Embed Size (px)
Citation preview
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 1
REPUBLIC OF RWANDA
MINISTRY OF HEALTHP. O. Box 84 Kigaliwww.moh.gov.rw
Private Health Facilities in RwandaHealth Service Packages
January 2017
Private Health Facilities in RwandaHealth Service Packages
January 2017
REPUBLIC OF RWANDA
MINISTRY OF HEALTHP. O. Box 84 Kigaliwww.moh.gov.rw
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 3
Table of ContentsAbbreviations .............................................................................................................................................. 4
Foreword ..................................................................................................................................................... 5
Acknowledgements..................................................................................................................................... 6
Background ................................................................................................................................................. 7
Purpose ....................................................................................................................................................... 7
Table 1: Definitions of Types of Facilities..................................................................................................... 8
Table 2: Levels of Health Care Workers. .....................................................................................................10
Table 3: Health Service Packages for Private Healthcare Facilities............................................................. 11
Table 4: Surgery.......................................................................................................................................... 35
Table 5: Therapeutic and Diagnostic Imaging Services .............................................................................. 79
Table 6: Ophthalmic Services ..................................................................................................................... 82
Table 7: Ophthalmic Definitions ................................................................................................................ 86
Table 8: Ophthalmic Services ..................................................................................................................... 87
Table 9: Ophthalmic Equipment ................................................................................................................ 90
Table 10: Dental services .......................................................................................................................... 92
Table 11: Rehabilitation Services ............................................................................................................... 94
Table 12: Nutrition and Dietetic Services .................................................................................................. 99
Table 13: Laboratory Services .................................................................................................................. 102
Table 14: Laboratory Equipment ............................................................................................................. 111
Table 15: Laboratory small Equipment .................................................................................................... 114
Table 16: Media and Culture Preparation Equipment that are required in hospital facility laboratories.................................................................................................... 118
Recommendations from Team from Private Hospitals and Polyclinics .................................................... 119
References .............................................................................................................................................. 120
Participant list.......................................................................................................................................... 121
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 20174
AbbreviationsACLS : Advanced Cardiac Life Support
AN : Antenatal
ARV : Antiretrovial
ASA : Acetylsalicylic Acid (aspirin)
BCC : Behavior Change Communication
BLS : Basic Life Support
CPAP : Continuous Positive Airway Pressure
D : Dispensary
ENT : Ear, Nose and Throat
FP : Family Practice
GA : General Anesthesia
GP : General Practitioner
H : Hospital
HIV : Human Immunodeficiency Virus
IMCI : Integrated Management of Childhood Illnesses
IUD : Intrauterine Device
LA : Local Anesthesia
LRA : Locoregional Anesthesia
M : Maternity Home
MO : Medical Officer
MP : Medical Practice
MC : Medical Clinic
NH : Nursing Home
NICU : Neonatal Intensive Care Unit
P : Polyclinic
PALS : Pediatric Advanced Life Support
PIT : Provider-Initiated Testing
PMTCT : Prevention of Mother-to-Child Transmission
RDS : Respiratory Distress Syndrome
RHSSA : Rwanda Health Systems Strengthening Activity
SC : Specialty Clinic
SH : Specialty Hospital
TB : Tuberculosis
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 5
Foreword
The Ministry of Health (MoH) of Rwanda is pleased to introduce the first set of Rwandan Private Healthcare Service Packages. This is the first description of health care service packages
for the private sector in Rwanda. It demonstrates an effort to facilitate partnerships between
public and private health care providers to strengthen the healthcare structure and services
provided. This document describes each level of the private healthcare system in Rwanda in
terms of the principal types of services offered, the description and qualifications of staff
required to provide the services and the basic equipment needed to carry out the services. The
health service packages support the clinical and managerial standards by which the healthcare
facilities operate. The goal of this document is to provide guidance in the organization of
private healthcare service facilities to work hand in hand with the Ministry of Health to improve
the quality of health care and services provided to the population of Rwanda.
The design of this document also illuminates the importance of effective referral processes,
linking each level of health care services to provide a seamless transition for the patients to
navigate. Rwanda is building a health system based on basic health services that address our
major health problems. This edition provides a description of services offered at each level by
identifying key interventions that are provided within each service area. This level of detail assists
in clarifying which services are available at various facilities within the health care system.
The Ministry of Health shares the vision of providing high quality, safe care for all Rwandans –
with the further aspiration of broadening the availability of these services to individuals within
the region. This document will provide an introductory resource to clarify the structure of the
private healthcare system in Rwanda and guide private practitioners in setting up their practice.
