Building Systems for Better Health: The Integrated Health Systems Strengthening Project, 2009–2014


Launched in 2009, the Integrated Health Systems Strengthening Project (IHSSP) expanded on work initiated by the Rwanda HIV/Performance-Based Financing Project (2005 – 2009), also funded by the US Agency for International Development (USAID) and implemented by Management Sciences for Health (MSH). IHSSP’s goal was to improve the health of all Rwandans through better access to quality health services. In its five years of implementation, IHSSP improved Rwanda’s information management, health financing, human resources for health, and quality of care and helped decentralize the country’s health services and management.

&;&;Just as all aspects of a health system are interdependent, so were IHSSP’s many interventions. It is impossible to fully support one aspect of a health system without affecting others.To improve quality, health system leaders must not only define the standard of care to be achieved, but also build the workforce’s capacity to meet those standards. A comprehensive process to track revenue and services provided is necessary for the system’s financial well-being, and also provides information for planning, quality improvement, and human resources management.To create better access, health systems must remove financial barriers and also ensure services are decentralized to extend geographic access.

Key Achievements of IHSSP:

  • Development of interactive databases to house and analyze Rwanda’s health information; comprehensive training on using the system to inform programming at all levels
  • Support for the revision and roll-out of the new community-based health insurance system, which provides equitable access to health services
  • Establishment of and support to professional councils, who set and uphold standards for all Rwandan health workers
  • Introduction of the accreditation system, which will standardize quality of care in Rwandan hospitals
  • Establishment of a performance-based financing system for community health workers
  • Determination of staffing needs at every health facility and revision of a national database to effectively manage distribution of the health workforce
  • Support for the development of the Rwandan Health Sector Strategic Plan III, the Human Resources for Health Sustainability Plan, the Health Care Financing Strategic Plan, and several other strategies that the Ministry of Health is using to guide its work