RWANDA INTERGRATED
HEALTH MANAGEMENT
INFORMATION SYSTEM
Ministry of Health
Rwanda’s Health System
Administrati No. of public Av. Type of service
ve Health care facilities / Catchment offered
structure delivery system CHWs area pop
Tertiary hospitals National ▪ Specialized hospitals serving the entire
7 country
(~12 m) ▪ Medical training
Provinces (5) 4
▪ Provide government defined “Complementary
package of activities (CPA) (C-section, treatment of
District
District complicated cases,..
hospitals
hospitals
36 ~ 255, 000 ▪ Provide care to patients referred by the primary
District (30) health centers
▪ Carry out planning activities for the health district
and supervise district health personnel
Sector (416) ▪ Provide government defined “minimum package of
activities at the peripheral level (MPA)
Health
Health 484 ~ 23 ▪ This includes complete and integrated services
centers
centers 000 such as curative, preventive, promotional, and
rehabilitation services
▪ Supervise health posts and CHWs operating in their
catchment area
380 ▪ Services provided are similar, albeit reduced from,
Cell (2148) Health
Health that by Health Centers.
posts ▪ Established in areas which are far from health
centers,
▪ Services include curative out-patient care, certain
diagnostic tests, child immunization, growth
monitoring for children under five years, antenatal
consultation, family planning, and health education
Community-based :
• Prevention, screening and treatment of
Community malnutrition
Health 45,011 ~ 250 • Integrated Management of Child Illness (CB-
IMCI)
Village (14,837) Workers • Provision of family planning
• Maternal Newborn Health (C-MNH)
• DOT HIV, TB and other chronic illnesses
• Behavior change and communication
80% of burden of disease addressed at this level
Intergarted tools for reporting
(At facility level)
Patient file
Registers
Reporting forms [Link]
Standard Operating Procedures [Link]
[Link]?id=154
Metadata Dictionary where all indicators are defined.
[Link]
Publication of routine data like Annual Statistical
booklet 2008-2014
[Link]
Reporting tools review to reduce
workload by removing unused data
New HMIS (based on DHIS-2) Old (GESIS)
Size 12 DH 46 DH
( pages) 11 HC 26 HC
New IMCI (Under 5 years) There was
sections Neonatal none before or
added section was
Nutrition screening
expanded
Physiotherapy
GBV (Violence basee sur le
genre)
Mental Health
Blood bank
Simplified Minimal and only on applicable They were too
R-HMIS reporting
modules
Modules designed in R-HMIS (DHIS2)
HMIS reporting forms (DH, HC, Referals,
Private facilities)
Rwanda Integrated Disease Surveillance
TB Quarterly report and ETB
CHW monthly Report (SISCOM)
HIV Module
Neonatal and child death report
Weekly child mortality report
Annual reports
Maternal Death audit reports
Contribution of Community Health Wor
1 Female
in charge of
maternal Health
1 female
1 male
3
CHWs/
village
Infant and Under-five Mortality from the RDHS/RIDHS, 2005, 2007-08, 2010, and 2014-15
Infant and Under-five Mortality dropping steadily.
250
196
200
173
152
150
107 103
100 95
86
76
62 50 50
50
32
0
2000 2002-03 2005 2007-08 2010 2014-15
2000 RDHS IMR 2000 RDHS U5MR 2005 RDHS IMR 2005 RDHS U5MR
2007-08 RIDHS IMR 2007-08 RIDHS U5MR 2010 RDHS IMR 2010 RDHS U5MR
Maternal Mortality Ratio form the RDHSs 2000, 2005, 2010, and 2014-15
Maternal mortality also dropping steadily
1400
1200
1071
1000
800
750
600
476
400
200 210
0
RDHS 2000 RDHS 2005 RDHS 2010 RDHS 2014-15
Rwanda Data Warehouse & Dashboard
Thematic Maps
INPUTS OUTPUTS
Facility
Registry Formatted reports
GESI Interoperability layer
S
Trac Indicator Trend Graphs
Net Data
Dictionary
Data
Other Ware-
DB
house
Pivot tables
IDSR
Periodic Data export
Reports
Main Challenges & Plans to address them
Challenges Next steps to address them
1 Population growth - Increase accessibility to FP services through multisectoral
approach
2 Shortage of skilled - In country training for health professionals through HRH Program
health professionals (doctors, nurses, midwives and Hospital managers) with US
(especially doctors) Universities
- Increase the intake in the medical school (x2)
- Encourage private sector to invest in the medical education
3 Financial - Framework for public hospitals to generate money through creation of
sustainability of private wings
health facilities - Partnership with private sector in expanding care for Primary health care
(PPCP framework for Health posts)
- Strengthening community health workers cooperatives in generate
more incomes
Quality of data - Mechanisms are in place like ISS/DQA, Coordination meeting, data
review by services before submission, data review and validation by
Programs before use and feedback from HMIS central level.
Thank You
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time