Managing for Managing for Results: RwandaResults: Rwanda

Louis Munyakazi Louis Munyakazi General DirectorGeneral Director

National Institute of StatisticsNational Institute of Statistics

Pamela JohnsonPamela JohnsonEVPEVP

Voxiva Voxiva

OutlineOutlineRwandaRwanda

Commitment to ResultsCommitment to Results Rwanda 2020Rwanda 2020 EDPRS EDPRS Performance ContractsPerformance Contracts

Monitoring ResultsMonitoring Results Statistics Statistics

Investing in ICTInvesting in ICT NICI Plan NICI Plan Mobile CoverageMobile Coverage

Innovation in IT: TRACnetInnovation in IT: TRACnet Collecting Data from Health FacilitiesCollecting Data from Health Facilities Data for Decision-makersData for Decision-makers

I. Commitment to I. Commitment to ResultsResults

Rwanda 2020: Rwanda 2020: Strategic Framework Strategic Framework for Resultsfor Results

EDPRS EDPRS

Performance ContractsPerformance Contracts

Citizen Report CardsCitizen Report Cards

In our case, in Rwanda . . In our case, in Rwanda . . ..

““, we are determined to engender a , we are determined to engender a statistics culture that must place us statistics culture that must place us on an effective path of evidence-on an effective path of evidence-based policy making.” based policy making.”

H.E. Paul KAGAMEH.E. Paul KAGAMEPresident of the Republic of RwandaPresident of the Republic of Rwanda

II. The Importance of II. The Importance of DataData

Data needed for decisionsData needed for decisions

Data for accountabilityData for accountability

Data for managementData for managementMore timely - - More timely - - not just after the fact not just after the fact

If you don’t count, you don’t countIf you don’t count, you don’t count

NATIONAL STATISTICAL SYSTEMNATIONAL STATISTICAL SYSTEM

Education

Système Administratif

Commerce / Industrie

Santé (TRACnet& HMIS)

Agriculture

INSR

NSDS guidelines

NSDS guidelines

Information FlowInformation Flow

Cell Level Source of Basic StatsBasic unit = 10 or more houses

Sector Level416 sectors

District Level30 districts

Regional Level5 regions

Flow of R

eliable Data

Flow of decision

III. Investing in ICTIII. Investing in ICT 2nd National Information & 2nd National Information &

Communications Infrastructure Plan Communications Infrastructure Plan (2006 to 2010)(2006 to 2010)

Investment - - 2.5% GDP per annumInvestment - - 2.5% GDP per annum Private Sector, e.g.Private Sector, e.g.

Mobile phone networkMobile phone network TechnologyTechnology ICT ParkICT Park

IV. IT for ResultsIV. IT for Results TRAC: Oversees national HIV/AIDS, malaria TRAC: Oversees national HIV/AIDS, malaria

and TB programs and TB programs TRACnet: TRACnet:

An innovative data collection and An innovative data collection and communication tool communication tool

Collects program indicators and other data from Collects program indicators and other data from health facilities health facilities

Sends feedback from authorities and specialists. Sends feedback from authorities and specialists. Developed by Voxiva - - with support from the US Developed by Voxiva - - with support from the US

