Workforce Development Models: Local leadership machines, the case of Rwanda

Human capacity remains one of the major constraints to the scale up of health systems and strategies in Africa, in large part because of sparse funding made available for sustainable workforce development and workforce continuity. Higher education also receives little attention, yet it is this sector that is responsible for medical, clinical and public health personnel. Schools of public health provide the basis for a sustainable leadership machine. Public health schools typically educate mid and senior level health sector leaders as well as providing applied and basic research in support of health sector reform.

This case study documents a six year partnership between the National University of Rwanda and Tulane University that was funded by USAID to create a full service public health school in Rwanda. The School's design builds from the Rockefeller Foundation-inspired Public Health Schools without Walls concept. The project components include development of educational programs and curriculum; faculty development; research and administrative capacity. A critical mass of faculty is being created through an innovative in-service sandwich PhD program that stresses a broad-based development framework and acquisition of program management skills in addition to technical public health competency. The School offers masters degrees using in-service and executive formats and also offers graduate certificate programs in areas of personnel surge need such as HIV/AIDS strategic management; malaria control, and psychosocial programming. E-learning tools are used extensively. School faculty members now participate in most Ministry of Health leadership committees and the research component of the School is active in conducting policy and evaluation research. The SPH is moving rapidly towards financial sustainability. Components of the financial sustainability plan are discussed.

This project has benefited from a strong university to university partnership. Both institutions have the support and engagement of the executive levels and faculty throughout the universities. Challenges include threats to faculty retention, due to donor-driven competition for human resources, and the resource requirements of master's degree theses.