In the fight against NCDs, the bottom billion is too often forgotten. There is a need to first work and breath in the most challenging settings as to understand the daily realities. Only then can we close the gap between the call for action and the delivery of quality care.
— Paul Park, Deputy Chief Medical Officer of Chronic Disease

Non communicable diseases lead to more deaths globally than all other causes combined. Diseases more commonly associated with wealthy countries such as diabetes, hypertension, and heart failure are both prevalent and rising in developing countries. In Rwanda we developed in collaboration with Rwandan Ministry of Heath an innovative model that integrates treatment of hypertension, heart failure, diabetes, and asthma. This model makes high quality NCD treatment feasible in low resource settings. After demonstrating success, the Government of Rwanda implemented NCD clinics nationwide based upon this model. Our goal is to help Rwanda implement a model of high quality NCD care that is accessible to all Rwandans in need.


Decentralizing care

By training nurses to be able to do tasks typically performed by physicians such as prescribe basic medicines for NCDs we were able to bring care out into the rural regions of the country including district hospitals and health centers. This model creates a working solution to the shortage of physicians and specialists in developing countries. Additionally, by integrating the care of hypertension, heart failure, diabetes, and asthma we are able to more effectively use the limited resources available. 


Capacity building

We provide regular trainings for doctors and nurses working at the three district hospitals we support on the diagnosis and management of noncommunicable diseases. Hospital staff also receives monthly mentorship from specialist including a cardiologist and endocrinologist. We also teach non clinical skills such as management, administration and organization of clinics. We develop individualized trainings for health centers and hospitals based upon pre-identified areas for improvement. Nurses at NCD clinics are trained in echocardiography; an essential tool for heart failure management. As NCD clinics are established across the country, we train new staff and then follow up with routine mentorship and supervision. Nurses working at the district hospitals are trained to become experts in their field and then go on to train nurses at the health centers in their districts. 

Scaling Up

As the Government of Rwanda works to implement NCD clinics across the country we continue to provide technical support. We are working with MOH to establish implementation work plans to make sure that all thirty districts have robust, well-equipped, and well-staffed NCD clinics that are integrated into the primary care structure. To improve the quality of care, the quality of data collection, and the quality of research conducted we are working to establish new national paper and electronic forms.  Our monitoring and evaluation team helps to ensure clinics are meeting national standards, adhering to set protocols, and works with the MOH staff to minimize waiting times and minimize patients lost to follow-up.