Rwanda’s primary health care strategy improves access to essential and lifesaving health services

In Rwanda, the ‘land of a thousand hills’, reaching the nearest health facility usually means a long walk that until recently took an average of 95 minutes. Although walking time has been halved to 47 minutes in 2020, it is still difficult for many people to access timely health care. Through an innovative approach that brings more health posts closer to communities, the government aims to further reduce walking time to less than 25 minutes by 2024. Health posts act as an interface between health workers community health and health centers. Here, health workers provide essential primary care services and refer to hospitals for specialized services, strengthening the foundations of the health system and improving the way people receive the care they need. Health posts have also contributed to an effective national response to COVID-19, with communities still able to access basic care despite the crisis.

Uwamariya Patricie and her newborn baby gave birth at Musovu health post in Bugesera, Rwanda. ©WHO/Alice Rutaremara

Musanabera Claudine, 30, had to bring her child who presented with a cough and fever to Musovu health post in Bugesera district. Fortunately, a health post had already been established near their home. She recalled how difficult it was when she and other members of her community had to walk for up to two hours to reach the nearest health center in Juru or Mwogo.

“I used to seek health services at Kabagore health center in Juru, but this place is closer now. There is an hour and a half between Musovu and Juru. When you don’t even have a bicycle, the situation can deteriorate very quickly before you can reach the health post,” Musanabera said.

Musovu health post in Bugesera district serves a population of 5,175 people, receiving between 30 and 100 patients per day, with a higher peak during the malaria season. It provides several outpatient health services, ranging from check-ups for non-communicable diseases to pharmacy, laboratory tests, and maternal and child health services.

For pregnant women and their babies, this health post is life-saving. Previously, mothers-to-be had to rent a motorbike for the expensive sum of 2,500 Rwandan francs (about $2.43) or walk for hours to deliver safely in an institution. Now, with the health post closer to home, they can receive the services they need when and where they need them.

The government has made primary health care a priority to improve access to health services and move towards universal health coverage (UHC). Its goal is to ensure that by 2024 people need to walk less than 24 minutes to get to a health facility.

Health posts: bringing health services closer to the community

With the support of administrative districts, communities and partners, the Ministry of Health has, since August 2021, established 1,179 health posts that provide basic health services across the country to underserved communities. The Ministry of Health has now created 21 new health posts, known as second generation health posts, with improved services such as maternity, laboratory, dental, ophthalmology and circumcision in various regions of the country.

The plan is to expand the program nationwide, with a focus on 15 border districts (out of 30 districts in total), which have been found to be at higher risk of health shock during the COVID-19 pandemic. The government intends to create 623 health posts in areas still lacking facilities by 2024.

Rwanda is among 115 countries and territories to which the UHC partnership helps provide WHO support and technical expertise to advance universal health coverage through a primary health care approach. The Partnership is one of WHO’s largest initiatives in international cooperation for universal health coverage and primary health care. It is funded by the European Union, the Grand Duchy of Luxembourg, Irish Aid, the Government of Japan, the French Ministry for Europe and Foreign Affairs, the United Kingdom – Foreign, Commonwealth & Development Office, Belgium , Canada, Germany and the Susan Thompson Buffett Foundation.

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