, the INRUD-IAA initiative is funded by the Swedish International Development Cooperation Agency. The objectives of the five-year initiative are to—

• Develop and validate a set of indicators that can be used to monitor adherence to ART
• Investigate adherence rates and determinants for these rates for ART programs and individuals in two target countries
• Pilot interventions to improve adherence in individual patients and in programs in two countries
• Establish the process needed for national AIDS control programs to scale-up successful interventions as part of national policy in the two countries
• Work with the other three countries in the region to develop national adherence policies and implement interventions to improve adherence

Technologies for Primary Health Care (PRITECH)

1983–1993

From 1983 to 1993, PRITECH—a major USAID effort to reduce infant and child mortality and morbidity associated with diarrheal disease—operated twenty-seven country and regional programs in Africa, Asia, and Latin America. As prime contractor, MSH managed the five subcontracts that comprised the consortium and provided over 2,500 person-months of assistance in some fifty countries. MSH has continued this successful experience through participation in BASICS and other worldwide projects. In Rwanda, PRITECH led a consultancy of regional health offices and health centers to develop information on how to establish oral rehydration therapy corners in health centers, estimate annual needs in oral rehydration salts (ORS) packets, gain advice on distribution methods, and investigate the possibility of local production of ORS.

Strengthening Pharmaceutical Systems (SPS) Program

2007–2012

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Strengthening Pharmaceutical Systems is a follow-on to the Rational Pharmaceutical Management (RPM) Plus Program. MSH is pleased to announce that the US Agency for International Development has awarded us the Strengthening Pharmaceutical Systems (SPS) Leader with Associates Cooperative Agreement. SPS will focus on four key results:

• Improve governance in the pharmaceutical sector
• Strengthen pharmaceutical management systems to support public health services
• Contain the emergence and spread of antimicrobial resistance
• Expand access to and improved use of essential medicines

The five-year, $147.5 million cooperative agreement is led by Dr. Douglas Keene as Program Director, Dr. Sameh Saleeb and Dr. Francis Aboagye-Nyame as Deputy Directors. To help meet goals relating to the key result areas, the SPS Program is building on the successes of RPM Plus while expanding the range of technical areas to include financing, pharmacovigilance, pharmaceutical care, integration of new health technologies, and increased use of the private sector, among others. MSH will accomplish this enhanced program of activities by collaborating with a number of new partner organizations. The SPS core partner team includes:

• BroadReach Healthcare
• Ecumenical Pharmaceutical Network
• The Lewin Group
• LMI Government Consulting
• University of Washington Department of Global Health
• WHO Collaborating Center in Pharmaceutical Policy: Harvard University/Boston University

In addition to the core team, MSH is joined by a select group of organizations that will serve as specialized resources for SPS. These organizations include:

• African Medical and Research Foundation
• American Society of Health-System Pharmacists
• Euro Health Group
• Infectious Disease Institute at Makerere University
• Joint Commission International
• London School of Hygiene and Tropical Medicine

As we work toward the overall goal of SPS, the SPS team is striving to advance the science and "art" of strengthening pharmaceutical management systems. The SPS Program provides a great opportunity for MSH and USAID to continue supporting developing countries in their quest to increase access to essential medicines and facilitate the scale up of vital treatment programs.