RWANDA
Table of Contents
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A Clinical Officer is a legally recognized Health Professional who is licensed to perform independently general medical duties such as diagnosis and treatment of disease and injury in all age group, ordering and interpreting medical tests, performing routine medical and minor surgical operations. Therefore, Clinical Officers treat all diseases seen in general practice and refer those beyond their skills to physicians. Medical Clinical Officers are also known as Medical Assistants or Physician Assistants in some parts of the world.
Provider Density & Statistics
Recently, Rwanda developed strategies and interventions to overcome shortages in human resources for health and to ensure the population has access to affordable quality health care. Between 2015 and 2017, the doctor–inhabitant ratio improved from 1:15 428 to 1:8592, while the nurse– inhabitant ratio improved from 1:1200 to 1:1070. As of 2017, Rwanda has 1407 medical doctors (367 specialists and 1040 general physicians) and 11 295 nurses. There are currently two medical schools and eight schools of nursing and midwifery.
The shortage of human resources in the health sector is one of the biggest challenges facing the government. In order to fill the gaps, the government has invested significant resources in implementing pre-service training programmes and strengthening institutions. The Government of Rwanda, in collaboration with development partners, has initiated a human resources for health project that includes a postgraduate training programme for ensuring quality health care for patients at provincial and national referral hospitals. A strategic plan (2016–2020) is being implemented with a focus on innovative models of health training, increasing health personnel productivity, strengthening the capacity of employment, improving data management for decisionmaking, and mobilizing the necessary sustainable financing
Primary Care / Specialty Care Distribution
The medical Clinical Officer, comparable to medical assistants, may perform health care tasks in any setting authorized by the supervising authority, including physician offices, clinics,
hospitals, ambulatory surgical centers, patient homes, nursing homes and other health care institutions. These tasks may include:
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Take comprehensive medical histories
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Examine patients
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Write case summaries/findings
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Order and interpret general Laboratory tests
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Make diagnosis and appropriate treatment
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Manage general medical conditions
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Communicate effectively with patients, relatives and colleagues
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Performing minor surgical procedures
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Carryout antenatal care, post natal
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Conduct Normal Deliveries and supervise immunization
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Refer emergence and complicated cases appropriately
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Promote community health within health facilities and catchment area.
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Works Public and Private health institutions and Manages Private Dispensaries.
Clinical Officers are also trained to manage effectively and efficiently the resources in the health centers,
outpatient units at various levels of health facilities, support supervision of staff and management of equipment, drugs, supplies and other assets and resources in a health facility.
Support promotion and maintenance of team-work among health workers in a health facility and catchment area; including promotion of health worker-patient relationship.
"Rwanda is among the few countries to have achieved universal health coverage due to its vision of inclusiveness, equity, and comprehensive and integrated quality service delivery, with a focus on primary health care (PHC). Rwanda’s health sector has made tremendous progress in improving the health status of the population. These improvements are mirrored by the improvements in access to health care services and utilization of those services. According to Rwanda annual health statistics, the PHC utilization rate increased from 0.81 to 0.94 visits per inhabitant from 2009 to 2013."
Scope of Practice
CLINICAL OFFICERS
Scope of Practice
NON PHYSICIAN ANAESTHETISTS
Within the Outpatient Department
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Take medical history
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Examine patients
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Order and interpret laboratory tests like X-rays, ECGs, ultra sonogram, echocardiogram, pulmonary function tests etc.
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Make diagnosis
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Treat common diseases, including serious and life-threatening ones, in all age groups
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Counsel patients and families
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Identify and refer patients/clients with conditions that cannot be managed within their scope
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Identify and reports notifiable diseases
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Identify medical legal conditions and take appropriate action
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Sign legal documents such as medical certificates
At wards and critical care units
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Take ward rounds
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Manage emergency situation
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Order or carry out therapy and refer complicated cases to a specialist
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Record progress notes
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Involve in pre-peri-postoperative management of the patients
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Carries out minor procedures/ operations
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Conducts normal delivery
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Provide discharge summary
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Sign legal documents such as medical certificates
At community level
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Carries out community diagnosis
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Plans, organizes, and conducts integrated PHC activities
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Promotes school health services
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Evaluates health services
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Institutes appropriate patient care including treatment, health education, counseling and rehabilitation.
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Identify vulnerable groups in the community, their needs and plan for appropriate interventions
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Participate actively in the planning, implementation and evaluation process of Primary Health Care, Community-Based Health Care and other national programmes
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Use the principles of epidemiology to control communicable and non-communicable diseases
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Provide health education to patients, special groups and the community in the catchment area.
