International Journal of Health Policy and Management

International Journal of Health Policy and Management

Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda

Document Type : Original Article

Authors
Corrado Cancedda 1
Philip Cotton 2
Joseph Shema 3
Stephen Rulisa 4
Robert Riviello 5, 6
Lisa V. Adams 7, 8
Paul E. Farmer 6, 9
Jeanne N. Kagwiza 10
Patrick Kyamanywa 11
Donatilla Mukamana 12
Chrispinus Mumena 13
David K. Tumusiime 14
Lydie Mukashyaka 3
Esperance Ndenga 3
Theogene Twagirumugabe 15
Kaitesi B. Mukara 16
Vincent Dusabejambo 17
Timothy D. Walker 17, 18, 19
Emmy Nkusi 20
Lisa Bazzett-Matabele 21
Alex Butera 22
Belson Rugwizangoga 23
Jean Claude Kabayiza 24
Simon Kanyandekwe 25
Louise Kalisa 26
Faustin Ntirenganya 27
Jeffrey Dixson 28
Tanya Rogo 29, 30
Natalie McCall 31
Mark Corden 32, 33
Rex Wong 34
Madeleine Mukeshimana 12
Agnes Gatarayiha 13, 35
Egide Kayonga Ntagungira 14
Attila Yaman 9
Juliet Musabeyezu 36
Anne Sliney 37
Tej Nuthulaganti 37
Meredith Kiernan 37
Peter Okwi 38
Joseph Rhatigan 6, 9
Jane Barrow 39, 40
Kim Wilson 41, 6
Adam C. Levine 42
Rebecca Reece 43
Michael Koster 44
Rachel T. Moresky 45, 46
Jennifer E. O’Flaherty 47, 48
Paul E. Palumbo 8, 48, 49
Rashna Ginwalla 48, 50
Cynthia A. Binanay 51
Nathan Thielman 52, 53, 54
Michael Relf 53, 55
Rodney Wright 56, 57
Mary Hill 58
Deborah Chyun 59
Robin T. Klar 60
Linda L. McCreary 61
Tonda L. Hughes 62
Marik Moen 63, 64
Valli Meeks 65
Beth Barrows 66, 67
Marcel E. Durieux 68
Craig D. McClain 6, 69
Amy Bunts 70
Forrest J. Calland 70
Bethany Hedt-Gauthier 6
Danny Milner 71, 72
Giuseppe Raviola 6, 73
Stacy E. Smith 74
Meenu Tuteja 75
Urania Magriples 21
Asghar Rastegar 76
Linda Arnold 31
Ira Magaziner 37
Agnes Binagwaho 6, 49, 77, 78
1 Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
2 Office of the Vice-Chancellor, University of Rwanda, Kigali, Rwanda
3 Rwanda Human Resources for Health Program Team, Ministry of Health, Kigali, Rwanda
4 Office of the Dean, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
5 Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, USA
6 Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
7 Center for Health Equity, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
8 Department of Medicine, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
9 Division of Global Health Equity, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
10 Office of the Principal, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
11 Department of Surgery, Faculty of Clinical Medicine and Dentistry, Kampala International University - Western Campus, Ishaka, Uganda
12 School of Nursing and Midwifery, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
13 Office of the Dean and Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
14 School of Health Sciences, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
15 Department of Anesthesiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
16 Department of Ear, Nose, and Throat, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
17 Department of Internal Medicine, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
18 School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
19 Department of General Medicine, Calvary Mater Hospital, Newcastle, NSW, Australia
20 Department of Neurosurgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
21 Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
22 Department of Orthopedic Surgery, Rwanda Military Hospital, Kigali, Rwanda
23 Department of Pathology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
24 Department of Pediatrics, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
25 Department of Mental Health, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
26 Department of Radiology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
27 Department of Surgery, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
28 Yale School of Medicine, New Haven, CT, USA
29 Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
30 Department of Pediatrics, BronxCare Health System, Bronx, NY, USA
31 Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
32 Division of Hospital Medicine, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
33 Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
34 Global Health Leadership Institute, Yale School of Public Health, New Haven, CT, USA
35 Department of Preventive and Community Dentistry, School of Dentistry, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
36 University of Global Health Equity, Kigali, Rwanda
37 Clinton Health Access Initiative, Boston, MA, USA
