A Senate report has pointed out areas which continue to deter the improvement of Rwanda’s health care services despite as Rwanda Seeks to digitize Community based health care program (CHP).
The report, on the state of health services released this July 13, 2022 showed that there are still many gaps in the availability of medication, unnecessary delays in time spent by patients to get treatment and lack of specialized care despite the increase in infrastructure and outreach of health workers.
The scope of the report covers inquiries made with the Ministry of Health, Rwanda Social Security Board (RSSB) and field visits conducted in 15 public hospitals and two private ones.
Senator Adrie Muhire who presented the findings said that Rwanda is obliged to implement seven international health delivery standards- which have been adopted in the National Strategy for Transformation (NST1) 2017 –2024 targets.
These standards include: effectiveness, care that is safe, patient based service, and timely service delivery, equal healthcare, monitoring and evaluation, and good and affordable healthcare services.
What was planned?
The government had also planned to train 70% of the 58,000 Community Health Workers’ (CHW) force on NCD treatment and services; however the report showed that only six of the 30 districts have been covered to date.
The other target was to have 40% of women tested for cervical cancer which has already kicked off but no official progress data availed.
Despite these efforts in attaining the NST targets, Muhire said that “Senate found loopholes in the healthcare services at health facilities especially delays in delivering services where the reception personnel are present but non-functional. We found issues of long queues especially in consultation, at the pharmacy and accounts sections due to lack of medical personnel and poor management,” Muhire said.
“Patients also go through a long process to get medical service. One has to do photocopies, confirm their health insurance on a computer, and then be sent for consultation, which is a long path before reaching the doctor and possibly being sent back home,” she explained.
The other challenge, Muhire said, is the process of patient transfers which is ineffective due to lack of ambulances (or existing ones are old or serve on poor roads); some hospitals act as both a district and referral hospital yet there is no specialist allocated to the facility in case a specialist service needs surfaces.
The report also showed that there is lack of prescribed medication in government owned facilities and many patients end up buying medicine (at 100% cost) despite being in the Community health insurance policy which currently has 80% Rwandans insured and allows them to get subsidized pharmaceutical medicine paying only 10%.
Upon hearing the outcomes, the Senate commended the efforts of CHW in improving health services but recommended that the line ministry considers bridging the above gaps if Rwanda is to digitize its health system.
This year, Rwanda launched a new project to increase benefits and expand skills of CHWs, and to fully digitalize its healthcare system by the year 2024. The project aimed at having “One patient-One Identity” will cost $12million in the initial implementation stage, with an anticipated total cost of about Rwf35billion in the long term.