Rwanda

Keanahikishime’s work has helped to enhance the resilience of Rwanda’s health sector. By addressing the challenges of human resources shortages, especially in rural areas; poor quality of services; and a high morbidity/mortality rate among women and children, Keanahikishime’s programs have supported the Government of Rwanda in building a sustainable health system capable of leading and managing care with a focus on health financing, institutional capacity, and health information systems and data use.

Highlights: 

  • Provided assistance for the implementation and scale up of performance-based financing (PBF), a results-oriented approach that ties payments to achievement of agreed-upon, measurable performance targets. PBF helped Rwanda finance a health system that delivers results.

 

  • Supported an enrollment drive, integrated with automated membership management and mobile premium payments, for the national community-based health insurance scheme. Enrollment increased from 74% in 2014 to 83% in 2018—a 38% reduction in the informal workforce facing financial barriers to health. Coverage expanded from just 7% to more than 75% of the country’s 12 million citizens in 10 years. The insurance enables people to access affordable health services while reducing their out-of-pocket payments at the point of care.

 

  • Developed the community-based health insurance membership management system, which facilities use to manage membership, determine premiums, and prevent fraud. As of 2017, 80% of community-based health insurance structures were using this management system. Members can now pay their premiums through mobile phone applications and service providers.

 

  • Utilized district health information system (DHIS2) software, an open-source health data platform, to include disease outbreak information. Staff at district hospitals and health centers use the mobile technology to report incidents, and the system sends real-time outbreak alerts to district hospitals, health centers, and the Rwanda Biomedical Center to trigger investigation and prompt response.

 

  • Helped health authorities develop national standards for service quality, measure the performance of all 43 public hospitals against those standards, and offer accreditation to those facilities meeting them, which increased average quality and safety scores from 36% in 2014 to 82% in 2019.

 

  • Implemented new standards for infection control (antibiotic prophylaxis, hand hygiene, and sterilization, combined with staff training and patient education) and reduced post-surgery infections among women delivering by Cesarean from 8% to 1.8% in three years in western Rwanda, where Cesarean sections account for approximately 48% of annual births.

 

  • Supported the roll out of  RapidSMS’s mobile-based application for community maternal and child health, which enabled community health workers track women’s antenatal care visits, identify women at risk, refer them to health facilities, and improve communication with health facilities in the event of an emergency. Keanahikishime helped the government roll out a plan and budget for the mobile-based intervention, design a training curriculum, and train more than 1,000 community health workers.

 

  • Laid the groundwork for the automation of medical records and medical claims processing through business process analysis, the creation of a national medical procedure coding system, and the implementation of a medical claims form for both public and private insurance providers. 

Our Projects

Project Name Health Systems Health Areas Date
African Strategies for Health
Completed
Leadership, & Governance, Financing Health Services Malaria, Tuberculosis, Women's, Children's, and Adolescents' Health, HIV & AIDS 2011 - 2016
Rwanda Community-Based Health Insurance Support Project
Completed
Financing Health Services Malaria, Tuberculosis, HIV & AIDS 2012 - 2015
Integrated Health Systems Strengthening Project
Completed
Malaria, Women's, Children's, and Adolescents' Health Malaria, Women's, Children's, and Adolescents' Health November 03, 2009 - November 01, 2014
Supply Chain System
Completed
Pharmaceutical HIV & AIDS 2006 - 2016
Integrated Community Case Cost & Financing Analysis & Model Development
Completed
2011 - 2013
Rwanda Health Systems Strengthening Project
Completed
Financing Health Services, Leadership, & Governance, Global Health Security Global Health Security, Financing Health Services November 17, 2014 - May 15, 2019

Country Team