Strengthening Pediatric Care in Rwanda: HRH Program and Beyond

Beginning in 2012 and continuing through the end of a 7-year capacity-building partnership with the Rwandan Ministry of Health, Boston Children’s Hospital (BCH) played a crucial role in the Rwanda Human Resources for Health (HRH) Program. This initiative, supported by USAID, CDC, and other partners, aimed to enhance Rwanda’s health workforce by sending pediatricians and sub-specialists for year-long and shorter-term rotations with the goal of improving pediatric residency training, hospital-based care, and nursing education for local healthcare workers. Through these efforts, the number of clinical pediatricians in Rwanda increased from approximately 10 to over 70, greatly enhancing access to pediatric care for Rwanda’s 7 million children.

BCH’s involvement included rotating faculty within Rwanda’s four main teaching hospitals, providing didactic instruction, bedside teaching, and engaging in research collaborations. This hands-on approach not only improved clinical care but also fostered quality improvement and research, leading to significant academic achievements for both BCH faculty and Rwandan pediatricians. Additionally, BCH’s Global Health Program facilitated pediatric electives for BCH residents at Kigali University Teaching Hospital, further strengthening the partnership.

With the formal HRH Program concluding in 2019, BCH, in collaboration with Rwandan pediatric faculty, transitioned to the Rwandan Pediatric Partnership. This ongoing initiative aims to sustain and build upon previous successes by focusing on faculty development in research and teaching, offering observership opportunities for Rwandan trainees, and expanding nursing involvement. Key priorities include enhancing pediatric subspecialty training in areas such as pediatric neurology, emergency medicine, adolescent medicine, and developmental-behavioral pediatrics.

The COVID-19 pandemic disrupted in-person postgraduate teaching, leading to the adaptation of the General Pediatrics Module to a flipped-classroom format in 2020. This approach, where students learn content at home and apply it in class, prompted the creation of an Introductory Public Health Module and an evaluation of this new teaching method. The development of an Introductory Public Health Module for pediatric residents covers topics like social determinants of health, community needs assessment, and early childhood development, while the shift to virtual and hybrid teaching formats has enabled Rwanda to maintain and enhance its international health partnerships following the conclusion of the HRH program.

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