Rwanda is a country emerging from war and disruption, and is heavily reliant on external aid. Donors currently pay for nearly all capital expenditure and up to 50% of recurrent health spending costs. An accord was signed in 2002 between SDC and the Government of Rwanda for the continuation of SDC support to the health sector at the level of the province in Kibuye province (Kibuye Public Health Project), for which the Swiss Tropical Institute (STI) would take the role of implementing agency. A project assistance unit has been set up by STI to work closely with the Provincial Health Office in Kibuye province.

The project aims to strengthen the planning and development of cost-effective “minimum” and “complementary” packages of preventive and curative care in the four Health Districts of Kibuye province, within the context of decentralisation and with the participation of the population. The financial volume is CHF 3,5 million over 2.5 years (until 31.12.2004). The expected outputs concentrate on four areas:

1. Increased community participation in the management of Health Districts and facilities and improved financial accessibility through the piloting of community financing schemes.
2. Improved implementation of the “minimum” and “complementary” service packages in the 4 Health Districts, focusing on the prevention and treatment of malaria, HIV/AIDS and childhood diseases (vaccine preventable, diarrhoea, respiratory infections).
3. Enhanced capacity of the four Health District management teams to plan, finance and manage health services.
4. Increased capacity of the Provincial Directorate for Health to co-ordinate, plan and finance the health sector decentralisation process and the provision of public health services in the Province.