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Carry out preventive, promotive and rehabilitative health services, including management of maternal and child health and reproductive health services and the screening of cases for referral
Non Physician Anaesthetists are members of the anaesthetic care team, trained both in the underlying scientific and medical knowledge pertinent to anaesthesia, and in the skills of administering anaesthesia. Their core responsibility is to provide anaesthetic services to patients requiring anaesthesia, respiratory care, cardiopulmonary resuscitation and/or other emergency, life sustaining services within the anaesthesia and wider theatre and critical care environments. Non Physician Anaesthetists are categorized according to education levels; they are Specialists Clinical Officer Anesthetists, Clinical Officer Anesthetists, Assistant Clinical Officer, Certified Registered Nurse Anaesthetists, Registered Nurse Anaesthetists, Nurse Anaesthetists and Anaesthetic Technicians. The range of practice of Non Physician Anaesthetists extends from preoperative assessment to postoperative anaesthetic care; however, the role is primarily defined by the scope of work undertaken in the operating theatre where in an independent or supervised capacity, participate in induction, maintenance and reversal of anaesthesia using skills and knowledge that are based on an in-depth understanding and application of physiology and pharmacology.
Age Distribution
Data on this particular realm does not currently exist, or is in the process of being gathered and verified.
Gender Distribution
Data on this particular realm does not currently exist, or is in the process of being gathered and verified.
Country Profile
Rural Practice Data
Data on this particular realm does not currently exist, or is in the process of being gathered and verified.
Training
Data on this particular realm does not currently exist, or is in the process of being gathered and verified.
History
Regulation & Accreditation
Rwanda Higher Education Council (HEC, Accreditation body)
The Review Process and Outcomes
The review process is based on international best practices. It involves the institution completing an application form providing basic information on the organization and operating of the institution and a self-assessment in which it evaluates its provision. The self-assessment is tested by a team of trained peer reviewers who visit the institution over four days. The institution is required to provide a Base Room in which all the documentary evidence to support the self-assessment is provided. The framework for the review takes account of inputs, processes and outputs, and is based on good practice. Institutions, to be granted a definitive operating agreement, are required to demonstrate that they are meeting threshold standards and quality as found in higher education institutions in Rwanda at the time of the visit. They are, additionally, required to demonstrate that they have the capacity (infrastructure, financial and human resource) to transform their academic provision in line with the national quality enhancement agenda and are actively planning to do so. They must be operating in conformity with the requirements of the 2005 Law Governing the Organization and Structure of Higher Education and other relevant legislation.
Academic Inputs:
Finance
Students
Academic Staff
Administration and Support Staff
Administrative Systems
Management and Governance
Curriculum
Facilities
Learning Materials
Academic Process:
Teaching , Learning and Assessment
Student Support and Guidance
Research and Scholarship
Use of Time and Space
Student Services
Leadership
Community Participation
Quality Management and Enhancement
Outputs
Retention, Progression and Achievement
Skilled Employable Graduates
Internationally Credible Graduates
Economic and Social Development
Producers of New Knowledge
Regulation and Quality Control
In order to obtain evidence for its judgements and recommendations, the accreditation team carries out a number of activities, including;
Reviewing the Institution’s own internal procedures and documents, such as regulations, policy statements, codes of practice, recruitment policy, financial accounts and reports, and minutes of relevant meetings, as well as the self-evaluation document;
Reviewing samples of assessed student work and observing teaching;
Reviewing the adequacy of the resources available to support the delivery of teaching and learning, research and community engagement in line with the Mission and strategic and operational plans of the institution;
Visiting the premises and looking at the facilities and resources;
Meeting with senior management and members of the Board of Directors;
Asking questions of relevant staff;
Talking to students about their experiences;
Talking to alumni and former students;
Meeting with employers and other stakeholders;
Exploring how the Institution intends to transform its provision and introduce the Academic Infrastructure.
Institutional audit is concerned to examine the extent to which the institution has in place the governance and management structures, the finances, infrastructure, learning and human resources and policies practices and procedures to deliver higher education and guarantee the quality and standards of its academic provision and awards. No institution received a fully confident judgement and the review teams concluded that at the time of the visit limited confidence could be placed in four of the institutions and no confidence in three. The three with judgements of no confidence subsequently met the requirements to be awarded provisional operating agreements. All the institutions have requirements that they have to meet to the satisfaction of the review team within 12 months of the initial visit.
Country Healthcare System Structure
