Governments & Regional Bodies
The Tenfold Gap: Rwanda's Health System Resilience
How Rwanda maintained 95% service continuity during a global pandemic.
Region
East Africa
Engagement
Type
System Resilience Assessment
Duration
24 Months
Only 4-5% service disruption vs 50% global mean
DHIS2 integration across all districts
Maintained 98% immunization coverage
Stabilized community-based health insurance
The Context
A Regional Outlier
During the COVID-19 pandemic, global health systems saw an average 50% disruption in routine services. Rwanda emerged as a significant outlier, maintaining nearly full service continuity.
The Challenge
Maintaining Routine Care
The primary challenge was preventing the "secondary crisis"—the collapse of maternal health and immunization programs while redirecting resources to pandemic response.
Novantum Strategic
Intervention
Five Mechanisms of Resilience
Novantum analyzed Rwanda's success through five key mechanisms: DHMT authority, imihigo performance contracts, DHIS2 data integration, the CHW-facility model, and community insurance stability.
Implementation Framework
01
Diagnostic
Service continuity mapping & bottleneck analysis
02
Strategy Design
Scaling the imihigo contract model for emergency response
03
Execution
District-level capacity building & data integration
Outcomes &
Impact
Measurable Resilience
4%
Service Disruption
95%
Continuity Rate
Full
District Coverage
Rwanda's model demonstrated that pre-authorized local authority and performance-based accountability are critical for health system agility.
This engagement was led by senior advisors with direct multilateral coordination experience.
Read full resilience report
Schedule a confidential briefing with our senior partners to discuss how these frameworks can be applied to your context.
Request Consultation