We believe that the private healthcare services will complement the activities of the public sector
and look forward to working together to improve the availability and quality of healthcare.
Dr. Diane GASHUMBA Minister of Health
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 20176
Acknowledgements
The production of the Rwandan Private Health Services Packages was completed through a
series of workshops and stakeholder feedback activities. The MoH would like to thank all the
participants for their contribution to this effort (Annex). The MoH was supported in this process
by the Rwandan Health Systems Strengthening Activity (RHSSA), a USAID-funded project
managed by Management Sciences for Health.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 7
BackgroundThe Ministry of Health (MoH) is strengthening its relationship with the private sector. This collaboration is based on 1) greater participation of the private sector in the provision of healthcare services, 2) improved access to care using services offered by the private sector and 3) strengthening the capacity of a unit within the MoH that oversees the private health sector. Private healthcare facilities are owned and operated by physicians, nurses, and other allied healthcare providers. Some of these facilities provide hospitalization and some provide a variety of specialty services such as obstetrics and gynecology, pediatrics, ophthalmology, dental, physiotherapy, mental health and laboratory investigations. Most of these services currently reside in Kigali.
The MoH has identified healthcare accreditation as a means of institutionalizing quality and safety of care; at the same time, the private sector working with the Rwanda Development Board (RDB) has also identified the need to pursue accreditation. In part, the motivation is driven by a desire to be recognized for quality and safety, with the anticipated outcome of increased utilization of services by Rwandans and a desire to attract medical tourism. These health service packages are one step in the process of defining and standardizing care available.
PurposeThe health services packages have three purposes: 1) to identify standard packages of services at each level of the healthcare system, 2) to provide a guide for the MoH, private sector and non-governmental organizations (NGOs) and donors on how the health care facilities should be staffed and equipped and 3) to promote a health referral system that integrates all levels of services. This document includes the description and qualifications of staff required but does not include the numbers of staff needed for each service, as the quantity of staff will vary based on types of services, workload indicator for staffing needs a human resource planning tool. This document identifies, with tables, the following elements for each level of facility so that the resources needed at each level may be compared:
1) Services available at each type of private healthcare facility
2) Types and qualifications of human resources required for each service
3) Basic equipment needed for each type of service
4) Laboratory test packages and required basic equipment
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 20178
Table 1: Definitions of Types of Facilities
Type of Facility Description Service Parameters
Dispensary First level curative, preventive and laboratory activities, which is staffed by an A1 nurse. Deliveries are not performed in dispensaries.
Not to exceed 12hours
Medical Practice Consultation, diagnostics, prescriptions of treatment andemergency laboratory tests are carried out, run by medical doctors.
Not to exceed 4hours; transfer if necessary
Medical Clinic Diagnosis and/or curative consultation, preventive care and hospitalization is carried out, which is operated by a general practitioner or a specialist in the field.
Maximum 7 hospitalbeds; night duty mandatory
SpecializedClinic
Diagnosis and specialized consultative care is provided and is operated by a specialist in the field. Hospitalization is permitted. Examples of specialized clinics include ophthalmology, pediatrics, gynecology, ENT, stomatology/dental surgery, dermatology, psychiatry, neuropsychiatry, geriatrics, cardiology, endocrinology, urology and medical imaging.
Hospital beds; nightduty mandatory (optional beds and night duties)
Polyclinic Diagnosis, consultation, curative and preventive care as well as hospitalization in different specialized domains are available. The clinic may be operated by a general practitioner or a specialist in the field.
May have 10-50beds; night duty is mandatory and services must be available 24/7.
Hospital A hospital has a clear clinical governance structure and provides the following services but not limited to: general medicine, surgery, gynecology-obstetrics, pediatrics, stomatology, ophthalmology, physiotherapy, dermatology, medical imaging, laboratory, a stock of health products and a dispensing room. A hospital has different departments operated by permanent qualified health professionals. An intensive care unit is mandatory.
Minimum of numberbeds 50
SpecializedHospital
Diagnosis, consultation, specialized treatment and/or specialized care is provided according to the specialization. Outpatient, inpatient, and investigation services as well as an intensive care unit are mandatory or clear written agreement with a hospital which has intensive care unit. The subspecialty services are operated by specialized professionals. Some health products and a dispensing facility are available; the list of health products is established by the Minister of Health.
Minimum of numberof beds 20
Paramedical Facilities
Biomedical Analysis of biological samples from the human body is exclusively carried out without
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 9
Laboratory Providing consultations, health care or distributing health products. The lab is managed by a biomedical laboratory scientist with a Bachelor’s degree.
