Rwanda: Our Impact

After successfully supporting the national scale-up of performance-based financing (PBF) for health centers in Rwanda, Management Sciences for Health (MSH) is now providing technical assistance to the Rwandan Ministry of Health (MoH) to sustain and improve this model and to introduce PBF at the community level. PBF is an innovative health financing solution that structures the flow of resources to pay for results rather than simply paying for processes or reimbursing activity costs.

In order to achieve the Government of Rwanda's long-term health vision to "provide sustainable financial resources for the delivery of primary health care for all" by 2020, specific long-term objectives related to health have been set and defined. The objectives are to establish a fair and efficient universal health financing system based on national solidarity, capacity-to-pay, prepayment, and financial protection for all.

Management Sciences for Health (MSH) is participating in the First Global Symposium for Health Systems Research being held from November 16-19, 2010 in Montreux, Switzerland.

Coptic Waiting in Tent. Photo Credit: MSH StaffOn November 4–6, 2009, in Gisenyi, Rwanda, the Initiative on Adherence to Antiretrovirals of the International Network for the Rational Use of Drugs (INRUD-IAA) hosted its third annual meeting on antiretroviral therapy (ART) adherence. Results of an INRUD-IAA research study showed that the adherence indicators chosen for study are clinically meaningful—that is, they correlate to increases in patients’ CD4 counts and weight gain.

A laboratory worker at Kabusunzu Health Center in Kigali, Rwanda. Photo Credit: Tempe Goodhue.Rewarding health service providers in Rwanda for positive results has increased the number of clients served and improved the quality of the services they receive. MSH has documented noteworthy gains in indicators of maternal-child health from 2005 through mid-2009.

MSH staff reported on the results of projects in Ethiopia, Kenya, Namibia, and Rwanda at this year’s meeting of agencies that implement programs funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR) in Windhoek, Namibia, from June 10 to 14. The meeting brought together about 1,500 people from 55 countries to share best practices and lessons learned in the fight against AIDS.

Management Sciences for Health (MSH) leaders in performance-based financing (PBF) of health services shared their successful experiences from Haiti and Rwanda in a new book from the Center for Global Development, Performance Incentives for Global Health: Potential and Pitfalls.The Haiti team, writing about scaling up a performance incentive model through a network of nongovernmental organizations (NGOs), found that rewarding NGOs for increasing access to a package of basic services and paying them for achieving performance targets resulted in significant increases in essential services such as

MSH: What is your role in the Ministry of Health? I am the coordinator of the support unit for contracting in the Ministry of Health of Rwanda. My mission was to set up a mechanism for introducing results-based financing into the health system, to make it functional and perform smoothly. MSH: What is your background working in public health financing? I have worked in the public health system since 1983. I was first a health program manager, including financial management.

As the Rational Pharmaceutical Management (RPM) Plus Program draws to a close, the Program Director, Dr. Douglas Keene of MSH, reviewed the successes of almost a decade of contributions to improved pharmaceutical management. He spoke at the annual conference of the Global Health Council in Washington, DC, on May 28, 2008. Getting Help to People in Need

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