Rwanda is working to expand access to healthcare through telehealth initiatives that train medical professionals and improve care in rural areas. The country faces challenges in ensuring specialists and continuing education are available nationwide. Tulane University is partnering with Rwandan institutions to establish telehealth programs that enable distance learning for health workers, remote patient monitoring, and specialist consultations between hospitals. These telehealth services aim to enhance medical education, reduce transfer costs, and expand availability of care across Rwanda.

1. TeleHealth in Rwanda -
Training the next gen of health professionals
Mike B. Ndimurukundo, MBA
Program Manager
Tulane University, Rwanda

2. Rwanda

6. Tulane University in Rwanda:
Human & Institutional Capacity Building

7. Collaborating Institutions
• University of Rwanda- College of Medicine and
Health Sciences
• Ministry of Health
• Ministry of Education
• Ministry of ICT
– Rwanda Information Society Agency (RISA) - Smart
Rwanda Implementation

9. A few stats…..
• Number of health professionals increased from
11,604 to 18,577
• Specialized physicians represent only 28.3% & are
based in Kigali even though 85% of the
population lives in rural areas
• More than 70% of population with health
insurance
• Transport costs & living expenses still high for
patients from rural areas
• Access to CME for doctors in rural areas still a
challenge

10. Rwanda’s Health System
Teaching hospitals
~ 250
~ 255, 000
National
(~12 m)
Health care
delivery system
Av. Catchment
area pop
Health centers
Health posts
No. of public
facilities / CHWs
472
56
45,000
District hospitals
~ 23 000
Type of service offered
▪ Specialized hospitals serving the entire country
▪ Medical training
▪ Provide government defined “minimum package of
activities at the peripheral level (MPA)
▪ This includes complete and integrated services such as
curative, preventive, promotional, and rehabilitation
services
▪ Supervise health posts and CHWs operating in their
catchment area
Community-based :
• Prevention, screening and treatment of malnutrition
• Integrated Management of Child Illness (CB-IMCI)
• Provision of family planning
• Maternal Newborn Health (C-MNH)
• DOT HIV, TB and other chronic illnesses
• Behavior change and communication
Provinces (5)
Sector (416)
District (30)
▪ Provide government defined “Complementary package of
activities (CPA) (C-section, treatment of complicated
cases,..
▪ Provide care to patients referred by the primary health
centers
▪ Carry out planning activities for the health district and
supervise district health personnel
42
5
▪ Services provided are similar, albeit reduced from, that by
Health Centers.
▪ Established in areas which are far from health centers,
▪ Services include curative out-patient care, certain
diagnostic tests, child immunization, growth monitoring for
children under five years, antenatal consultation, family
planning, and health education
Village (14,837)
Cell (2148)
Administrative
structure
Community
Health
Workers
80% of burden of disease addressed at this level

11. Policies in place
• Strong political will to use ICT in all aspects of
development of Rwanda
• Vision 2020 to be a knowledge based economy &
middle income country & IT Hub in Africa
• Economical Development & Poverty Reduction
Strategies I & II
• National ICT Strategy & Plan (NICI)
• SMART Africa Manifesto developed during
Transform Africa 2013 in Kigali.

12. Telehealth for quality education &
clinical services
• Support the education programs (esp. clinical teaching
programs)
• Support rural health workforce to access to continuous
professionals development within their health facilities
• Reduce the costs of care for remote patients who live
in rural areas
• Reduce the delays associated with patient transfers
• Bring unavailable services in rural areas and rest of the
country
• Avail home care services for chronic diseases using
mobile devices.

13. Telehealth Services
• Distance learning
– Health professionals
– Students
• Remote patient care & monitoring
• Store and forward applications
• Workforce development

14. UR-CMHS approach

15. UR-CMHS approach

18. Telehealth for Physicians
• Post-grad training of physicians in specialty areas
• Knowledge exchange across sites within Rwanda, and
with external experts (e.g. case review and lectures
with partner institutions)
• Facilitating in remote diagnosis and treatment between
referral and district hospitals
• Improve access to medical knowledge source, both
within Rwanda and worldwide
• Reduce the number of transfers cases
• Reduce the cost of continuous medical education
programs

22. Murakoze!
Mike B. Ndimurukundo
mndimuru@tulane.edu
@mikebago