Medicine, Nursing and Allied Health Professions

Dr Adam Bitunguramye, GP at Munini Hospital, Republic of Rwanda

New Munini Hospital (Jan 2021), Republic of Rwanda

Primary care in Rwanda and reasons to join the course



Dr Adam Bitunguramye, GP at Munini Hospital, Republic of Rwanda shares his thoughts on primary care in Rwanda and why he would like to join the course

Primary health care is fundamental to the health promotion in Rwanda. It is delivered from the community level by the community health workers to health posts and health centers by nurses and the district hospital level include medical doctors in the care of patients.

It basically offers a package consisting of different activities such as promotional, preventive and curative.

Promotional activities include  information, education, and communication (IEC); psychosocial support; nutritional activities related to small farming and food preparation; community participation; management and financing of health services; home visits; and hygiene and sanitation in the catchment area around the health center. 

Preventive activities are premarital consultation, ANC, postpartum care for the mother and child, family planning counseling and services, school health, and epidemiologic surveillance activities.

Curative activities such as consultations, management of chronically ill patients, nutritional rehabilitation and curative care, observation before hospitalization, normal deliveries, minor surgical interventions, and laboratory testing are given at the level of a health center.

District hospitals will receive referred cases from Health centers and manage them with more laboratory services and Imaging as well. In addition, some minor and major surgeries are carried out here and would refer complex cases to the tertiary-level.

Rwanda has achieved the universal health coverage largely due to the insurance scheme known as the Community-based health insurance or Mutuelle de Santé which is an equity-rooted insurance scheme. The latter has unanimously increased the accessibility to health care services and thus has played a huge role in the health promotion of many people especially those ones with limited financial means. To highlight this, over 90% of Rwandans have health insurance coverage

For further details download an overview of the health system in Rwanda.

Why am I interested in the course?

I am applying to take the course of “Principles of Primary Care International” because I want to acquire more knowledge and skills in order to be able to improve the health of the population especially in the remote area of Rwanda where infrastructure usually hinders the effective delivery of primary care services including but not limited to poor antenatal care and contribute to increased maternal mortality. So far Rwanda decreased the maternal mortality ratio to 210 deaths/100,000 live births according to the Rwanda Demographic and Health Survey 2014-2015 which is still three times the SDGs- Goal 3 aiming at decreasing the later to less than 70 deaths/100000 live births by 2030.

The majority of the above deaths are preventable and might be directly or indirectly linked to inadequate antenatal care. Upon completing this module, I will be in the position to undertake research on how to increase antenatal care, especially in the rural community.

I envision doing a Master of Public Health as well to further my knowledge about research. I convincingly believe that you can offer more to the world once you have more as well, therefore pursuing further knowledge in a good University like Exeter would be my next goal.

Finally, I would say that studying at the University of Exeter would be the bridge to some important professional and academic connections that are needed to benefit from partnerships in the long-term and to be a renowned public health expert who would offer his best to the community.