Registering and Licensing Rwandan Nurses and Midwives Improves Quality of Care

 {Photo credit: Candide Tran Ngoc/MSH}A Rwandan nurse immunizes a child.Photo credit: Candide Tran Ngoc/MSH

Until recently, nurses and midwives in Rwanda had varying degrees of knowledge, training, and capacity. Some had received inadequate instruction abroad and others had even bought counterfeit diplomas. Because there was no system in place to ensure nurses were adequately prepared, many Rwandans were subjected to inconsistent care and unreliable service quality.

To address these challenges and comply with the East Africa Community health system standards, Rwanda’s Ministry of Health (MOH) asked the USAID-funded Integrated Health System Strengthening Project (IHSSP), led by Management Science for Health (MSH), to support their plans to establish a national licensing system for nurses and midwives. In 2011, with help from IHSSP, the National Council of Nurses and Midwives (NCNM) developed standard criteria for registration and licensing and designed a national database with information on health workers’ qualifications and clinical experience.

IHSSP is now working with the NCNM to finalize the national database and develop their website so nurses and midwives can register online. The revised website will also allow health workers to obtain accurate information on laws, ministerial orders, and the latest research related to their profession.

Today, all practicing nurses and midwives in Rwanda are required to apply for registration and licensure. Registered nurses must hold authentic diplomas, have up-to-date clinical skills, maintain professional conduct and renew their licenses every three years. In the event of misconduct or poor performance, NCNM is able to remove or suspend nurses’ licenses. Once it is finalized, the NCNM will also be able to catalogue and track these punitive measures in the national database. Information collected through the database will also be used to inform the MOH’s strategic planning, technical supervision, monitoring and evaluation, and resource coordination.

According to Dr. Bonaventure Nzeyimana, the MOH’s Public Health Facilities Expert, the new registration system has already helped to increase the quality of health care Rwanda. To date, more than 11,000 of Rwanda’s estimated 12,000 nurses and midwives have been registered in the national database. Over 400 of these nurses have been licensed, and NCNM is currently processing an additional 8,000 licensing applications.