• Rwanda currently faces a critical shortage of physicians and other health care workers.
 There are only 633 physicians for a population of over 10 million people.
• One key root cause of this shortage is an inadequate number of faculty to train future physicians.
• There are very few trained subspecialists , and residency training programs in Rwanda, begun in 2005, are still developing.
• 90% of nurses have only a high school level education
2

To achieve this goal, the Ministry of Health created the HRH Program to significantly increase the quantity and quality of physicians, nurses and midwives.
Nurses and midwives Key points
2 952
6 052
5 095
104
797
2011
Physicians
17
1 011
2019
1,182
120
A2
A1
A0
M.S.
• Strong focus on upgrading A2 to A1
• Dramatic increase in A1, through a combination of elearning and strengthening of nursing and midwifery schools
• Training A0s to ensure sufficient Rwanda lecturers
• Develop an MSN program
633
150
483
2011
551
631
2019
Specialists
GPs
• Most physicians will be trained in 6 main residencies:
- Internal Medicine
- Pediatrics
- Surgery
- Anesthesia
- Ob/gyn
- Family & Community
Medicine
3

As part of the HRH Program, the Ministry of Health convened a consortium of 17 US schools who agreed to send faculty to live and work full-time in Rwanda.
# of US faculty FTEs for the 2012-
2013 Academic Year Medical Schools
Brown University
Duke University
Dartmouth College
Harvard University
University of Colorado
University of Texas
University of Virginia
Yale University
Schools of Nursing
Duke University
Howard University
New York University
University of Illinois at Chicago
University of Maryland
University of Texas
Schools of Public Health
Yale University
Schools of Dentistry
University of Maryland
Harvard University
52
42
6
2 physicians nursing educators and clinical mentors health management mentors dentists
4

Key principles
•
This project will create a new paradigm for cooperation between US academic institutions and academic institutions in Rwanda.
•
Instead of small scale cooperative efforts between individual academic institutions involving exchanges of a few people, this will be a coordinated approach intended to upgrade medical and nursing professions in a comprehensive way according to a national government plan.
• US academic institutions will make a far more significant commitment than has ever been done before. They will do so under contract from the Rwanda Government and in cooperation with each other.
•
Since funds to US academic institutions will now come the Rwanda Government rather then directly from the US Government, responsibility, control and accountability will rest with the Rwanda Government.
•
After 8 years, the Rwanda Government is positioned to sustain the HRH Program on its own without foreign aid .
5

The HRH funding will flow directly from the US Government to the Ministry of Health and then disbursed to academic institutions and teaching hospitals.
US Government
Funding
Ministry of Health US Academic Institutions
Rwanda Academic Institutions and Teaching Hospitals
• Contract between the US Government and the MOH
• Standardized contracts between the MOH and US Institutions
• Contracts between US Institutions and US faculty members