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ROLES AND RESPONSIBILITIES IN SUPERVISION AND REPORTING SYSTEM IN THE DECENTRALISATION FRAMEWORK

ROLES AND RESPONSIBILITIES IN SUPERVISION AND REPORTING SYSTEM IN THE DECENTRALISATION FRAMEWORK. Dr. Bonaventure NZEYIMANA Ministry of Health n zeyimana.bonaventure68@gmail.com Tel: (+250) 788585815. Existing Health Facilities. National Referral Hospitals : 4 Provincial Hospitals: 5

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ROLES AND RESPONSIBILITIES IN SUPERVISION AND REPORTING SYSTEM IN THE DECENTRALISATION FRAMEWORK

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  1. ROLES AND RESPONSIBILITIES IN SUPERVISION AND REPORTING SYSTEM IN THE DECENTRALISATION FRAMEWORK Dr. Bonaventure NZEYIMANA Ministry of Health nzeyimana.bonaventure68@gmail.com Tel: (+250) 788585815

  2. Existing Health Facilities • National Referral Hospitals : 4 • Provincial Hospitals: 5 • District Hospitals: 36 • Health Centers: 458 • Health posts: 192 • Community Health Workers: + 45000 • Private sector: (1 Hospital, 40 clinics and 280 dispensaries).

  3. Building a Health System WHO-recommended health worker density: 2.3 per 1,000 pop. Rwanda’s health worker density: 0.84 per 1,000 pop. Referral Hospital (5) Physician Specialist (150) New : 3 Referral 4 Provincial District Hospital (34 to 42) Physician Generalist (475) Complexity of care Nurse Generalist (8,273) Health Center (234 to 469) Health post Community Level (0 to 14,837) ~80% of burden of disease addressed here Community Health Workers (45,011)

  4. Some demographic data • Population: 10.537,222 • Population density: 416/km2 • Increase in population (2002-2012)-29.6% • Average annual growth 2.6% • Female: 51.8% • Male: 48.2% • Current staffing is based on population ratios and institutional size without consideration of needs. MOH, RWANDA

  5. Current ratios of HRH & the distribution in country specific to health facilities: • Proportion of professionals currently; • Doctors ratio 1: 16,000 population • Nurses ratio 1: 1,346 • Midwives ratio: 1: 92,149 • Distribution of health professionals in the Country • 28.3% of 661 specialized physicians in and around the capital city • 80% of G.Ps are deployed in rural area indicating unbalanced deployment.

  6. Integrated roles and responsibilities in supervision Central Level MOH Dpts + Partners at central level Social Dvpt and territorial administration Unit District Social Affairs + CS Sector CHWs + Local Leaders Community

  7. Roles et Responsibilities in the reporting and supervision Admin supervision MINALOC Technical supervision Central level Dpts + Partners at central level Technical and admin supervision MINISTER MOH and PS Reporting to A copy of report to Provincial Hospitals DH Social Dvpt Unit: Health Desk Mayor & Executive Secret. of District HC Exec. Secret. of Sector H Post Exec. Secret. of Cell CHW + Local Leaders Chief of Village

  8. Financial accessibility to health care • Health Insurances are cross-cutting at all levels of the health system. • There is no health service free of charge in Rwanda • Currently, four regimes of health insurance: Community health insurance, Public workers health insurance, military health insurance and private health insurance. • In total more than 95% of Rwandans are covered ( Universal Coverage) • The Government pays for indigents

  9. Policy level • Haring law has been reviewed • Existing Health policy • Health System Strategic Plan II (revision of HSSP I) • Departmental policies and strategies: NCDs, Quality Care management, Health Insurance, PBF etc. • A set of ministerial instructions: (on management of health facilities in decentralized framework, Drugs use, Customer care, • Law on full autonomy of health facilities in Parliament (from semi-autonomy regime). In the line with EDPRS II and Vision 2020.

  10. MERCI

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