Programme d’Appui aux systèmes de santé des Grands Lacs
This phasing-Out stage shall focus on managing local knowledge-transfer processes revolving around medial and non-medical determinants of health. To do this is relevant in a stage of phasing-out because it capitalizes on the efforts made by Switzerland in a systemic support to the public health system over the last 15 years. Monitoring the stunting path among children’s under 2yo - as good proxy of wellbeing and of social learning processes - will be undertaken with the cooperation of parents, Community Health Workers (CHWs) and Local Governments. Therein lays the potential for successful replicating of good health practices, locally, and as a basis for upscaling to the Western Province and beyond.
Primary health care
Health systems strengthening
- Parents become Action Researchers
- CHWs can act as Action Research assistants
- The capacity of interrogating health data is enhanced at district level
- At regional and national level, a concerted process from practice to strategy and policies is devised and agreed upon
- The results of the Action Research are assessed in the light of 15 years of Swiss presence in the sector
- Foreign private sector North
With the goal of providing universal health care, Rwanda has successfully focused in the last 15 years on strengthening supply and demand interventions. The complementarity of these interventions has enabled significant progress in improving the health of women and children to achieve Millennium Development Goals 4 and 5. While the adherence to the compliance standards across the health system is improving, this has not been associated with a comparable improvement in undernutrition rates in children.
In a medium-term framework, the expected impact will be a significant reduction of child stunting in Rwanda, stemming from adequate upscaling action with the concerned national actors, Development Partners and civil society organizations. This upscaling will be operated by the mentioned actors and be outside the phasing-out exercise of SDC.
Some 4’500 frontline workers will coach a process that “enables” parents, locally and independently, to replicate practices to combat chronic undernutrition. Arithmetically, this represents an outstanding coaching density of one CHW for 220 persons (or about 50 households), reaching out to 3,000 parents with at least one child.
The core outcome of the Action Research phase is an evidence-based understanding of the causes of child stunting and of the array of good practise to prevent it, as perceived by the primary care-givers. Properly documented and disseminated, the results of the Action Research will be a main ingredient in a comprehensive strategy for the prevention of chronic undernutrition. As such, the approved stunting prevention strategy will constitute a valuable capitalization outcome of the Swiss presence in the health sector.
Results from previous phases:
SDC has provided “proximity cooperation” to three districts of the Western Province ever since the inception of the health sector commitment in 2002. As this was a conscious mix between decentralized investments in health infrastructure, training, coaching and a district-level budgetary support, it was well appreciated by the involved districts. With the impressive development of the health system in Rwanda, the SDC’ approaches lost its efficiency and relevance.
Presently, about 4,800 Community Health Workers in the Western Province constitute a frontline workforce for preventive health which can to be put to use more systematically in the framework of the phase-out stage.
|Directorate/federal office responsible||
Western Province; ChW Cooperatives; Health Centers; District Health Management Teams.
|Coordination with other projects and actors||
SDC funded, OneUN supports to the National Nutrition and Food Program Coordination Secretariat under the Ministry of Local Government
World Bank Rwanda; University of Zurich; OneUN Rwanda; SDC Global Programme Nutrition; DPs/NGOs actives in Nutrition.
|Budget||Current phase Swiss budget CHF 1'200'000 Swiss disbursement to date CHF 1'176'106|
|Project phases||Phase 2 01.10.2017 - 30.12.2020 (Current phase) Phase 1 01.02.2013 - 31.12.2018 (Completed)|