The work of WHO Rwanda in 2014-2015: Biennium Supporting Health Services Delivery for Universal Health Coverage in Rwanda
AbstractRwanda has made outstanding socioeconomic progress in the last two decades. Significant improvements in health outcomes and other key development indicators have been observed, especially in the area of maternal and child health. Despite the significant gains and improvements recorded, malnutrition remains a problem among children aged underfive years. Additionally, Rwanda is experiencing a significant increase in the number of malaria cases, from 514 173 cases in 2012 to 1 967 402 cases in 2015. The Ministry of Health and partners are currently tackling this challenge. This biennial report 2014/2015 outlines the work of the WCO Rwanda in cooperation with the Government of Rwanda (GoR) using five strategic priorities that guided the country office work. The strategies include: i) Support to health system strengthening, ii) Contribution towards reduction of morbidity and mortality associated with communicable and noncommunicable diseases, iii) Reduction of maternal, newborn and child morbidity and mortality; iv) Promotion of health by addressing the social determinants of health, health and environment, nutrition and food safety and v) Strengthening disaster risk management and epidemic emergency preparedness and response. During the reporting period, in collaboration with the Ministry of Health and other partners, the WHO Country Office contributed to strengthening the health system by developing policies and strategic documents in the area of health financing, health products and human resources for health. Comprehensive assessment of the health information system was also conducted, along with the implementation of a National Health Observatory and its components. In the area of communicable and non-communicable diseases, the development of policy, prevention and treatment guidelines contributed to the increase in antiretroviral therapy coverage to 80 per cent; and reached a treatment success rate for confirmed TB cases of 89.8 per cent. MOH was supported to develop a five-year malaria contingency plan in response to the recent increasing incidence of malaria. The Expanded Programme on Immunization (EPI) achieved 97 per cent vaccination coverage for all antigens, and maintained the country’s polio-free status, which was achieved in 1993. The programme supported the introduction of the Rotavirus vaccine which helped reduce rotavirus infections among children as evidenced by the decrease in positivity rate from 50 to 19 per cent three years following the introduction of the vaccine in 2012. WHO also provided guidance to the MOH and its partners to develop and implement Ebola preparedness activities. The revision of the National NTD Master Plan 2013-2018 and deworming of more than 95 per cent of school-age children in all districts using Albendazole and Praziquantel were also conducted with the support of WHO. Additionally, the WCO supported the MOH to review the algorithms for the management of severe acute malnutrition. Seven thousand (7,000) copies of comic booklets on proper nutrition were also distributed to school-age children and their families, along with 10,000 recipe books on complementary foods for infants and young children in the context of prevention of stunting in under-five children. Multiple capacity building activities for health workers on nutrition were conducted; and an operational research aiming at strengthening interventions to reduce malnutrition is also being undertaken. A STEPS (STEPwise approach to Surveillance) survey to determine the prevalence of Non Communicable Diseases (NCDs) and to determine their risk factors was conducted at the national level. To strengthen Maternal and Child Health, WHO provided technical support in the development of several documents and tools especially in the domain of maternal, neonatal and child death audit, Integrated Management of Childhood Illness (IMCI) and postnatal care of the mother and new born. The social determinants of health, health and environment, nutrition and food safety were promoted through support to create the Water and Sanitation (WATSAN) Secretariat, the implementation of the Health Promotion Policy and Strategic Plan 2014-2018 and the review of the tobacco taxation policy. Capacity building for health care providers and community health workers was also provided to promote life through the life course. Official WHO Health Days, along with national campaigns, were also commemorated with WHO support. WHO provided support for the development of the Regional Refugees Response Plan to address the emergency needs of Burundian refugees, specifically in the areas of: mobilization of funds for response, routine immunization campaigns, and recruitment of additional staff. In addition, the organization contributed to the management of an outbreak of Salmonella typhi in the Mahama refugee camp during which a case-control study was conducted to identify risk factors contributing to the spread of the disease. The organization played a leading role in implementing the health component of the United Nations Development Assistance Plan (UNDAP) in partnership with other UN agencies. Enabling factors such as good technical and financial support from different levels of the organization permitted the Office to achieve most of its targets, and to reach a programme budget implementation rate of 94 per cent. Challenges such as increased incidence of malaria, decrease in external funds, and staff shortage resulted in a heavy portfolio, and impacted upon the work of the organization during the period in review. In the 2016/17 biennium, the Office will continue to support the country to sustain the achievements made so far, support will be provided to the Ministry of Health and other relevant sector Ministries to implement the SDGs, strengthen the health systems especially in the area of Universal Health Coverage, health financing and sustainability and information generation for decision making. All these will be implemented in line with the WHO Regional Office for Africa Transformation Agenda.
World Health Organization, Rwanda Country Office. (2016). The work of WHO Rwanda in 2014-2015: Biennium Supporting Health Services Delivery for Universal Health Coverage in Rwanda. World Health Organization, Rwanda Country Office. http://www.who.int/iris/handle/10665/205467
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