38 Clinton Health Access Initiative, Kigali, Rwanda
39 Office of Global and Community Health, Harvard School of Dental Medicine, Boston, MA, USA
40 Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
41 Department of General Pediatrics, Boston Children’s Hospital, Boston, MA, USA
42 Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
43 Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
44 Department of Pediatrics, Warren Alpert Medical School of Brown University, Providence, RI, USA
45 sidHARTe Program, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City, NY, USA
46 Department of Emergency Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA
47 Department of Anesthesiology, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
48 Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
49 Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
50 Department of Surgery, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
51 Duke Hubert-Yeargan Center for Global Health, Durham, NC, USA
52 Department of Medicine, Duke University School of Medicine, Durham, NC, USA
53 Duke Global Health Institute, Durham, NC, USA
54 Duke University Medical Center, Durham, NC, USA
55 Duke University School of Nursing, Durham, NC, USA
56 Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine, New York City, NY, USA
57 Obstetrics & Gynecology and Women’s Health, Montefiore Medical Center, New York City, NY, USA
58 Division of Nursing, Howard University College of Nursing and Allied Health Sciences, Washington, DC, USA
59 University of Connecticut School of Nursing, Storrs, CT, USA
60 New York University Rory Meyers College of Nursing, New York City, NY, USA
61 University of Illinois at Chicago College of Nursing, Chicago, IL, USA
62 Columbia University School of Nursing, New York City, NY, USA
63 Department of Family & Community Health, University of Maryland School of Nursing, Baltimore, MD, USA
64 Global Education and Mentorship, Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA
65 Department of Oncology & Diagnostic Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
66 Office of Global Health, University of Maryland School of Nursing, Baltimore, MD, USA
67 Partnerships, Professional Education, and Practice, University of Maryland School of Nursing, Baltimore, MD, USA
68 Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, VA, USA
69 Department of Anesthesiology Perioperative and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA
70 Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, USA
71 Center for Global Health, American Society for Clinical Pathology, Chicago, IL, USA
72 Department of Immunology and Infectious Diseases, Harvard T. H. Chan School of Public Health, Boston, MA, USA
73 Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA
74 Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
75 Global Health and Research Programs, Biomedical Research Institute, Brigham and Women’s Hospital, Boston MA, USA
76 Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
77 Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
78 Office of the Vice-Chancellor, University of Global Health Equity, Kigali, Rwanda
10.15171/ijhpm.2018.61
Abstract
Background
The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda.

 
Methods
The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors.

 
Results
In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions.

 
Conclusion
The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.

Highlights

Commentaries Published on this Paper

  • The Human Resources for Health Program in Rwanda – Reflections on Achievements and Challenges; Comment on “Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda”

            Abstract | PDF

  • Reflections on Health Workforce Development; Comment on “Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda”

            Abstract | PDF

 

 Authors' Response to the Commentaries

  •  The Human Resources for Health Program in Rwanda: A Response to Recent Commentaries

             Abstract | PDF

 

Watch the Video Summary here.

 

Keywords
Health Professional Training
Human Resource for Health
Institutional Capacity
Strengthening
Academic Partnerships
Rwanda
Subjects

 

 

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International Journal of Health Policy and Management
Volume 7, Issue 11
November 2018
Pages 1024-1039

  • Received Date 24 January 2018
  • Revised Date 18 June 2018
  • Accepted Date 19 June 2018
  • First Published Date 01 November 2018
  • Published Date 01 November 2018