Background: The Rwanda Human Resources for Health Program (HRH Program) is a 7-year (2012-2019) health professional training initiative led by the Government of Rwanda with the goals of training a large, diverse, and competent health workforce and strengthening the capacity of academic institutions in Rwanda. Methods: The data for this organizational case study was collected through official reports from the Rwanda Ministry of Health (MoH) and 22 participating US academic institutions, databases from the MoH and the College of Medicine and Health Sciences (CMHS) in Rwanda, and surveys completed by the co-authors. Results: In the first 5 years of the HRH Program, a consortium of US academic institutions has deployed an average of 99 visiting faculty per year to support 22 training programs, which are on track to graduate almost 4600 students by 2019. The HRH Program has also built capacity within the CMHS by promoting the recruitment of Rwandan faculty and the establishment of additional partnerships and collaborations with the US academic institutions. Conclusion: The milestones achieved by the HRH Program have been substantial although some challenges persist. These challenges include adequately supporting the visiting faculty; pairing them with Rwandan faculty (twinning); ensuring strong communication and coordination among stakeholders; addressing mismatches in priorities between donors and implementers; the execution of a sustainability strategy; and the decision by one of the donors not to renew funding beyond March 2017. Over the next 2 academic years, it is critical for the sustainability of the 22 training programs supported by the HRH Program that the health-related Schools at the CMHS significantly scale up recruitment of new Rwandan faculty. The HRH Program can serve as a model for other training initiatives implemented in countries affected by a severe shortage of health professionals.

The observed mortality rate was in the range reported in other resource-limited settings. The initial attempt to create and implement a risk of mortality tool for this setting determined a score that could identify those patients at higher risk of mortality. In PICUs in resource-limited settings, the gathering of data and use of severity of illness tools could improve care in a number of ways.

Background Irrational drug use is a worldwide problem at all levels of health care, especially in hospitals. Prescribers in community tend to omit hospital prescribing practices, thus this problem is present at all levels of health care. Use of medicines can be greatly improved and wastage reduced if simple principles of drug management are followed. To help in solving this problem, World Health Organization (WHO) has designed prescribing core indicators that were used to evaluate drug prescription patterns in Rwanda Social Security Board (RSSB) affiliated patients.Material and Methods A retrospective cross-sectional study with quantitative analysis was carried out for a period of six months. Among the 1000 prescriptions collected, 18 of them were rejected for not fulfilling the inclusion criteria, the remaining 982 prescriptions were almost distributed equally from either private and public hospital or clinics. The study analyzed prescriptions from health facilities located in Kigali City, Rwanda. The results were presented in table with comparisons with the WHO prescription indicators.Results The average number of drugs per prescription is 2.4 which is higher than 1.8 recommended by WHO. The percentages of drugs prescribed with a generic name and those from National Essential drug List are 28.5% and 61.1% respectively, which are very low compared to WHO target of 100% for both core prescribing indicators. The percentage of encounters with an antibiotic prescribed is 42.5% and the encounters who received an injections account 1.2%.Conclusion This study revealed that there is a big gap in implementing WHO core indicators of prescription and concerned stakeholders should take measures to address this issue.