Antenatal Clinic Consultations, antenatal and postnatal care are carried out. The clinic is operated
by at least a midwife with advanced diploma.
Nursing Home A nursing home is a place for people who do not need to be in a hospital but cannot be cared for at home. Most nursing homes have nursing aides and skilled nurses on hand 24 hours/day. Some nursing homes are set up like a hospital. The staff provides nursing care, as well as physical, speech and occupational therapy.
Physiotherapy Diagnosis and/or consultation treatment and physical exercises are carried out in
the areas of narco-therapy, thermotherapy, cryotherapy, pulley therapy, physical re-education and/or physiotherapy. The clinic is managed by a holder of at least a Bachelor’s degree in physiotherapy.
Dental Diagnosis and/or consultation and care in the domain of the odontology is
provided. The clinic is managed by a person with at least a Bachelor’s degree in
dental therapy.
OphthalmicTechnician
Consultation and treatment in the areas of ophthalmology is provided and is
managed by at least an ophthalmic technician with a Bachelor’s degree.
Optometry Only a clinical optometrist having academic qualification of at least A0 level is
permitted to prescribe and sell medical eyeglasses or contact lenses; they examine, prescribe and dispense.
Ophthalmologist An ophthalmologist possesses all the equipment necessary to prescribe medical eyeglasses and treat all eye related diseases but does not sell eyeglasses.
Imaging Center Medical imaging techniques are carried out by a medical imaging officer with at
least a Bachelor’s degree.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201710
Table 2: Levels of Health Care Workers
Table 2 describes the qualifications required in Rwanda for each level of health care worker.
Type of Health Care Worker Qualifications
Sub-specialists:Cardiologist, pulmonologist, anesthesiologist, ophthalmologist, radiologist, oncologist, pediatrician, psychiatrist, obstetrician, ENT, maxilla- facial surgeon, nephrologist, gastroenterologists, pathologist
Specialty certification (greater than A0)
Master in Pediatrics/Pediatrician and Internal Medicine and Sub specialization Cardiology, Master in Anesthesiology, Master in Ophthalmology (Specialization in Ophthalmology), Master in Radiology (Specialization in Radiology), Master in Oncology, Master in Psychiatry(Specialization in Psychiatry), Gynecology & Obstetrician/Master in Gynecology & Obstetrician, Master in Ear, Nose and Throat Surgeon/ Ear, Nose and Throat Surgeon, Master in Maxilla-facial surgery, Master in Nephrology, Master in Gastroenterology, Master in Pathology.
Specialists: Internal medicine, surgeon, dentist, podiatrist, emergency medicine
Master Degree/Specialization in Internal Medicine, General Surgery, Orthopedic, Neurosurgery, Emergency Medicine, Dentist
Physicians: General and family practitioners A0
Psychologists Bachelor’s degree
Nurses/Midwives A0 level: Bachelor’s degree
A1 level: advanced certificate following 3 years of school
Nurse Anesthetist A1/A0
Mental Health Nurse A1/A0
Allied Health Professionals A1/A0
• Dental Dental Assistant (DA) – 1 year training
Dental Therapist (BDT) – 3 years’ training
Bachelor of Dental Surgery (BDS) – 5 years’ training
• Dietician/Nutritionist A0/Master’s degree
• Physiotherapist A1/A0
• Occupational Therapist A0
• Optometrist A0
• Optician Diploma
• Ophthalmic Technician A1 special course; certifications
• Lab Scientist A0
• Lab Technician A1
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 11
Tabl
e 3:
Hea
lth S
ervi
ce P
acka
ges f
or P
rivat
e He
alth
care
Fac
ilitie
s
CLIN
ICAL
SER
VICE
S
Serv
ice
Inte
rven
tions
Leve
l of S
ervi
ceLe
vel o
f Hea
lthca
re W
orke
r
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Heal
th P
rom
otion
Beha
vior
cha
nge
com
mun
icati
on(B
CC);
heal
th e
duca
tion
for p
atien
ts a
nd
fam
ilies
XX
XX
XX
XX
XN
urse
/M
idw
ifeA
1/A
0
Com
mun
ity h
ealth
mob
iliza
tion/
sens
itiza
tion
XN
urse
A1/
A0
Scho
ol h
ealth
XX
XX
XPs
ycho
logi
st/M
enta
lhe
alth
Nur
se/
Pedi
atri
cian
s/
Psyc
hiat
rist
A1/
A0/
Spec
ialis
t
Figh
t aga
inst
stig
ma
of p
atien
ts w
ithch
roni
c di
seas
es,
e.g.
chr
onic
dis
ease
s,
men
tal h
ealth
, HIV
, epi
leps
y.
