The 1994 genocide in Rwanda destroyed much of the socio-economic fabric of Rwanda as well as its health infrastructure. The healthcare system is still suffering in its aftermath. Although the health status of the Rwandan population has improved significantly in recent years, it remains insufficient. Training health workers to advanced levels has taken time and has not been quick enough to meet the needs of the Rwandan population. (hrhconsortium.moh.gov.rw/rwanda-at-a-glance).
That’s partly why the Honorable Minister of Health, Dr. Agnes Binagwaho, recently specified that the Government of Rwanda views health care as a basic human right. As such, our health care delivery model aims to serve all Rwandans, especially the most vulnerable.
This rights-based approach is at the root of Rwanda’s health strategy. It is articulated in Rwanda’s Economic Development and Poverty Reduction Strategy, Rwanda’s Vision 2020, and the United Nations’ Millennium Development Goals. (Chronic care integration for Endemic NCDs, foreword, 2011).
Palliative care is considered part of everyone’s right to health. Palliative care is an approach which improves the quality of life of patients with life-threatening and their families.
The Rwandan Ministry of Health has approved a national stand-alone for palliative care, as well as a strategic plan for the next 4 years to oversee its implementation. It aims to integrate a comprehensive approach to palliative care at all levels in the health system.
Through the technical support of Intrahealth/Mildmay organization and the Rwandan technical working group, a number of tools have been created for dissemination of palliative care at all levels of health system. The linkage between the community and hospitals will be through those tools and help all health providers at each level to get the really information about their patients.
According to Dr. Marie-Aimee Muhimpundu, the head of NCDs from Rwanda Biomedical Center (NCDs/RBC) the availability of those tools are a big step for improving the quality of life of patients with life threatening illnesses: “The continuum of information between health facilities and the community in palliative care is a big challenge; after being discharged most of our patients are lost because of lack of information. These tools will keep the linkage with community where the patient belongs…. Data will help health facilities to map their catchment area, the number of patients, general condition and management” said Dr Marie-Aimee.
The tools available are:
- Patient file;
- Patient-held record for home-based care;
- Home visit record for care providers;
- Palliative care patient register;
- Palliative care monthly report;
- Referral to palliative care team;
Each level of health system will receive those tools and training on how to use them. The Ministry of Health is planning training for community health workers who work in the villages. As a result, it will be easy for them to report to the next level of referral system. This means health centers where a nurse is trained in palliative care will visit the patient or share information to doctors for better orientation. Slowly by slowly, Rwanda Palliative Care system is building up taking into account the challenges. Integration of palliative care and building sustainable systems will be the foundation for the future success of Rwanda.