Rwanda Case studyRwanda Cok New patients starting ART East, 43875, 11% Kigali City, 52941, 13%...

September 9 - 10, 2020

Rwanda Case study

Mugwaneza Placidie, MD, MPH

Rwanda Biomedical Centre

Fast-Track Cities Virtual Conference • September 9-10, 2020

VIRTUAL FAST-TRACK CITIES 2020

COVID- 19 National Coordination structure



COVID- 19 National data Trend, March- 9th September 2020



COVID 19 Data Trend, City of Kigali, March – September 2020

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COVID 19 cases_City of Kigali by District

150 115

786

354 334

931

504449

1717

Gasabo Kicukiro Nyarugenge

Female Male Total



COVID-19 cases _City of Kigali by Gender

Female39%

Male61%

Female Male



COVID 19 cases_City of Kigali by Age category

133

305

341

159

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10

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< 20

20 - 29

30 - 39

40 -49

50 - 59

60 - 69

70 - 79

80+

Male Female



COVID-19 management

• COVID-19 Testing

• Contacts tracing and testing

• Mapping of geographic hotspots

• Patient management using both health facility and home based models



COVID- 19 and Services Delivery



HIV services delivery

• Prevention measures for COVID 19 • National lockdown mid March

• Restriction of movement

• Social distancing

• Hand washing

• HIV preventions services

• Community HIV testing outreaches targeting

Key populations and education sessions for

DREAMS beneficiaries

• Condoms distribution through social marketing

• Care and treatment services • Delayed drugs refill

• Poor adherence due to food insecurity

• Delay in ARV shipment

0

200

400

600

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1200

Jul-19 Aug-19 Sep-19 Oct-19 Nov-19 Dec-19 Jan-20 Feb-20 Mar-20 Apr-20 May-20 Jun-20

Rwanda Cok

New patients starting ART

East, 43875, 11%

Kigali City, 52941, 13%

North, 22252, 6%

South, 40321, 10%

West, 42240, 10%



Trend of HIV services delivery

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Gasabo District Kicukiro District Nyarugenge District0

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Gasabo District Kicukiro District Nyarugenge District

Patients starting ARTHIV Testing and Counseliing



Strategies to sustain HIV services delivery

▪ National Program- Reinforce Multi month drugs dispensing strategy (drugs for 3

months to unstable patients and 6 months to stable patients)- Development of SOP on HIV services delivery and COVID 19

▪ Network of people living with HIV- Community follow up of PLHIV using phone call - Putting in place a free line to quickly respond to PLHIV needs - ARV home delivery by peer educators- Identification of people with food insecurity and link with

them program

▪ Civil society organizations - Awareness of key populations on COVID- 19 prevention using

social media - Identify and support to key populations with adherence issues

Virtual Fast-Track Cities 2020 • September 9-10, 2020


Trend of TB case notification

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1540

Jan-March 2019 Jan-March 2020

TB cases notification Jan-March 2019 and 2020

1150

1200

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1350

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1450

April-june 2019 April-june 2020

TB cases notification April-June 2019 and 2020

12.7%1.9%

Slight reduction on the first quarter because lockdown started mid March 2020

The reduction was mainly observed in big cities due to non availability of public transport to

facilitate movement of patient but the service was available

Virtual Fast-Track Cities 2020 • September 9-10, 2020


14

▪ Issue of an Instruction to support treatment adherence by providing one month treatment instead of Direct Observed Treatment

▪ Health facilities advise patient to be treated at community level by CHWs

▪ CHWs helps to collect sputum for bacteriologically follow up of patients

▪ Provision of personal protection equipment to community health workers

▪ Health facilities screen TB for patient screened for COVID- 19 and presenting symptom of TB

Strategies to maintain high quality of TB services



TRENDOF UPTAKE OF MATERNAL & CHILD HEALTH SERVICES



LESSONS LEARNED



▪ High level leadership in COVID- 19 response▪ National committee of Ministries involved in response chaired by the Prime Minister

▪ Effective communication increased accountability of everyone ▪ Ministry of health’ Daily report on COVID- 19 ▪ National campaigns on COVID-19 preventions #GumaMuRugo”, #NtabeAriNjye” ▪ Media involvement in awareness raising▪ Engagement of civil society organizations in community mobilization on COVID prevention

measures

▪ Effective control of COVID- 19 require multisectoral collaboration and strong partnership ▪ Government▪ Partners ▪ Civil society organizations ▪ General population

▪ Use of innovative technologies

Lessons learned for COVID-19 response



▪ Quick adaptation of national strategies and services delivery models

was instrumental to sustain high quality and the coverage of HIV, TB,

MCH services

▪ Close monitoring of key program indicators is essential to inform program on necessary strategies to be implemented

▪ Involvement of community health workers is important to ensure the continuity of services, support and follow up of patients

▪ Involvement of network of people living with HIV and CSO organizations is essential to provide treatment adherence support and addressing of challenges of services beneficiaries.

Sustaining high quality of HIV, TB & MCH programs



Thank you

Murakoze

Rwanda Case studyRwanda Cok New patients starting ART East, 43875, 11% Kigali City, 52941, 13%...

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