Health posts, the lowest form of health facility in Rwanda's healthcare system, now lead the country’s healthcare network constituting 57.5% of all health facilities nationwide with a total of 1,280 facilities including 102 second-generation health posts (SGHPs), officials said on Thursday, January 16. ALSO READ: Government to upgrade 1,000 health posts by 2025 Health posts are the basic public or subsidized health facilities that provide minimum services at cell level. Providing oversight to the health posts are health centers at sector level which offer all primary healthcare services. Health posts are located far from health centers and offer a reduced package of activities, including curative outpatient care, child immunizations, growth monitoring for children under 5 years, antenatal care and family planning counselling, health education and a few laboratory tests (most particularly rapid tests). The demand for services at health posts has grown from just 71,212 visits in 2016-2017 to 3.96 million visits in the 2023-2024 period, the Minister of Health, Dr. Sabin Nsanzimana, said as he addressed the Senate, highlighting the critical role health posts play in bringing healthcare closer to communities. ALSO READ: The year Rwanda fought off two epidemics and achieved key milestones in delivering healthcare services “Health posts reduce the distance people need to travel while ensuring quality and a wide range of services. Over the next five years, 100 new health posts will be established and 420 existing ones will be rehabilitated,” he said, noting that nearly 50% of the country’s health posts are managed by private operators with the rest under health centers. ALSO READ: Rwanda to roll out tech for health payment, insurance transparency Health posts in Rwanda are categorized into two types; first-generation health posts (FGHPs) and second-generation health posts (SGHPs). The former provide basic healthcare services including malaria and pregnancy testing, short-term family planning, growth monitoring for children under five, antenatal care and health education. In contrast, second-generation health posts offer advanced services such as maternity care, laboratory testing, dental care, ophthalmology and circumcision services. The minister emphasized that strengthening and enhancing health posts is a cornerstone of the five-year health sector strategic plan (HSSP). The strategy includes addressing staffing shortages and expanding the range of services to include primary maternal and child healthcare as well as dental and eye care services in second-generation health posts. Challenges and strategic interventions While the government’s goal is to establish a health post in every Cell, Sen. Alexis Mugisha pointed out the need for thorough assessments, noting disparities in cell populations. “Some cells are densely populated, while others have fewer residents. This variation should guide resource allocation,” he suggested. ALSO READ: Rwanda looks to quadruple healthcare workforce Dr. Nsanzimana acknowledged that 80% of health posts operate regularly, while 20% face challenges including a shortage of nurses. To address this, the government introduced the “4x4” reform, a strategy aimed at quadrupling the number of healthcare workers within the country over the next four years. Infrastructure challenges are also being tackled through public-private partnerships. The Ministry of Health equipped 97 health posts in remote areas without electricity with solar panels and Starlink internet to ensure uninterrupted service delivery. Sen. Amandin Rugira pointed out that while many people in Rwanda typically visit health posts only when they feel unwell, these health posts should also offer routine checkups. This would help in early detection of health issues leading to better treatment outcomes and reduced healthcare costs, he suggested. Financial sustainability Responding to concerns about financial sustainability, Dr. Nsanzimana outlined key measures being implemented including a services package offered by health posts that was upgraded and a revision of health service tariffs that is underway. He added that Rwanda Social Security Board (RSSB) introduced the intelligent health benefit system (iHBS Kwivuza), thereby reducing payment delays from 120 days to just 15 days.
