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Rwanda Health Systems Strengthening (RHSS) Project Rwanda Health Systems Strengthening (RHSS) Project Quarterly Report: September - December 2018 Alain Joyal Rwanda Health Systems Strengthening Activity (RHSSA) will enhance the resiliency of the Rwandan health sector to address new challenges and will help build a country-owned sustainable health system capable of leading and managing change, through provision of extensive technical support. [Health systems strengthening – USAID – community health services] This report was made possible through support provided by the US Agency for International Development and USAID Rwanda, under the terms of Cooperative Agreement Number AID-696-A-15-00001 and Elisabeth Uwanyiligira. The opinions expressed herein are those of the author(s) and do not necessarily reflect the views of the US Agency for International Development. USAID RHSS Management Sciences for Health 200 Rivers Edge Drive Medford, MA 02155 Telephone: (617) 250-9500 http://www.msh.org Rwanda Health Systems Strengthening (RHSS) Project Cooperative agreement: AID-696-A-15-00001/MSH Quarterly Report: September - December 2018 Photo Caption: A Mother and Child at the launch of the Integrated campaign on Health by the Ministry of Health in Nyabihu District. P hoto credit: Rwanda Health Communication Center t No: AID-696-A-15-00001 MSH MSH Rwanda 200 Rivers Edge Drive KK 341 St., Plot No. 22 Medford, MA 02155 Kigali, Kicukiro, RWANDA USA Tel.: (+250)-788-308-081/82 www.msh.org This report is made possible by the support of the American people through the United States Agency for International Development (USAID). The contents of this report are the sole responsibility of Management Sciences for Health (MSH) and do not necessarily reflect the views of USAID or the United States Government. Table of Contents Section 1: Overview 6 Activity Description 6 1.1. Summary of main achievements 7 IR1 - Leadership and Advocacy 7 IR 2 - Governance, Policy and Planning 7 IR 3A - Health Finance 8 IR 3B - Quality Improvement 8 IR3.C Private Sector Engagement / Public Private Partnerships 8 IR 4 - Health Information, M&E, and Research 8 Cross-Cutting Technical Support 9 1.2. Major Challenges 10 Section 2: Discussion of Achievements for the Current Quarter 13 2.1. Accomplishments by intermediate results (IR) and sub-results 13 IR1. Institutionalized health systems thinking approaches and practices 13 IR2. Improved multi-level Government of Rwanda policy, planning, and implementation capacity 20 IR3.A. Increased revenue mobilized by the health sector through domestic and private sector sources to achieve sustainability 22 IR3.B. Improved and expanded quality health services through more effective and efficient use of existing resources in the health system, achieving better value for money 25 IR 3.C. Private Sector Engagement/Public Private Partnerships 28 IR4. Improved M&E frameworks developed, strengthened, and implemented at the central and district levels 29 3.1 Support standardizing medical acts and procedures through adoption of an international nomenclature classification system 35 3.2 Support District Hospitals’ strategic and business planning processes 35 3.3 Rolled out LDP+ to three district hospitals 36 3.4 HSS-MAG (Health sector microfinance scheme) 36 Section 4: Collaboration, Learning and Adapting 36 Section 5: Public Events 37 Section 6: Management and Administration 37 6.1 RHSS Communications 37 6.1.1 Communication products completed 37 6.1.2 Communication products in development 38 6.2 Project Management 38 Page | 2 6.3 Planned Short Term Technical Assistance 38 Annexes 40 Page | 3 List of Acronyms 3MS Mutuelle Membership Management System AAP Annual Action Plan AFR Access to Finance Rwanda BTC Belgian Technical Cooperation BPR Banque Populaire du Rwanda CBHI Community-Based Health Insurance CCG CBHI Consultative Group CHAI Clinton Health Access Initiative CHWs Community Health Workers CoK City of Kigali DCA Development Credit Authority DDS District Development Strategy DH District Hospital DG Director General DHIS-2 District Health Information Software II DHMT District Health Management Team DHSP District Health Strategic Plan DHUs District Health Units DORCF District Operational Research Challenge Fund DP Development Partner(s) DRC Democratic Republic of Congo DSDM Differentiated Service Delivery Model eIDSR electronic Integrated Disease Surveillance and Response system e-LMIS electronic Logistics Management and Information System Enabel Belgium development agency (new name - previously BTC) EPR Epidemic Preparedness and Response ESR Epidemic Surveillance and Response FY Fiscal Year GBV Gender-Based Violence GHS Global Health Security GHSC-PSM Global Health Supply Chain- Procurement Supply Management GIS Geographical Information System GoR