XX
XX
XX
XX
All
heal
thca
rew
orke
rsA
0, S
peci
alis
ts,
A1/
A0
Hom
e vi
sits
XX
XX
XX
XX
XN
urse
A1/
A0
Eye
and
oral
hea
lth p
rom
otion
XX
XX
XX
XX
XN
urse
A1/
A0
Org
aniz
ation
of M
utue
lle H
ealth
Insu
ranc
eX
Nur
seA
1/A
0
Epid
emio
logi
cal s
urve
illan
ce o
fdi
seas
esX
XX
XX
XX
XX
Nur
seA
1/A
0
Nut
ritio
n pr
omoti
onX
XX
XX
XX
XX
Die
ticia
n/N
urse
A1/
A0
Hyg
iene
, san
itatio
n an
den
viro
nmen
tal h
ealth
XX
XX
XX
XX
Nur
seA
1/A
0
Educ
ation
on
non-
com
mun
icab
ledi
seas
esX
XX
XX
XX
XN
urse
A1/
A0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201712
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Out
patie
nt S
ervi
ces
Gen
eral
Med
ical
Cons
ulta
tion
Gen
eral
Pra
ctice
XX
XX
XX
Phys
icia
nD
egre
e in
Med
icin
e
Den
tal
XX
XX
XX
Den
tist
A0
Spec
ialis
tO
phth
alm
olog
yX
XX
XX
Oph
thal
mol
ogis
tSp
ecia
list/
Mas
ter
in d
egre
e
Ane
sthe
sia
XX
XX
XA
nest
hesi
olog
ist
Spec
ialis
t/M
aste
r in
deg
ree
Fam
ily M
edic
ine
XX
XX
XX
Fam
ily P
racti
tione
rD
egre
e in
Med
icin
e or
Sp
ecia
list i
n Fa
mily
Med
icin
e
Psyc
hiat
ryX
XX
XX
Psyc
hiat
rist
Spec
ialis
t
Emer
genc
y M
edic
ine
XX
XX
XX
Phys
icia
n or
Spe
cial
ist
in E
mer
genc
y M
edic
ine
Phys
icia
n or
Spe
cial
ist i
n Em
erge
ncy
Med
icin
e
Radi
olog
yX
XX
XX
Radi
olog
ist
Spec
ialis
t in
Radi
olog
y
Inte
rnal
Med
icin
eX
XX
XX
XIn
tern
ist
Gen
eral
Med
icin
e or
Inte
rnis
t
Obs
tetr
ics
& G
ynec
olog
yX
XX
XX
Obs
tetr
icia
nG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list/
Mas
ter
in
Gyn
ecol
ogy
& O
bste
tric
ian
Pedi
atri
csX
XX
XX
Pedi
atri
cian
Spec
ialis
t/M
aste
r in
Ped
iatr
ics
Med
ical
Onc
olog
yX
XX
XX
Onc
olog
ist
Mas
ter i
n O
ncol
ogis
t/Sp
e ci
alis
t in
Onc
olog
y
Stom
atol
ogy
XX
XX
XSt
omat
olog
y/
Max
illof
acia
l Sur
geon
Spec
ialis
t in
Stom
atol
ogy/
M
axill
ofac
ial S
urge
ry/M
aste
r in
Max
illof
acia
l Sur
gery
Ear,
Nos
e, a
nd T
hroa
t (E
NT)
XX
XX
XEN
T sp
ecia
list
Mas
ter i
n EN
T su
rger
y/Sp
ecia
lizati
on in
EN
T Su
rger
y
Rena
l Dia
lysi
sX
XX
XN
ephr
olog
ist
Sub
Spec
ialis
t in
Nep
hrol
ogy
with
Mas
ters
in M
edic
ine
or
Pedi
atri
cs
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 13
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Endo
scop
yX
XX
XG
astr
oent
erol
ogis
tSu
b Sp
ecia
list i
n G
astr
oent
erol
o gy
with
M
aste
rs in
Med
icin
e or
Pe
diat
rics
Nur
se/M
idw
ives
and
Allie
dHe
alth
Clin
ics
Clin
ical
Psy
chol
ogy
XX
XX
XX
Clin
ical
Psy
chol
ogis
tA
1/A
0
Fam
ily P
lann
ing
XX
XX
XX
XX
Nur
se/
Mid
wife
A1/
A0
Gen
eral
Cou
nsel
ing
XX
XX
XX
XX
XN
urse
A1/
A0
Mid
wife
Epi
sode
XM
idw
ifeA
l/A
0
Nut
ritio
n/D
iete
tics
XX
XX
XX
XX
XN
utri
tioni
st/ D
ietiti
an
A1/
A0
Occ
upati
onal
The
rapy
XX
XX
XX
Occ
upati
onal
Th
erap
ist
A1/
A0
Opt
omet
ryX
XX
XX
Opt
omet
rist
A1/
AO
Phys
ioth
erap
yX
XX
XX
XPh
ysio
ther
apis
tA
1/A
0
Prim
ary
Hea
lth C
are
XX
XX
XX
