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The report examines some of the underlying causes of domestic violence and the impact on children of being exposed to violence in the home.
January - December 2017
The purpose of this strategy is to guide the planning, management and development of human resources for health in Rwanda for the period 2011 - 2016. The overall aim of the plan is to increase the number of appropriately skilled, motivated and equitably distributed health service providers for Rwand
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a.
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A guidance document in simple language for health personnel, setting out their rights and responsibilities in conflict and other situations of violence. It explains how responsibilities and rights for health personnel can be derived from international humanitarian law, human rights law and medical e
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thics.The document gives practical guidance on:
- The protection of health personnel, the sick and the wounded; - Standards of practice; - The health needs of particularly vulnerable people; - Health records and transmission of medical records; - "Imported" health care (including military health care);
- Data gathering and health personnel as witnesses to violations of international law; - Working with the media
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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
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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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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
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tandard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda.
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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
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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 | 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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Health Systems for Outcomes Publication | The government of Rwanda has identified human resources for health as one of its policy priorities. This study aims to contribute to building a better understanding of health worker choice and behaviour, and to improve evidence based polcies.
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 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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The report reflects on the trends, achievements and challenges in global health over the past decade during which Dr Margaret Chan has been Director-General of WHO. It discusses the role of WHO in dealing with such issues as the rise of noncommunicable diseases, leaps in life expectancy, and emergin
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g threats like climate change and antimicrobial resistance.
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TRAINING MANUAL on DISABILITY STATISTICS
World Health Organization United Nations Economic and Social Commission for Asia and the Pacific
United Nations
(2008)
C2
WHO/ESCAP Training Manual on Disability Statistics | This training manual intends to enhance the understanding of the ICF-based approach to disability measurement. It provides an overview of the ICF framework as well as guidelines on how to operationalize the underlying concepts of functioning and
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disability into data collection, dissemination and analysis.
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This manual summarizes the methodology used to develop WHODAS 2.0 and the findings obtained when the schedule was applied to certain areas of general health, including mental and neurological disorders.
The manual will be useful to any researcher or clinician wishing to use WHODAS 2.0 in their prac
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tice. It includes the seven versions of WHODAS 2.0, which differ in length and intended mode of administration. It also provides general population norms; these allow WHODAS 2.0 values for certain subpopulations to be compared with those for the general population.
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