Government of Rwanda HCP Health Care Providers HIV Human Immunodeficiency Virus HMIS Health Management Information System HQ Headquarters HRH Human Resources for Health HRTT Health Resource Tracking Tool HSS Health Systems Strengthening HSSP4 Fourth Health Sector Strategic Plan HSWG Health Sector Working Group IFMIS Integrated Financial Management Information System IMIHIGO Kinyarwanda word meaning performance contract IR Intermediate Result ISS/DQA Integrated Service Supervision and Data Quality Assessment ITC Interim Technical Committee JADF Joint Action Development Forum JEE Joint External Evaluation JSR Joint Sector Review KM Knowledge Management L&G Leadership and Governance LDP+ Leadership Development Program Plus LODA Local Development Agency MAG Mutual Aid Group MCSP Maternal and Child Survival Project MoH Ministry of Health M&E Monitoring and Evaluation MINALOC Ministry of Local Government MINECOFIN Ministry of Finance and Economic Planning Page | 4 MSH Management Sciences for Health MITEC Ministry of Information Technology & Communications MTEF Mid-Term Expenditure Framework NCD Non-Communicable Disease NCST National Council for Science and Technology NGOs Non-Government Organizations ODK Open Data Kit PBF Performance-Based Financing PHFIS Planning, Health Finance, and Information System PFM Public Financial Management PPP Public Private Partnership PSE Private Sector Engagement PTAs Provincial Technical Advisors PY Project Year OPD Outpatient Department Q1,Q2,Q3,Q4 First, second, third, fourth quarters QI Quality Improvement QMIA Quality Management Improvement Approach RALGA Rwanda Association of Local Government Authorities REG Rwanda Energy Group RBC Rwanda Biomedical Center RDB Rwanda Development Board RGB Rwanda Governance Board RHSS Rwanda Health Systems Strengthening project RISA Rwanda Information Society Authority RMA Rwanda Medical Association RMNCAH Reproductive, Maternal, Newborn, Child and Adolescent Health RSSB Rwanda Social Security Board SCHS USAID’s “Strengthening the Capacity of the Health Sector” project SOPs Standard Operating Procedures SPH School of Public Health SSF Single Stream Funding TA Technical Assistance ToT Training of Trainers STTA Short Term Technical Assistance TWG Technical Working Group UHC Universal Health Coverage UNFPA United Nations Population Fund UR/CMHS University of Rwanda/College of Medicine and Health Sciences USAID United States Agency for International Development WASAC Water and Sanitation Corporation WHO World Health Organization WISN Workload Indicators of Staffing Need Page | 5 Section 1: Overview Activity Description Activity Title Rwanda Health Systems Strengthening (RHSS) Project Agreement Number Cooperative Agreement No: AID-696-A-15-00001 Name of Prime Management Sciences for Health (MSH) Implementing Partner Names of Sub- Banyan Global awardees Jembi Health Systems, SA Tulane University School of Public Health and Tropical Medicine UR/CMHS School of Public Health Activity Start Date November 17, 2014 Activity End Date June 30, 2019 Reporting Period October - December, 2018 The five-year, United States Agency for International Development (USAID)-supported Rwanda Health Systems Strengthening (RHSS) Project aims to strengthen and expand the performance of the Rwandan health system at the national, decentralized, and community levels. Implemented by Management Sciences for Health (MSH) and its partners, the project works to enhance the resilience of the Rwandan health sector and its capacity to address new challenges. The project helps build a country-owned sustainable health system capable of leading and managing change, through the provision of extensive technical support across four strategic areas with four Intermediate Results (IRs): IR1: Leadership and Advocacy: Institutionalized health systems thinking to increase advocacy, leadership, and stewardship; IR2: Governance, Policy, and Planning: Improved policy, planning, and implementation at the central and district levels; IR3: Management, Coordination, and Implementation: a) Increased revenue for the health sector through domestic and private sector sources to achieve sustainability; b) Improved quality of health services and greater efficiency in resource use, and; c) Private Sector Engagement (PSE)/Public Private Partnerships (PPPs) IR4: Monitoring and Evaluation (M&E), Learning, and Knowledge-Based Practices: Improved monitoring and evaluation, health systems research, learning, and knowledge-based practices. Page | 6 The four IRs are interrelated and many activities are cross-cutting and implemented jointly to achieve overall results. Building on previous achievements, the RHSS Project continues to support innovations and to build the capacity of the Government of Rwanda (GoR) to deliver quality health services for,
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