Immaculée Kantengwa, a midwife at Kibagabaga Level Two Teaching Hospital, has told The New Times that she values her work because it allows her to care for mothers, babies, and other patients. However, she noted that long-distance commuting remains a major challenge for nurses and midwives, particularly those working outside Kigali, as many do not live near their workplaces. She said transport support would help ease their daily commute.
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Kantengwa also stressed that nurses and midwives need continuous training, scholarships, mentorship programmes, and recognition to strengthen their skills and motivation.
According to Emmanuel Munyaneza, the Chairperson of the National Council of Nurses and Midwives (NCNM), the government’s 4x4 programme which aims to quadruple the number of trained health professionals within four years, is expected to ease the burden on nurses and midwives as staffing levels improve.
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He explained that staff shortages have left nurses handling large numbers of patients and working long hours. Munyaneza explained that diploma-level nurses working in health centres and district hospitals earn about Rwf200,000 per month, with salaries varying in referral and teaching hospitals.
‘The workload is heavy’
The Ministry of Health acknowledges that "the workload is heavy,” and nurses and midwives in Rwanda need more opportunities in specialised training, continuous professional development, and improved working conditions as the health system expands.
Dr. Menelas Nkeshimana, the Head of the Health Workforce Department at the Ministry of Health, said this is connected to pressure on the workforce serving more than 14 million people.
"The country has close to 20,000 nurses and midwives, about 17,000 nurses and 3,000 midwives. But if you compute the population served, the workload is heavy,” he said.
Dr. Nkeshimana said nurses spend 80 per cent of their time with patients in health facilities, where they carry the biggest workload as most patient care is delivered by nurses in emergency and other departments, with the low density of health workers continuing to strain service delivery.
"Some nurses are required to move from their home bases to work in other districts or provinces, and this can be challenging as they wait for relocation to be completed. There is also need to improve pay and ensure better access to housing and transport,” he said.
He pointed to pay as a main issue, saying it should be gradually adjusted to reflect the changing needs of the sector, adding that continuous professional development is important.
The official explained that medical training and nursing education are not one-off events, saying learning must continue so that knowledge stays sharp and skills current.
"As Rwanda expands specialised services such as cardiac surgery and kidney transplant programmes, nurses will also need advanced training.
"We are seeing more nursing specialisations emerging. As we open cardiac surgery units and kidney transplant programmes, we ensure that nurses are able to keep up, and that means they must undergo specialised training. It is a continuous journey,” Dr. Nkeshimana stated.