Session V: NCDs and the Human Resources for Health Agenda #NCDsynergies
Panelists: 1. Charlotte Bavuma, Academic Head of Internal Medicine Department, National University of Rwanda 2. Emmanuel Rusingiza, Lecturer at National University of Rwanda, Pediatric Cardiologist at Kigali University Teaching Hospital 3. Gedeon Ngoga, NCD Program Manager, Inshuti Mu Buzima/Partners In Health Rwanda 4. Richard B Mark Munyaneza, In Charge of Monitoring and Evaluation in Community Heatlh, Community Health Desk, Rwanda MOH
HRH burden The WHO recommends that for African countries to meet the healthrelated MDGs the population should be covered by a minimum of 1 medical doctor per 5.000 population and 2.3 nurses and midwives per 1.000 population (African Health Workforce Observatory, 2009) WHO/WB 2002 Addis Ababa consultative meeting: Need to ensure the relevance of education and training of health professionals to the health needs of the population served; Importance of forging new partnerships between the health and education sectors, and of continuing development of the health workforce
Sub-Saharan Africa - HRH accounts for 24 per cent of the global disease burden worsened by the HIV/AIDS epidemic and now the NCD and NTD burden served by only 3 per cent of the global health work force 13 medical doctors/100,000 population (Brazil 192/100/000; US 280/100,000) (WHO 2006, SAMSS 2010) 168 medical schools in the 48 countries of Sub-Saharan Africa; estimated to graduate 10,000 physicians per year (SAMSS 2010)
Rwanda 19 years post-genocide One medical school; 12 nurse and allied health training schools; 1 school of public health HSSP II (2009-2012) : more emphasis on improving the quality of trained professionals and their distribution over the country (GoR, MoH, 2009). the Rwandan Government, with the support of DPs, embarked on promoting and supporting pre-service education, strengthening the capacity of training institutions, scaling up
Rwanda Evolution of health workforce density between 2005 and 2011 in Rwanda 2005 2008 2011 Doctor / Popn Ratio 1/ 50,000 1/ 33,000 1/ 17,240 Nurse / Popn Ratio 1/ 3,900 1/ 1,700 1/ 1,294 Midwife / Popn Ratio Not available 1/ 100.000 1/ 66,749 Source: IHP+ (2011)
Education and Health Sector interaction Most countries: Parallel and uncoordinated policies and programs Adapted from WHO/WB (2002) Rwanda: More inter-sectoral collaboration in HSS HSR: Health Sector Reform; ET: Education and Training; DR: Deployment and retention
Interfaces between education and Health in Rwanda Educational institutions are crucial to transform health Systems (Frenk et al, 2010) Deans of Faculty of Medicine, School of public health and school of nursing are members of the Senior management team of the Ministry of Health HRH TWG Planning and financing for education Research and policy formulation CPD provision Health professionals associations
Current and projected core health work force Physicians Nurses Hospital Managers 1,455 10,171 50 500 175 +203% A1 6,609 457 7,171 +54% Med. Assist. Sub- spec. Specialists Generalists 480 43 70 367 0 565 215 A2 6,152 3,000 0 Current 7- year target Current 7- year target Current 7- year target
1. What are specific examples of the benefit of the HRH program for NCD treatment? 2. How are physicians who participate in the international academic partnership integrated into ongoing clinical training programs in Rwanda? 3. What is the financing model for HRH? How is this included as part of the US Government s support to Rwanda? What is innovative about the financing model? 4. How are shorter, post-graduate certificates complementary to HRH? 5. What programs (within and beyond the HRH model) focus on increasing human resourcing for adherence support for chronic care at the community level? #NCDsynergies