The expansion of primary health care
creates new jobs in Rwanda

In recent years, Rwanda has made significant progress in expanding its health system. Both the quality of medical care and access to health insurance have improved greatly. But pressure on the health system will remain high. Rwanda’s population is expected to increase to more than 14 million people by 2027. This would correspond to a growth of 40 percent within 15 years. Since 2011, the Ministry of Health has been working to establish so-called Health Posts throughout the country. The facilities are under the supervision of the state Health Centres and intended to ensure a basic level of medical services for the population living in the surrounding areas. This includes vaccinations, curative treatments and therapies, prenatal care, and laboratory tests. Second-generation Health Posts also offer dental services and support for patients with diabetes and heart diseases.

The Health Posts offer a first point of contact for all health-related questions. Citizens can get advice there on family planning issues, and regular health checks can be carried out for children up to the age of five. The government relies specifically on cooperation with private and civil society organisations for the establishment and operation of the Health Posts. It is a key objective that citizens should not have to walk for more than 30 minutes to reach a Health Post.

The NGO Society for Family Health (SFH), founded in 2012, will use two separate grants by the Facility Investing for Employment to build, equip and operate 100 new second-generation Health Posts. A grant agreement signed in 2022 provides for the construction of 80 Health Posts in 12 districts of the country. 40 have already been completed, and nine of them are operational. Another 20 second-generation Health Posts will be in the districts Burera, Rusizi, Nyamasheke and Nyagatare in northern and south-western Rwanda. These parts of the county still have a lack of medical facilities. Their construction is co-financed under a separate grant agreement that was signed in 2024.

The project is being carried out in close cooperation with the Rwandan Ministry of Health. A single Health Post is designed to provide basic medical care for 5,000 to 7,000 people and can treat up to 120 patients daily. The single-storey buildings are largely standardised. On 200 square meters of floor space, they include, among other things, two consultation rooms, a small laboratory, observation and treatment rooms as well as a storeroom for medical supplies. Sanitary facilities and a waiting area for up to 60 people are located outside.

An online system for the Health Posts is being developed by a specialised IT service provider. It will be used to manage appointment bookings, treatments, billing processes and patient files. The new Health Posts will be open around the clock. SFH will also buy seven ambulances. If patients need to be hospitalised, the ambulance cars will be used for rapid transfer.

In the coming years, more than 1,260 new full-time positions are to be created to administer and operate the Health Posts. This number includes IT specialists involved in the development of the new online system for health management. An additional 21 people will be hired as ambulance crews. Around 100 new employees will take part in short-term training courses before starting work. To attract staff to remote areas, the employees will receive salaries above the average Rwandan wage. The Health Posts will not depend on government subsidies for their day-to-day operations. The partner NGO Society for Family Health (SFH) will advertise the centres and inform the population about the health services offered. Most employees will be women. The nationwide mandatory community-based health insurance for low-income households will be further strengthened by the new health posts.

SFH plans to invest a total of EUR 8.27 million to build and equip the 100 second-generation Health Posts and to provide the services related to their operation. The Facility Investing for Employment grants a subsidy of EUR 6.65 million (82%). The Facility’s funds will finance the construction of the Health Posts, their equipment with medical technology and IT systems, the training of employees and the purchase of the seven ambulances.

The Facility Investing for Employment (IFE) of KfW Development Bank is part of the Special Initiative "Decent Work for a Just Transition" of the German Federal Ministry for Economic Cooperation and Development (BMZ). With its support, the Facility wants to remove barriers that prevent the creation of new and better jobs in the private sector.