Rwanda: Our Impact

 {Photo credit: MSH Rwanda}Left to right: Lisa Godwin, USAID Rwanda Health Office Director, Dr. Diane Gashumba, Rwanda's Minister of Health, Alain Joyal, RHSS Project Director, Management Sciences for Health.Photo credit: MSH Rwanda

Over the past five years, the United States Agency for International Development (USAID) has invested in measures to strengthen and sustain Rwanda’s health sector through its Rwanda Health Systems Strengthening (RHSS) Project (2014-2019). In a ceremony at the Kigali Serena Hotel, USAID, the Ministry of Health (MoH), as well as the implementing partner, Management Sciences for Health (MSH), marked the culmination and remarkable achievements of the five-year effort to strengthen the country’s health sector.

{Photo credit: Todd Shapera}Photo credit: Todd Shapera

Cesarean section (C-section) delivery, which is usually initiated when complications arise during pregnancy or delivery, is one of the most frequent surgeries performed at health facilities worldwide.

{Photo credit: Todd Shapera}Photo credit: Todd Shapera

Raissa Iradukunda and her two children live near Remera-Rukoma District Hospital, about one hour from Kigali, Rwanda. The family is covered under Rwanda’s community-based health insurance (CBHI) program, known locally as Mutuelle de Santé. “We are farmers,” she explains, “but we can afford to pay the required 3,000 Rwf [USD 3.45] per year because we know that Mutuelle de Santé has enabled us to access health care even in situations where we did not have enough money for some services.”

{Photo credit: Todd Shapera}Photo credit: Todd Shapera

When Ruhengeri Hospital in northern Rwanda upgraded from a district to a referral hospital in 2014, it began receiving cases from 15 health centers in its own district and five hospitals in surrounding districts. In 2015 alone, the hospital had nearly 6,000 monthly outpatient visits—about 25% above previous levels and among the highest in the country. While these numbers indicate how important the status upgrade was in relation to local health needs, the facility struggled to consistently meet those needs.

{Photo Credit: Irene Nambi, MSH}Photo Credit: Irene Nambi, MSH

Linda* arrived at Kibagabaga Hospital exhausted and desperate. Referred by a smaller health center, she had already been in labor for more than 24 hours. A midwife admitted Linda and put her on an IV. There, she waited for several hours until an obstetrician examined her. Realizing that the baby had an accelerated heartbeat, which is a sign of distress, the doctor ordered a Cesarean section (C-section). When the baby emerged, he was not responsive. Hospital staff worked to help him breathe and eventually, he let out a wail.

 {Photo credit: Irene Nambi, MSH}Beatrice Uzamukunda visits with a nurse in Rwamagana Hospital.Photo credit: Irene Nambi, MSH

By Irene Nambi On an early morning at Rwamagana Hospital in Rwanda’s Eastern Province, patients began to fill the busy outpatient department. As health workers started receiving patients, Beatrice Uzamukunda rushed in with her daughter, Esther. “My baby was very ill with a very high temperature. I was so worried that I had almost lost hope as we approached the facility,” says Beatrice.

{Photo credit: Alanna Savage}Photo credit: Alanna Savage

By Alanna Savage Mist had settled over the morning. I was visiting with staff at Remera-Rukoma District Hospital in the Southern Province of Rwanda. Founded in 1927, the 177-bed hospital serves a population of more than 376,000 and receives patients referred by 11 surrounding health centers.

 {Photo Credit: Denise Museminali/MSH} Women waiting at a health center in Rwanda hold up their health insurance identification cards.Photo Credit: Denise Museminali/MSH

The USAID-supported, MSH-led Rwanda Health Systems Strengthening (RHSS) Project works to reinforce the Rwandan government's capacity to plan, lead, and implement strategic interventions to strengthen key health system structures and processes, all while building sustainability and country ownership.

On March 22 and 23, stakeholders from a number of global organizations (NGOs, USAID, Ministries of Health [MOHs], and others) met at a symposium in Washington, DC, to discuss progress and future capabilities of DHIS 2, the open-source web platform that helps governments and organizations collect, manage, and analyze health data.

{Photo Credit: Denise Museminali}Amina, a community health worker, urged Jean Cyiza to take his son Daniel to the Ntoma Health Center for nutritional support after she diagnosed him as severely malnourished.Photo Credit: Denise Museminali

When Daniel was just 11 months old, his mother suddenly passed away from illness. Without her, he was no longer able to breastfeed and gradually became malnourished. In Rwanda, 38 percent of children under five years old experience chronic malnutrition, or stunting.[i] Stunted children tend to perform poorly in school and are less likely to become productive adults In fact, the World Bank Group estimates that malnourished children are at risk of losing 10 percent of their lifetime earning potential.[ii]

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