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The Kabeho Mwana project (2006–2011) supported the Rwanda Ministry of Health (MOH) in scaling up integrated community case management (iCCM) of childhood illness in 6 of Rwanda’s 30 districts. The project trained and equipped community health workers (CHWs) according to national guidelines. In p
...
roject districts, Kabeho Mwana staff also trained CHWs to conduct household-level health promotion and established supervision and reporting mechanisms through CHW peer support groups (PSGs) and quality improvement systems. The iCCM model implemented by Kabeho Mwana resulted in greater improvements in care-seeking than those seen in the rest of the country. Intensive monitoring, collaborative supervision, community mobilization, and CHW PSGs contributed to this success. The PSGs were a unique contribution of the project, playing a critical role in improving care-seeking in project districts. Effective implementation of iCCM should therefore include CHW management and social support mechanisms. Finally, re-analysis of national survey data improved evaluation findings by providing impact estimates.
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Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review
Maurice Bucagu, Jean M. Kagubare, Paulin Basinga, Fidèle Ngabo, Barbara K Timmons & Angela C Lee
Reproductive Health Matters
(2012)
CC
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit
...
erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the S
...
tandard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda.
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We have long been working to prevent and end sexual violence in armed conflicts and to ensure that the countless victims – men, women, boys and girls – receive the help they need.
In this document, we examine sexual violence specifically in relation to people deprived of their liberty. We c ... onsider why individuals are at risk of sexual violence in detention and how to prevent and reduce that risk. We also set out some potential steps to take when sexual violence occurs. more
In this document, we examine sexual violence specifically in relation to people deprived of their liberty. We c ... onsider why individuals are at risk of sexual violence in detention and how to prevent and reduce that risk. We also set out some potential steps to take when sexual violence occurs. more
Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec
...
t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
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Identifying characteristics associated with performing recommended practices in maternal and newborn care among health facilities in Rwanda: a cross-sectional study
Sipsma, H.L., Curry, L.A., Kakoma, J.P., Linnander, E.L., & Bradley, E.H.
Human Resources for Health
(2012)
CC
This study examined the quality of facility-based maternal and newborn health care by describing the implementation of recommended practices for maternal and newborn care among health care facilities to determine whether increased training, supervision, and incentives for health workers were associa
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ted with implementing these recommended practices.
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Health Systems for Outcomes Publication | This report summarizes the findings of a qualitative study on health workers’ performance and career in Rwanda to identify bottlenecks, strengths and shortcomings for human resources in the health sector, as perceived by both health workers and users of he
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alth services.
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Health Systems for Outcomes Publication | Using qualitative data from Rwanda, this study focuses on four institutional factors that affect health worker performance and career choice: incentives, monitoring arrangements, professional norms and health workers’ intrinsic motivation. It also provides
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illustrations of three institutional innovations that work, at least in the context of Rwanda: performance pay, the establishment of community health workers and increased attention to the training of health workers.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery
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of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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Who wants to work in a rural health post? The role of intrinsic motivation, rural background and faith-based institutions in Ethiopia and Rwanda
Serneels, P., Montalvo, J.G., Pettersson, G., et al.
Bulletin of the World Health Organization
(2010)
C_WHO
This paper examines the extent to which health workers differ in their willingness to work in rural areas and the reasons for these differences, based on the data collected in Rwanda analysed individually and in combination with data from Ethiopia.
The Capacity Project worked to strengthen HRIS in several low-resource countries to assist decision-makers and human resources managers in identifying and responding to critical gaps in HRH. The findings and recommendations in this report cover the Capacity Project’s implementation of HRIS in Swaz
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iland, Rwanda and Uganda.
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Consultancy to conduct desk review on impact of national policies and programs on disability rights and develop an action plan to make existing policies and programs and legislation disability friendly
This document presents the findings of the National Census of Persons with Disabilities in Rwanda. The preliminary result of this census has been used to produce a summary analysis of tables and figures. It shall be possible to derive basic socio-demographic indicators as well as to obtain the estim
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ate of persons with disability in Rwanda, all of which shall serve as a reference to the categorization activity planned to be done in the near future by a medical committee from the Ministry of Health. The data of this report relate to (1) Persons with disability size for various administrative units (Districts and Provinces), (2) Distribution of Persons with disabilities by sex, age, marital status and type of disabilities.
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo
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r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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CBR Workers’ Training Needs for People with Communication Disability
Yeap, C.E., Ibrahim, H., Van Dort, S., et al.
Disability, CBR & Inclusive Development Journal (DCIDJ)
(2016)
CC
This study, although not generalizable, builds up the literature on worker training needs in developing countries, and would be of benefit for speech-language pathologists and worker trainers. This paper aimed to investigate the training needs of Malaysian workers in relation to people with communic
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ation disability. The primary aim was to investigate common self-perceived training needs in relation to communication disability and to find how important these needs are to workers. A secondary aim was to explore the relationship between selected worker variables and training needs.
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Inclusive Project Cycle Management
This report brings attention to achieving gender equality in the context of women, girls, and the HIV response. This six-month consultation in 2016 with adolescent women and young girls found that #WhatWomenWant is: collaboration and joint action by all to invest in women's HIV and Sexual and Reprod
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uctive Health and Rights (SRHR), to be leaders and articulate the priorities of women and girls in all their diversity, and to speak to the new Political Declaration on AIDS and the SDG framework as a tool for civil society to meet their agenda to achieve gender equality in the HIV and SRHR response.
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Inclusive Project Cycle Management
Inclusive Project Cycle Management - The Participants’ Folder contains the course outline, some handouts, a list of online references and a glossary of gender terms. Additional handouts will be provided to add to the folder, during the course.
Inclusive Project Cycle Management
