The 4x4 Reform: A Path to Quality Health Care in Rwanda

In July of 2023, the Government of Rwanda approved the 4x4 Reform, a visionary strategy aimed at quadrupling the number of healthcare workers in the country within the next four years to meet the WHO recommendation of at least 4 healthcare professionals per 1,000 population density. This strategic initiative builds upon the groundwork laid out in the National Strategy for Health Professionals Development (NSHPD) 2020-2030 and aligns with the MOH’s Strategic Priorities 2023-2025, which aims at improving the primary healthcare system and public health security through promoting evidence-based medicine and systems, enhanced leadership, and digital integration approaches, among others.

Under the 4x4 reform, the health sector is projected to expand its pool of health professionals, including residents, fellows, general practitioners, dental surgeons, pharmacists, nurses, midwives, and allied health sciences personnel. By the year 2028, this ambitious plan aims to increase the health workforce by a total of 32,973 personnel.

Under the 4x4 reform, the health sector is projected to expand its health workforce by a total of 32,973 personnel.

Achieving this goal necessitates collaboration with various partners, stakeholders, and sector institutions; and in November 2023, the Ministry of Health (MOH) and the Ministry of Education signed a synergy Memorandum of Understanding (MoU) with 31 institutions including 13 higher learning institutions, 14 teaching hospitals and 4 professional councils to commit to work together and share knowledge and resources where needed to increase Rwanda’s health workforce. As part of this initiative, five new training programs were launched in partnership with the University of Rwanda before the year’s end, expediting the implementation of the 4x4 strategy.

The attainment of this bold strategy would also entail not only increasing the quantity and quality of trained health professionals in priority programs but also focusing on recapturing local faculty and hiring visiting faculty to fill immediate teaching needs, improve training capacity, and enhance teaching facilities.

It is important to note that the 4x4 reform is being implemented alongside other strategic initiatives including strategic acquisition of medical equipment, revamping of the Community Health Workers program and retention of healthcare workers, among others, which will undoubtedly exemplify Rwanda’s unwavering determination to create a healthier, more resilient nation with impactful change that will transcend national boundaries and be immeasurable.

Related:

4X4 Reform: Executive Summary  

4x4 Reform: Towards Quadrupling the Current Health Workforce in 4 Years


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