Centers for Disease Control Centers for Disease Control

Data collectionData collection

CellPhone

Hosted Software

And TelecomInfrastructure

TheInternet

Tele-Phone

PayPhone

PDA

Web View ofApplication

Field communication and Field communication and data retrievaldata retrieval

CellPhone

Hosted Software

And TelecomInfrastructure

TheInternet

Tele-Phone

Web View ofApplication

PayPhone

J2ME

Dummy Data

TECHNOLOGY DATA BASEDATA, DASHBOARDS

Field communication and Field communication and data retrievaldata retrieval

CellPhone

Hosted Software

And TelecomInfrastructure

TheInternet

Tele-Phone

Web View ofApplication

PayPhone

J2ME

Dummy Data

DATA, DASHBOARDS

TECHNOLOGY DATA BASE

How TRACnet How TRACnet WorksWorks

Level 2 Consolidation

Aggregate and Verify

Analyze and Make Decisions

Level 3 Consolidation

Store and Interpret

Central Level

Submit Data

Capture and Analyze

Communicate and Disseminate

Analyze and Make DecisionsShare Data and

Receive Feedback

Before

After MOH, TRAC, CAMERWA, NATIONAL LABORATORY

Day

s, W

eeks

, M

onth

sSe

cond

s

ResultsResults

CoveragCoveragee

Deployed in all 133 health facilities offering Deployed in all 133 health facilities offering ART in Rwanda, accounting for 100% of all ART ART in Rwanda, accounting for 100% of all ART patients in Rwanda (30,000+). Currently, the patients in Rwanda (30,000+). Currently, the system has baseline patient data on 9000 + system has baseline patient data on 9000 + individuals. Seven health facilities are using individuals. Seven health facilities are using the system to retrieve lab results (CD4 Count).the system to retrieve lab results (CD4 Count).

Trained Trained PersonPerson

nelnel

More than 500 site level users have been More than 500 site level users have been trained and are using the system to submit trained and are using the system to submit monthly program indicator reports and weekly monthly program indicator reports and weekly consumables (drug) reports. consumables (drug) reports.

AccessAccess

Most users (90%) access the system via the Most users (90%) access the system via the toll-free telephone interface, thereby toll-free telephone interface, thereby minimizing infrastructure-linked constraints minimizing infrastructure-linked constraints (unreliable power supply, poor or non-existent (unreliable power supply, poor or non-existent internet connection), as well the cost of internet connection), as well the cost of accessing the internet.accessing the internet.

User User AdoptioAdoptio

nn

Anecdotal evidence has shown that most health Anecdotal evidence has shown that most health facility personnel own mobile phones, and that facility personnel own mobile phones, and that those who have a phone, and are accustomed to those who have a phone, and are accustomed to using text messaging features, demonstrate an using text messaging features, demonstrate an ease of use after 15-30 minutes of training.ease of use after 15-30 minutes of training.

Monthly. Monthly. 95% on time.95% on time.

Paper-based. Paper-based. SlowSlow

CompletenCompleteness.Timeliess.Timeli

nessness

Reporting of Reporting of program program

indicatorsindicators

Time from Time from sample to sample to receipt of receipt of results results

Facilities Facilities offering offering

treatmenttreatment

# patients # patients on ARTon ART

MeasureMeasure Jan 07Jan 07Jan 05Jan 05

3 days3 days

133133

31,00031,000

2 weeks2 weeksTest ResultsTest Results

1616Participating Participating Healthcare Healthcare FacilitiesFacilities

3,0003,000Rwanda’sRwanda’s

ARV TreatmentARV TreatmentScale-upScale-up

TRACNet was implemented by the Ministry of Health of Rwanda to support scale-up of TRACNet was implemented by the Ministry of Health of Rwanda to support scale-up of HIV/AIDS programs. Here are their results…HIV/AIDS programs. Here are their results…

ResultsResults

Data use:Data use: Monitor facility, district, national Monitor facility, district, national

performanceperformance Managing scale-upManaging scale-up Ensuring drug supplyEnsuring drug supply Donor reporting Donor reporting EtcEtc

Next Steps:Next Steps:

New Technology, New Technology, e.g. Smart Phonese.g. Smart Phones Improve “ease of use” Improve “ease of use”

and speed of data and speed of data entryentry

Tested in Rwanda Tested in Rwanda with NIS for SCAN-with NIS for SCAN-ICT SurveyICT Survey

Extension to other Extension to other sectors, e.g.sectors, e.g. Consumer Price Index Consumer Price Index

Education

Système Administratif

Commerce / Industrie

Santé (TRACnet& HMIS)

Agriculture

INSR

Next steps: focus on Next steps: focus on districts and health districts and health

facilitiesfacilities

ReflectionsReflections ““The ability to maximise use of information The ability to maximise use of information

is now the single most important factor in is now the single most important factor in deciding the competitiveness of nations…”deciding the competitiveness of nations…”Nelson Mandela Nelson Mandela

““It can be no accident that there is today It can be no accident that there is today

no wealthy developed country that is no wealthy developed country that is information poor….and for that matter no information poor….and for that matter no information rich country that is poor and information rich country that is poor and underdeveloped…”underdeveloped…”Mahathir Mohammed, Mahathir Mohammed, Former Malaysian Prime MinisterFormer Malaysian Prime Minister