USAID Celebrates Contributions of Rwanda Health Systems Strengthening Project

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.

The RHSS Project represents USAID’s continued commitment to support Rwanda on its journey to sustainable improvements in the health of its 12 million people.

The overall goal of the RHSS Project was to support the Ministry of Health to improve population health outcomes. The project did this by strengthening the performance of the health system at the national and decentralized levels. It also increased the resilience of the health sector to respond to new health challenges, such as decreasing outside funding to the health sector or the recurrent emergence of Ebola in the sub-region.

The RHSS Project strongly supported the implementation of Rwanda’s Health Sector Strategic Plans and contributes to Rwanda’s Vision 2020 for a health system that guarantees universal and equitable access to quality health care for all people in Rwanda. The RHSS Project was implemented by MSH in partnership with Banyan Global, Jembi Health Systems, Tulane University School of Public Health and Tropical Medicine, and the University of Rwanda School of Public Health.

“In total, by working hand-in-hand with the Government of Rwanda, this project has been integral in laying the foundations for a successful and sustainable health system in Rwanda,” said USAID Mission Director, Leslie Marbury. The project focused on five strategic areas: effective leadership and governance, sustainable health financing and private sector engagement, improved quality of care, evidence based decision making, and a mobilized, skilled workforce.

The main achievements of the RHSS Project, include the following:

• Promoted and supported a standards driven approach to healthcare quality improvement by scaling up the use of quality standards from 5 to 43 public hospitals at provincial and district levels across the country. In the last survey (2018), 25 of the 43 districts, provincial and referral hospitals reached accreditation level 1.
• Supported development and dissemination of primary health care standards for the country’s 502 health centers. 
• Introduced the World Health Organization’s (WHO) workload indicators of staffing need (WISN) tool in all public district hospitals across the country, an evidence-based planning tool that calculates adequate staffing levels to ensure quality care and meet population health needs.
• Strengthened the capacities of all 30 District Health Management Teams (DHMT), the decentralized health coordination body, with 24 out of 30 DHMTs being assessed as fully functional during the last annual assessment (2018).
• Supported the establishment of the Mutual Assistance Group (MAG) scheme, a saving and loans mechanism for the health sector, addressing health workers priority needs.
• Promoted the availability of comprehensive, effective financial management systems for hospitals (IFMIS) and community health workers cooperatives. Appropriate facility income generating models increase domestic resources for health.
• Facilitated automation of the membership management for Community Based Health Insurance (CBHI). Members can now pay their premiums through mobile phone applications and service providers can quickly confirm client’s eligibility.
• Developed a fully functional web-based Monitoring and Evaluation system for CBHI built on Rwanda’s health reporting system, DHIS2.
• Private health providers have access to commercial loans from a local bank through USAID’s Development Credit Authority (DCA) program, thereby increasing domestic financing of health care and increasing access to specialized services.
• Local facilitators can support and adapt the Leadership Development Program approach to help hospitals assess, plan, and monitor quality improvement initiatives.
• The first cohort of the District Operational Research Challenge Fund established partnerships and systems for building research capacity and managing research grants.

Learn more about the project

Read the final report