Annual Project Report Narrative: Rwanda Integrated Health Systems Strengthening Project

The project is based on priority gaps in the Rwandan health system and is funded by the United States Agency for International Development (USAID). The project's main purpose is to strengthen the health systems in Rwanda, with a focus on improving the utilization of data for decision-making and policy formulation, strengthening financial systems for the rational use of available health resources, and improving leadership and management and human resource productivity. The project also aims to enhance quality improvement for results in access to and quality of services through standardized approaches. To achieve these objectives, the project has implemented several key interventions. In the area of data utilization, the project has supported the Ministry of Health (MOH) in managing the National Income Categorization database, upgrading and maintaining the Performance-Based Financing (PBF) and Community-Based Health Insurance (CBHI) web-based applications, and upgrading the Health Management Information System (HMIS). The project has also supported the Rwanda Health Enterprise Architecture (RHEA) and the setup of the Health Professional Council registration system. In terms of financial systems, the project has provided national support for PBF, supported the Community PBF system, and supported the development and implementation of CBHI. The project has also supported the Provider Payment reform. The project has also focused on strengthening leadership and management and improving human resource productivity. Assistance has been provided to the MOH to revise the Human Resources for Health (HRH) Policy, support the MOH capacity to manage HR development through the Continuous Professional Development (CPD) Program, and assist the National Council of Nurses and Midwives (NCNM). The project has also supported the registration of Pharmacists and Allied Health Professionals Council and the roll-out of the Workload Indicators for Staffing Needs (WISN) methodology. In addition, the project has worked on quality improvement for results in access to and quality of services through standardized approaches. Review and development of health service packages, clinical protocols and treatment guidelines development, district hospital operational policies and procedures development, and harmonization and review of the patient file have been some of the key activities undertaken. The project has also provided cross-cutting technical assistance, including support to the Health Sector Strategic Plan (HSSP III) development, RBC functional analysis and development of its strategic plan, and finalization of the Decentralization strategic plan. Capacity transfer to the MOH has been another key area of focus, with the project providing technical assistance to the MOH to ensure that the project's results are sustained beyond the project's lifespan. The project has made significant progress in the past year, with notable achievements including the completion of the National Income Categorization database, the upgrade and maintenance of PBF and CBHI web-based applications, and the setup of the Health Professional Council registration system. The project has also supported the development and implementation of CBHI, which has resulted in increased revenue and expenditures for health facilities. The project has also made progress in strengthening leadership and management and improving human resource productivity. The MOH has revised the HRH Policy, and the CPD Program has been implemented to support HR development. The project has also supported the registration of Pharmacists and Allied Health Professionals Council and the roll-out of the WISN methodology. In terms of quality improvement, the project has reviewed and developed health service packages, clinical protocols and treatment guidelines, and district hospital operational policies and procedures. The project has also harmonized and reviewed the patient file and edited and formatted clinical treatment guidelines. Overall, the Rwanda Integrated Health Systems Strengthening Project has made significant progress in the past year, with notable achievements in data utilization, financial systems, leadership and management, and quality improvement. The project continues to work towards its goal of improving the financial and geographical accessibility of health services in Rwanda.