28 November 2012

Rwanda: 'Human Resource for Health' a Boost to Health Service Delivery


Rwanda has shown significant progress in the health sector and results have been acknowledged worldwide as a lead country for sustainable and innovative solutions that save lives.

The cornerstone to some of these innovations is the use of Community Health Workers (CHWs) to address health challenges at grassroots level, which make up for 80 per cent of Rwanda's health burden.

Progress shows that there has been a reverse in morbidity and mortality of infectious diseases such as HIV/AIDS, Malaria, TB, Diarrheal diseases, respiratory diseases and conditions related to poor hygiene. Negative perceptions and ignorance that hinders uptake of family planning and obstetric services has positively changed, hence lowering maternal deaths that result from such causes. In a period of 18 years, life expectancy has increased from 41 years in 1994 to 58 years in 2010 with reference to the 2010 Demographic Health Survey.

Economic prosperity and access to public health are resulting in reduction of communicable diseases, longevity and modified lifestyles which, in turn, add up to social and economic challenges with the emergence of non-communicable diseases such as obesity, cardiovascular diseases, diabetes, injuries and other chronic diseases.

Non-communicable diseases are chronic in nature, complex to treat, need sophisticated equipment to diagnose (detect) as well as specialized medical personnel for adequate management.

The health sector has managed to cope with communicable diseases and other health challenges that pose a threat to our population but with an aim of addressing the healthcare needs in a more sustainable way, and it has become apparent that the sector needs to boost its human resource capacities to cope with the emergence of diseases related to lifestyle.

Estimates show that treating one case of cervical cancer for one year could be as costly as treating 200 cases of malaria, or put differently, the cost of training one cancer specialist can be as costly as training 10,000 community health workers.

The Doctor to Population ratio is still low where one doctor serves 18,000 people but we cannot undermine the difficult path undertaken to reach where we are today. Training highly skilled medical personnel is quite expensive but government has continuously played its part to bridge this gap.

With reference to the 2001 Abuja Declaration, the Government of Rwanda has fulfilled its pledge to the people as stipulated in article 41 of the Constitution where 15 per cent of the annual budget is allocated to improve the health sector.

Achieving the right and duty to health demands that human resource challenges be met.

It is in this regard that the government adopted a cost effective strategy to increase the number of highly skilled professionals by introducing the Human Resource for Health (HRH) programme. The programme has been tailored to provide quality medical health professionals co-trained by faculty members from the top most 14 medical Universities in the USA.

The programme which was launched early this year will see over 1,182 general practitioners acquire intensive training by the year 2019. The number will significantly rise from the 631 that the country has today.

Through this programme, the health sector will be boosted with 551 specialist doctors by 2019 compared to the current 150.

HRH is the first programme of its kind in Africa and it is believed that once this pilot initiative achieves its goals, then other countries could emulate it as a successful tool in increasing access to quality health care.

It is a new home-grown solution that will meet the increasing demand of highly skilled health care providers in the country. It is unique in a sense that Rwandan medics will acquire skills right here at home where they will continue to serve the population yet having their capacity built as training continues.

To some, this sounds like an ambitious plan but for those who are familiar with Gacaca, Agaciro, Girinka, Ubudehe and Umuganda surely understand that this is already a fulfilled commitment.

Dr. Thierry Nyatanyi is the Head of Division/Other Epidemic Infectious Diseases Institute of HIV/Aids, Disease Prevention and Control Rwanda Biomedical Center

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