The government has embarked on a plan to hand over health posts to Non-Governmental Organisations (NGOs) in order to make them more efficient. The health facilities are said to be struggling due to poor management and lack of interest from investors. The disclosure was made on Thursday, September 23, by Valens Ndonkeye, Corporate Services Division Manager at the Ministry of Health, during the parliamentary Public Accounts Committee (PAC)’s public hearings. During the hearings, Nyamagabe District and Kaduha Hospital – the district hospital – were responding to queries on public asset mismanagement cases that were identified in the Auditor General’s report for the financial year 2019/2020. Such issues include the ineffective management of health posts. Some districts have been struggling to make health posts operational due to the lack of investors, being under-staffed, and inadequate planning, a situation limiting citizens access to healthcare services For instance, the Auditor-General’s report for 2018-2019 revealed that districts spent over Rwf804 million to construct some 70 new health posts in the same financial year. However, 54 of those health posts were idle. These are worth more than Rwf609 million. Ndonkeye said that they realised the existing individual Public Private Partnership (PPP) model was not working well in terms of running these health facilities intended to bring healthcare services close to communities in all cells of the country, indicating that some [some] individuals incurred losses and they left the initiative. “In most cases, private investors acquired them but they probably thought that they would get high profits from them. But, they incurred losses and quit,” he said, pointing out that in general, ineffective health post management is a common issue in districts. After realising the issue at the central level, he said that they undertook a pilot phase to hand over some of them to NGOs, indicating that over 180 health posts have been handed over to Society for Family Health (SFH) and they are performing well so far. “We have taken that angle to encourage our partner international NGOs who we realise are willing and have capacity for that [to run health posts],” he said. “The plan we have is to take them (health posts) from the failed individual PPP and hand them over to international NGOs that proved they can be productive so that Rwandans can adequately benefit from the health services offered there [at health posts],” he said. Health posts intend to help reduce the workload at health centres, provide rapid primary health care to patients by reducing the walking distance to health facilities. They offer a reduced package of services, including curative outpatient care, child immunisations, growth monitoring for children under five years, antenatal care and family planning counselling, health education and a few laboratory tests. Health centres provide oversight to the health posts. Also, he said, they have announced the expression of interest for the second batch – consisting of some 174 health posts – so that interested NGOs can take over their management. He added that more health posts would be run through this approach in the future. He said that the second batch focuses especially on districts located near borders so as to address the healthcare needs for their residents. While Rwanda has 2,148 cells, there were only 831 health posts in the country as of 2019. Under the fourth Health Sector Strategic Plan 2018-2024 (HSSP IV), the Government sought to double that number of health posts [by 2024]. PAC Chairperson, Valens Muhakwa said that this plan seems promising in terms of addressing the issues affecting health posts, but called for attention to ensure that it yields intended results. “There is a need to make follow up and engagements with NGOs because they [health posts] are somehow idle countrywide,” he said.
