SERVING THE MOST RURAL AND DISADVANTAGED IN RWANDA

Dr. Alex Coutinho

February 28, 2018 2

IMB SUPPORTS THREE SITES ACROSS RWANDA

S. Kayonza (since 2005)

> 300,000 people

District Hospital with 150 beds

8 Health Centers

Rwinkwavu District Hospital

Kirehe (since 2006)

> 350,000 people

District Hospital with 226 beds

16 Health Centers

Kirehe District Hospital

Burera (since 2008)

> 300,000 people

District Hospital with 156 beds

19 Health Centers

Burera District Hospital

This year, these three district hospitals were ranked among the top 10 hospitals of

Rwanda after accreditation assessment; with results of 80% and more.

February 28, 2018 3

ACROSS SITES, PIH OFFERS A VARIETY OF SERVICES TO THE MOST RURAL AND DISADVANTAGED

Neonates

Mental Health

Oncology NCD

CHWs

February 28, 2018 4

AS OF JULY 2016, ALL PIH-SUPPORTED HOSPITALS HAVE A NICU

5% of children in Rwanda die before they reach the age of 5, and almost 40% of these deaths occur in the first month of life.

Kirehe was the last of the three to open a NICU; since opening in July 2016, it has served 617 babies.

Source: DHS 2014-2015.

Rwinkwavu Hospital NICU

PIH Co-founder Ophelia Dahl visiting KireheHospital NICU

A premature baby receiving phototherapy in ButaroHospital NICU

February 28, 2018 5

A CANCER DIAGNOSIS IS NO LONGER A DEATH SENTENCE IN RWANDA, EVEN FOR THE RURAL AND DISENFRANCHISED

Nurse Christophe Rwagema administers

chemotherapy to Esther Kabagwira at Butaro

Ambulatory Cancer Center. Esther is being treated

for an early stage breast cancer

Dr. Egide Mpanumusingo, PIH/IMB Burera District

Clinical Director, discussing with patients in the

garden of the Butaro Ambulatory Cancer Center.

Photo by Dr. Alex Coutinho

Dr. Fidel Rubagumya and Pediatric

Cancer Patient at BCCOE

February 28, 2018 6

THE BUTARO CANCER CENTER OF EXCELLENCE CONTINUES TO SERVE THE PEOPLE OF RWANDA

We reduced the

time patients

waited for biopsy

lab results from 7

weeks to 5 days

We referred

100 patients

for radiotherapy

We provided high

quality care and

followed up with

3,802 patients

In the last year….

February 28, 2018 7

PIH OPENED A NEW PATHOLOGY LAB, INCREASING THE TURNAROUND OF RESULTS FOR PATIENTS

In October 2016, a new pathology opened at BCCOE funded by the American Society of Clinical Pathology

Reducing the average turnaround time between pathology between biopsy and results from 7 weeks to 5 days

Dr. Deo Ruhangaza, Butaro Hospital pathologist,

analyzing digital slides in the pathology lab

Lab technician Gaspard Muvugabigwi gives a tour of the

pathology lab at Butaro District Hospital. Photo by Cecille

Joan Avila

February 28, 2018 8

AN INTEGRATION OF MENTAL HEALTH ENSURES THAT THE WHOLE PATIENT IS TREATED

Bashar, beneficiary of our mental health program, and his

sister sit near the family’s home together with the MOH nurse

from Kinyababa health center and Sifa Dorcas, PIH/IMB

Mental Health Community and Social Support coordinator who

are visiting them

Bashar and Dorcas confer near his family home. A year ago, Dorcas

helped Bashar, a farmer who was suffering from hallucinations and

paranoid delusions, get his illness diagnosed and treated.

February 28, 2018 9

PIH/IMB HAS CONTINUED TO INTEGRATE MENTAL HEALTH INTO PRIMARY CARE ACROSS RWANDA

After 2 years, mental health is integrated in 19 health centers of the Burera District:

48 primary care health center nurses received intensive decentralized training on the practical aspects of clinical care of patients with severe mental disorders and epilepsy.

946 CHWs were trained on the identification of patients with severe mental disorder, and supported by PIH/IMB to ensure appropriate patient follow-up and integration between levels of care.

Mental health service integration is now being expanded to the Musanze District, and PIH/IMB is seeking support to expand to Southern Kayonza and Kirehe Districts

The number of Mental

Health patients visit at

Health Centers increased

from 2,252 (FY16) to 3,351

(FY17)

Patients experienced an

average of 54%

improvement in symptoms

after 6 months

February 28, 2018 10

NCD CLINICS OFFER A VARIETY OF SERVICES

NCD counseling for children with diabetes.

Nurse Clemence during her first consultation at the

new NCD Clinic of Rutare Health Center

February 28, 2018 11

PIH/IMB HAS PROVIDED INCREASED ACCESS TO NCD CARE

In collaboration with the MOH, PIH/IMB developed an innovative model that integrates hypertension, heart failure, diabetes, and asthma.

The MOH has decided to implement NCD clinics nationwide based upon our model.

In FY17 we contributed to the opening of 3 new health center level NCD clinics in Southern Kayonza, and 4 in Kirehe.

We have seen 90% of

our NCD patients

attend their next

scheduled appointment

these past 6 months

We provided high

quality care and

followed up with 3,438

patients

We helped 60% of our

diabetes patients

achieve glycemic control

(Hba1C<8%)

February 28, 2018 12

CONTINUED EVOLUTION OF COMMUNITY HEALTH WORKERS’ ACCOMPANIMENT

Nutrition

Malaria Testing & Treatment

Anti Retroviral Treatment

February 28, 2018 13

CHWS CONTINUE TO SUPPORT HIV-POSITIVE PATIENTS

83% of Rwandan patients have demonstrated viral load suppression, indicating they can successfully take their medication as prescribed.

In July 2016, PIH/IMB and RBC officially launched a new initiative – targeted Community-based Accompaniment for those with proven adherence challenges.

CHW Mukamana with HIV patient. CHWs providing pediatric HIV accompaniment.

February 28, 2018 14

CHWS CONDUCT NUTRITION EVALUATIONS

February 28, 2018 15

CHWS PROVIDE MALARIA TREATMENT

CHWs explaining their

work, including malaria

treatment