Transformative Education
for Health Professionals

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Rwanda’s Clinical Officer

Emmy Bushaija MCHD, CO tutor, Marie Meckel MPH, PA-C, Nadia Cobb MS, PA-C

The University of Rwanda, College of Medicine and Health Sciences has trained clinical officers (COs) since 2011. This health cadre was introduced in collaboration with the Ministry of Health  to address the severe shortage of health care providers that became even more critical after the genocide in 1994.  Although, the health status of the Rwandan population has improved significantly in recent years, it remains insufficient. Currently the doctor to population ratio is 1/15,428 people, which is far below the WHO recommendation of 1 doctor per 1000.

Full project description: 

The development of the Clinical Officer (CO) was a great way to address the dire health provider shortage, as these professionals are well established and utilized in neighboring countries such as Uganda, Kenya and Tanzania.   It was therefore imperative to have a similar middle level health worker in Rwanda’s health care system.

The four-year CO training program includes theory, skills lab practicum, clinical exposure  and community  attachments. Some of the modules  students learn include but are not limited to  anatomy and physiology,  medicine,  pathophysiology, pharmacology,  community/public  health and research methodology. The program is rooted in primary care, community health and health facility management.

The CO students learn the skills needed to manage health centers, practice medicine and engage with the community to address community health needs. The vision statement of the CO programme is "To train Clinical Officers of highest standard to serve humanity and improve the standards of health care in Rwanda” and the mission statement is  “To produce graduates who are competent and ethically committed   to deliver quality health care based on curative, preventive, rehabilitative and restorative services to individuals and families in the community and facilitate sound health centre management”.

The first cohort of the clinical officers bridging program graduated in 2013 and the second class will graduate in 2016.The bridging program is 18 months in length for those with advanced diplomas (A1) in Nursing or Clinical Medicine and Community Health. The 4 year program is for senior six leavers or A2 Nurses. When these health care professionals complete their studies, they will be posted by the Ministry of health to work in  health centers. The health centre is a level after dispensaries and health posts in the Rwandan health care system.

Currently, the University of Rwanda College of Medicine and Health Sciences is training 176 COs  and the Ministry of Health hopes to produce enough CO’s to deploy in  over 430  health centers throughout Rwanda. The Rwandan CO will not only increase the overall number of health care providers, it will also create a cadre of health professionals that will serve in rural locations where not only is the need greatest but retention is challenging.




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