Rwanda Health Sector Performance Report 2019-2020 TABLE OF CONTENT FOREWORD ....................................................................................................................................................... i TABLE OF CONTENT ......................................................................................................................................... ii LIST OF TABLES................................................................................................................................................ vii LIST OF FIGURES ............................................................................................................................................. viii LIST OF ACRONYMS .......................................................................................................................................... 1 INTRODUCTION ................................................................................................................................................ 3 1. HEALTHCARE SERVICE DELIVERY .............................................................................................................. 3 1.1. Outpatient department (OPD) visits in health facilities ..................................................................... 3 1.2. Hospitalization .................................................................................................................................. 5 1.3. Access to clinical laboratory services ................................................................................................ 5 1.4. Access to Safe surgery and anesthesia services ................................................................................ 6 1.5. National Blood Transfusion ............................................................................................................... 7 1.6. Referral Healthcare Services ............................................................................................................. 7 1.6.1. Butare University Teaching Hospital (CHUB) ............................................................................ 7 1.6.1.1. Background ...................................................................................................................... 7 1.6.1.2. CHUB Healthcare Services Delivery in 2019-2020 ............................................................ 8 1.6.2. Kigali University Teaching Hospital (CHUK) ............................................................................... 9 1.6.2.1. Background ...................................................................................................................... 9 1.6.2.2. CHUK Healthcare Services Delivery in 2019-2020............................................................. 9 1.6.3. Huye Isange Rehabilitation Center ......................................................................................... 12 1.6.3.1. HIRC Background and Status .......................................................................................... 12 1.6.3.2. HIRC Performance in 2019-2020 .................................................................................... 12 1.6.3.2.1. Inpatient and outpatient care ..................................................................................... 12 1.6.3.2.2. Laboratory Testing...................................................................................................... 13 1.6.3.2.3. Social Reintegration .................................................................................................... 13 1.6.3.2.4. Medical Expertise ....................................................................................................... 14 1.6.4. Neuropsychiatric Hospital CARAES Ndera .............................................................................. 14 1.6.4.1. CARAES Ndera and Status .............................................................................................. 14 1.6.4.2. Hospital Capacity, outpatient consultations, and hospitalization ................................... 14 1.6.4.3. Causes of outpatients consultations in psychiatric department and in the Neurology department 16 1.6.4.4. Causes of hospitalization in the psychiatric department and in the neurology department 18 1.6.5. Emergency Medical Services .................................................................................................. 19 ii 1.6.5.1. Overview of the Emergency Medical Services Division ................................................... 19 1.6.5.2. Calls and time response in 2019-2020 ............................................................................ 20 2. HEALTH SYSTEM STRENGTHENING......................................................................................................... 24 2.1. Governance and policy development .............................................................................................. 24 2.1.1. Guidelines and Standards ....................................................................................................... 24 2.1.2. Strategic Plans ........................................................................................................................ 24 2.2. Human Resources for Health .......................................................................................................... 24 2.3. Geographical accessibility to Healthcare Services. .......................................................................... 26 2.4. Access to quality medicines, food and drugs for the Rwanda population. ....................................... 27 2.4.1. Food and Drugs Inspection and Safety Monitoring ................................................................. 27 2.4.1.1. License and visa issuance ............................................................................................... 27 2.4.1.2. Inspection ...................................................................................................................... 27 2.4.2. Adverse Drug Reaction Monitoring ........................................................................................ 27 2.4.2.1. Recalled products........................................................................................................... 27 2.4.2.2. Mapping of Food Sector ................................................................................................. 28 2.4.3. Registration and Marketing Authorization ............................................................................. 28 2.4.3.1. Drugs and Health Technologies ...................................................................................... 28 2.4.3.2. Food products ................................................................................................................ 28 2.4.4. Quality Control of regulated products .................................................................................... 28 2.4.4.1. Testing equipment ......................................................................................................... 28 2.4.4.2. Test reports .................................................................................................................... 29 2.4.5. Documentation ...................................................................................................................... 29 2.4.6. Trainings ................................................................................................................................ 31 2.5. Health Information Systems............................................................................................................ 31 2.6. Health Financing ............................................................................................................................. 32 2.6.1. Health Insurance .................................................................................................................... 32 2.6.1.1. Government subsidies to the community-based health insurance scheme .................... 32 2.6.1.2. Subsidies from health insurance entities ........................................................................ 33 2.6.1.3. Subsidies to the community-based health insurance scheme from telecommunication or fuel trade companies .......................................................................................................................... 33 2.6.2. Performance Based Financing ................................................................................................ 33 3. DISEASES PREVENTION AND CONTROL .................................................................................................. 35 3.1. Non-communicable Diseases (NCDs) and Injuries ........................................................................... 35 3.1.1. Prevention and early detection of NCDs:................................................................................ 35 3.1.2. NCDs care and treatment ....................................................................................................... 35 iii 3.1.3. NCDs Monitoring, Evaluation and Research. .......................................................................... 35 3.1.4. Injury registry ......................................................................................................................... 36 3.1.5. Mental Health Services .......................................................................................................... 38 3.1.6. Oral health, eye care, earing and hearing