Ministry of Health’s 4X4 reforms to cost Rwf508 billion by 2028

By Wycliffe Nyamasege
On 28 March 2024 at 11:49

The Ministry of Health says the ongoing 4X4 reforms that aim to train an additional 49,802 medical professionals by 2028 will cost USD 395,297,026 (about Rwf 508 billion).

The ministry revealed on Thursday, March 28, 2024, that its plans to spend USD 7,937 (Rwf 10.2 million) per student in the ambitious four-strategy program with 32,973 students expected to graduate by 2028.

The new strategy is aimed at ensuring availability of a minimum of four healthcare workers for every 1,000 people by the next four years. Currently, one healthcare worker serves about 1,000 people.

The ministry plans to spend USD 141,288,063 (Rwf 182.6 billion) to increase the quantity and quality of trained health professional students in priority programs and USD 172,847,301 (Rwf222.2 billion) to recapture local faculty and hire visiting faculty to fill immediate teaching needs.

An additional USD 80,992,886 (Rwf 104.1 billion) will be used to improve training capacity and teaching facility sites and another USD 168,776 (Rwf217 million) in the coordination of the 4x4 reform implementation.

“Hiring new faculty in rare fields is the biggest cost driver, accounting for 44% of the total budget. Support to students for increased enrollment also accounts for 36% of the budget and about 20% of the total cost is related to laboratory, infrastructure and equipment needs,” the ministry said in its update on the implementation of the reforms during an event held at the Kigali Convention Center (KCC).

The new healthcare workers set to join the profession by 2028 will be drawn from at least seven professional cadres including resident and fellows (897), general practitioners (1,686), dental surgeons (185), pharmacists (832), nurses (15,770), midwives (5,209), and allied health sciences (8,394).

While lauding the program, the Minister for Health, Dr Sabin Nsanzimana, expressed confidence that the new workforce would also benefit the international market.

"The 4X4 reform will help us improve the way we deliver our courses and provide people with quality knowledge. We consider where they will work because they may be needed in the labor market both domestically and internationally. Although the epidemics are increasing every day, we can also explore opportunities in the labor market outside the country,” he said.

The ministry emphasized that 4x4 reform has been prepared and reviewed extensively through a series of consultations with the Ministry of Education (MINEDUC), Ministry of Finance (MINECOFIN), partners in the health sector and teaching institutions.

The 4X4 strategy was endorsed by the Cabinet on July 13, 2023 for immediate implementation.

On November 2, 2023, 31 institutions including 13 Higher Learning Institutions, 14 Teaching Hospitals and 4 professional councils signed a Synergy Memorandum of Understanding (MoU) for the 4x4 reform emphasizing the commitment to work together and share knowledge and resources where needed to increase Rwanda’s health workforce.

Currently, four development partners are also involved in funding and providing technical support for the 4x4 reform. The partners are Susan Thompson Buffet Foundation (STBF), Clinton Health Access Initiative (CHAI), Management Science for Health (MSH), and the United Nations Population Fund (UNFPA).

Dr Sabin Nsanzimana, the Minister for Health