ArticleGlobal health action2015
Improving district facility readiness: a 12-month evaluation of a data-driven health systems strengthening intervention in rural Rwanda.
Article in Global health action, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Methods to derive composite indicators used for quality and safety measurement and monitoring in healthcare: a scoping review.Frontiers in health services · 2026Pooled it
- The complexity of inequity: rethinking global health through lived experience, power, and structural vulnerability.International journal for equity in health · 2026Article
- Integrated management of childhood illness in Rwanda: Impact of mentorship on the quality of care in Nyanza and Huye districts.Public health challenges · 2024Article
- Readiness to provide child health services in rural Uttar Pradesh, India: mapping, monitoring and ongoing supportive supervision.BMC health services research · 2021Article
- Factors associated with the performance of routine health information system in Yaoundé-Cameroon: a cross-sectional survey.BMC medical informatics and decision making · 2020Article
- Successful implementation of a combined learning collaborative and mentoring intervention to improve neonatal quality of care in rural Rwanda.BMC health services research · 2018Article
- Advancing the health of women and newborns: predictors of patient satisfaction among women attending antenatal and maternity care in rural Rwanda.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2018Article
- A Comparison of Health Achievements in Rwanda and Burundi.Health and human rights · 2018Article
- Article
- Data-driven quality improvement in low-and middle-income country health systems: lessons from seven years of implementation experience across Mozambique, Rwanda, and Zambia.BMC health services research · 2017Article
- Article
- Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.PloS one · 2017Article
- Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.Journal of the International AIDS Society · 2016Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-level HSS intervention in two rural districts of Rwanda.
designThe partnership provided limited funds to 14 health centers for targeted systems support in 2010; six others received support prior to the intervention (reference). RMOH health systems norms were mapped across the WHO HSS framework, scored from 0 to 10 and incorporated into a rapid survey assessing 11 domains of facility readiness. Stakeholder meetings allowed partnership leaders to review results, set priorities, and allocate resources. Investments included salary support, infrastructure improvements, medical equipment, and social support for patients. We compared facility domain scores from the start of the intervention to 12 months and tested for correlation between change in score and change in funding allocation to assess equity in our approach.
resultsWe found significant improvements among intervention facilities from baseline to 12 months across several domains [infrastructure (+4, p=0.0001), clinical services (+1.2, p=0.03), infection and sanitation control (+0.6, p=0.03), medical equipment (+1.0, p=0.02), information use (+2, p=0.002)]. Composite score across domains improved from 6.2 at baseline to 7.4 at 12 months (p=0.002). Across facilities, 50% had composite scores greater than the average score among reference facilities (7.4) at 12 months compared to none at baseline.
conclusionsRapid facility surveys, stakeholder engagement, and information feedback can be used for gap analysis and resource allocation. This approach can achieve effective use of limited resources, improve facility readiness, and ensure consistency of facility capacity to provide quality care at the district level.
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