Historical context of Abajyanama b’Ubuzima Program
Rwanda started its community health program in 1995 after the genocide against the Tutsi. There are four main objectives of the program:
Strengthen the capacity of decentralized structures to allow community health service delivery;
Strengthen the participation of community members in community health activities;
Strengthen Community Health Workers (CHWs) motivation through Community
Performance-Based Financing (CPBF) to improve health service delivery;
Strengthen coordination of community health services at the central, district, health center, and community levels (Rwanda Ministry of Health. National Community Health Strategicm Plan July 2013–June 2018).
By 2005, the program had grown to over 45,000 CHWs (There are three CHWs in each village: a male-female CHW pair called binômes). From 2005, after the decentralization policy had been implemented nationally, the Ministry of Health (MOH) increased efforts to train and provide supplies to CHWs to deliver Maternal and Child Health (MCH) services.
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