Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda.

Corrado Cancedda,Joseph Shema,Rebecca Reece,Rashna Ginwalla,Kim Wilson,Faustin Ntirenganya,Madeleine Mukeshimana,Jane Barrow,Tanya Rogo,Louise Kalisa,Meredith Kernan,Tonda L Hughes,Deborah Chyun,Lisa V Adams,Marik Moen,Amy Bunts,Rodney Wright,Joseph Rhatigan,Vincent Dusabejambo,Linda Arnold,Robert Riviello,Lydie Mukashyaka,Stacy E Smith,Natalie Mccall,Jean Claude Kabayiza,Alex Butera,Valli Meeks,Donatilla Mukamana,Linda L Mccreary,Urania Magriples,Adam C Levine,Tej Nuthulaganti,Forrest J Calland,Egide Kayonga Ntagungira,Meenu Tuteja,Attila Yaman,Asghar Rastegar,Stephen Rulisa,Belson Rugwizangoga,Simon Kanyandekwe,Craig D Mcclain,Timothy D Walker,Agnes Gatarayiha,Jennifer E O’Flaherty,Jeffrey Dixson,Peter Okwi,Juliet Musabeyezu,Marcel E Durieux,Rex Wong,Patrick Kyamanywa,Giuseppe Raviola,Anne Sliney,Beth M Barrows ,Michael V Relf ,Nathan M Thielman ,Paul Palumbo ,Michael Hill ,Paul Farmer ,Michael Köster ,Bethany Hedt‐Gauthier ,Jeanne Kagwiza ,Emmy A Nkusi ,Chrispinus H Mumena ,Cynthia Binanay ,David Tumusiime ,Rachel T Moresky ,Kaitesi Batamuliza Mukara ,Mark H Corden ,Ira C Magaziner ,Espérance Ndenga ,Robin Toft Klar ,Théogène Twagirumugabe ,Lisa Bazzett‐Matabele ,Danny A Milner ,Philip Cotton ,Agnès Binagwaho

doi:10.15171/ijhpm.2018.61

Abstract

Background: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. Methods: The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. Results: In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. Conclusion: The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.

Highlights

Rwanda’s Health Workforce Shortage Rwanda is a small and densely populated country in subSaharan Africa about the size of the state of Maryland in the United States and with a population of approximately 11 million
Activities Conducted and Milestones Achieved by the Human Resources for Health Program Since 2012 Increased Number and Diversity of Health Workforce Trained Since the launch of the HRH Program in 2012, 22 training programs (12 of which did not exist previously) have been supported across 4 health-related disciplines (Table 1)
The HRH Program is on track to graduate an estimated total of 4598 students across these programs (Table 1); a significant increase from the number of students who graduated from these programs in the 7 years preceding the HRH Program (Figure 5)

Summary

Introduction

Rwanda’s Health Workforce Shortage Rwanda is a small and densely populated country in subSaharan Africa about the size of the state of Maryland in the United States and with a population of approximately 11 million. By 2011 Rwanda’s ratio of health professionals to general population of 0.72/1000 was still falling significantly short of the World Health Organization’s (WHO’s) recommended (at the time) target of 2.3/1000.2 The majority of practicing physicians, nurses, and midwives were lacking any kind of formal postgraduate degree while a shortage of faculty and limited infrastructure, equipment, and supplies in the country’s health graduate schools and teaching hospitals were preventing Rwanda from increasing the output and improving the quality of the existing training programs.

Methods

Results

Discussion

Conclusion