Health Education

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Education
Rwanda has one medical school, 8 schools of nursing, one dental school and one school of public health. The College of Medicine and Health Sciences is located at the University of Rwanda in Butare. The School of Nursing & Midwifery (SoNM) and the School of Dentistry (SoD) are located at the former Kigali Health Institute in Kigali. The School of Public Health is also located in Kigali. There are 5 government schools of nursing and midwifery: Nygatare, Kibungo, Byumba, Rwamagana and Kabgayi.

Physicians
The majority of Rwandan physicians are general practitioners, a term indicating that they did not complete a formal, post-graduate training program in a medical specialty. As of February 2011, there were 470 Rwandan generalist practitioners, 133 Rwandan specialists, and 58 inpatriate specialists working in Rwanda, for a total of 191 specialists (Rwanda Medical Council).

The College of Medicine and Health Sciences (formerly known as the Faculty of Medicine) was established in 1963. In 2013, the College was restructured under the University of Rwanda. The College is the only academic training institution for physicians in Rwanda. The mission of the faculty is to ensure high quality medical education, carry out biomedical research, and provide medical services to the Rwandan population. It seeks to become a center of excellence for medical teaching and research responsive to the health needs of the Rwandan population. The College trains at both the undergraduate and post-graduate level in Rwanda and has three main departments: Medicine, Pharmacy and Clinical Psychology. Training takes place primarily at four teaching institutions: University Teaching Hospital Butare (CHUB), University Teaching Hospital Kigali (CHUK), King Faisal Hospital (KFH), and Kanombe Military Hospital (KMH).

In Rwanda, an undergraduate degree allows a doctor to practice as a general practitioner. Undergraduate education lasts 6 years in general medicine and is followed by one clinical internship year. The number of undergraduate candidates has steadily increased since the reopening of the University after the 1994 genocide.

Postgraduate degrees with a residency component allow doctors to practice as specialists. In 1997, post-graduate training programs in Medicine were launched with Belgian collaboration, and students were required to spend one year in Belgium or France during their training. This program was able to graduate 17 specialists by 2004. In 2005, an in-country training program was launched. Currently, seven post-graduate training programs are available to physicians in Rwanda: Internal Medicine, Pediatrics, Obstetrics-Gynecology, Surgery, Anesthesia, Family and Community Medicine, and Ear-Nose-Throat. Other specialists and sub-specialists are extremely rare in Rwanda and are typically trained abroad.

Nursing and Midwifery
There are currently 9,138 nurses in Rwanda for a population of over 10 million, and most of these nurses have only the minimum level of training. Most nurses and midwives are now being educated in 3-yr programs at schools of nursing and midwifery throughout the country. The School of Nursing & Midwifery, which prepares nurses at the baccalaureate level, offers a Bachelor of Nursing Education degree, a Bachelor’s degree in General Nursing and a Master’s program in Critical Care Nursing. Historically, there have been three levels of training for nurses and midwives in Rwanda—A2, A1, and A0. A2 level nurses and midwives are trained to the secondary school level while A1 nurses and midwives have an advanced certificate following three years of tertiary education. A0 nurses and midwives possess a bachelor’s degree, and often become faculty members. Beginning in 2006, the Ministry of Health stopped training and deploying A2 level nurses and midwives, deeming their skill sets insufficient to provide quality patient care. The minimum requirement for a Rwandan nurse is now A1, though many health facilities continue to be staffed by mostly A2 nurses due to the serious shortage of A1 nurses.

Health Management
There are only 7 individuals with any public health training in hospital management roles in Rwanda. The training opportunities for healthcare management are minimal and health management is not a well-developed profession in Rwanda or in the East Africa region. While Rwanda has a School of Public Health, it has not previously had a formal health management training program. As a result, management capacity in hospitals is variable and often substandard.