The Ministry of Health has announced plans to amend the existing policy on the management of health posts, a process that officials say should be complete by 2023. The health post is the lowest medical unit and these were introduced to bring medical services closer to the population. The anticipated changes were announced by the State Minister in charge of Primary Healthcare, Dr Tharcisse Mpunga while appearing before parliament where was summoned to explain why hundreds of health posts in the country are not operational. The session took place virtually on Friday, January 28. “The plan is to review the policy, paving way for investors, religious organizations, NGOs and business people to take up the management of the health posts,” he said during his presentation. The existing policy, he continued, only provides for a nurse at a health post and the management is largely under the government. We want to change that as a way to bring on board the private sector and other stakeholders. Under the supervision of the government and some NGOs, health posts are built at the cell level to offer primary treatment and medical services, including curative outpatient care, child immunisations, growth monitoring for children under five years, antenatal care, family planning counseling and reproductive health education among others. The new policy will also include a capitation payment from July 2022, where the health posts will be given enough funds to support their operations every month. “We will come up with an estimate of the number of patients a health post receives every month and their expenditure so that we can allocate them monthly budget” he said. This element will help health posts plan for their money accordingly, increase accountability and solve the problem of delay of funds from the Rwanda Social Security Board (RSSB) insurance scheme. Rwanda has a total of 1,157 health posts of which 588 are managed by the government whereas 569 fall under the Non-Governmental Organisation category, providing maternity, ophthalmology and dentistry services among others. Challenges in health posts Fraud, provision of limited services, shortage of staff, lack of medicine and other medical equipment, poor service delivery, lack of enough water and electricity and lack of proper management among others were the most raised challenges raised by the Members of Parliament during the session. MP Georgette Rutayisire raised the issue of shortage of staff. “From the health posts we visited, we found that they only work a few days a week, yet they are supposed to receive patients every day, and we hope that with this new budget we hope to see these health posts hiring permanent nurses to work in them” she said, applauding the policy revision. MPs said that delay in giving operating licenses, and limited budgets by the insurance companies compared to the money they spent in treating the patients, results in losses and later on the closure of these health posts, adding that the new policy should solve this issue.