XX
Nur
seA
1/A
0
Wou
nd M
anag
emen
tX
XX
XX
XX
XN
urse
A1/
A0
Mat
erna
l and
New
born
Hea
lth
Gen
eral
Cons
ulta
tion
XX
XX
XX
XX
Gen
eral
Pra
ctitio
ner
(GP)
/Med
ical
Offi
cer
(MO
), G
ynec
olog
y &
Obs
tetr
icia
n, F
P,
Nur
se
A0,
Spe
cial
ist
A1/
A0
Pre-
mar
ital c
onsu
ltatio
nX
XX
XX
XX
XG
P/M
O, G
ynec
olog
y &
Obs
tetr
icia
n, F
P,
Nur
se
A0,
Spe
cial
ist
A1/
A0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201714
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Preg
nanc
yAn
tena
tal C
are
Child
birt
h
Scre
enin
g fo
r mat
erna
l illn
esse
sX
XX
XX
XX
XG
P/M
O, G
ynec
olog
y &
Obs
tetr
icia
n, F
P, N
urse
/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Scre
enin
g fo
r hyp
erte
nsiv
e di
sord
ers o
f
preg
nanc
y
XX
XX
XX
XX
GP/
MO
, Gyn
ecol
ogy
&
Obs
tetr
icia
n, F
P, N
urse
/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Scre
enin
g fo
r ane
mia
XX
XX
XX
XX
GP/
MO
, Gyn
ecol
ogy
&
Obs
tetr
icia
n, F
P, N
urse
/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Iron
& fo
lic a
cid
supp
lem
enta
tion
XX
XX
XX
XX
GP/
MO
, Gyn
ecol
ogy
&
Obs
tetr
icia
n, F
P, N
urse
/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Teta
nus
and
hepa
titis
vacc
inati
ons
At th
e D
ispe
nsar
y Te
tanu
s va
ccin
ation
XX
XX
XX
XG
P/M
O, N
urse
/ M
idw
ifeA
0, S
peci
alis
tA
1/A
0
Coun
selin
g on
fam
ily p
lann
ing,
bir
than
d em
erge
ncy
prep
ared
ness
XX
XX
XX
XX
GP/
MO
, Nur
se/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Prev
entio
n &
man
agem
ent o
f HIV
XX
XX
XX
XX
GP/
MO
, Nur
se/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
with
H
IV tr
aini
ng
Prev
entio
n &
man
agem
ent o
f mal
aria
XX
XX
XX
XX
GP/
MO
, Nur
se/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Smok
ing
cess
ation
XX
XX
XX
XX
GP/
MO
, Nur
se/
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Scre
enin
g &
trea
tmen
t of s
yphi
lisX
XX
XX
XX
XG
P/M
O, N
urse
/ M
idw
ifeA
0, S
peci
alis
tA
1/A
0
De-
wor
min
gX
XX
XX
XX
XG
P/M
O, N
urse
/ M
idw
ifeA
0, S
peci
alis
tA
1/A
0
Trea
tmen
t of u
rina
ry tr
act i
nfec
tions
XX
XX
XX
XG
P/M
O,
Nur
se /
Mid
wife
A0,
Spe
cial
ist
A1/
A0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 15
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Prev
entio
n of
pre
-ecl
amps
ia:
• C
alci
um•
Low
dos
e A
SA
XX
XX
XX
XX
GP/
MO
,M
idw
ifeA
0A
1
Trea
tmen
t of e
clam
psia
: mag
nesi
umsu
lfate
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Mid
wife
Spec
ialis
tA
1/A
0
Indu
ction
of l
abor
to m
anag
e pr
e-la
bor
rupt
ure
of m
embr
anes
at t
erm
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Mid
wife
Spec
ialis
tA
1/A
0
Prev
entio
n of
resp
irato
ry d
istr
ess
synd
rom
e (R
DS)
in p
rete
rm b
abie
sX
XX
XG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list
A1/
A0
Mon
itori
ng la
bor
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Mid
wife
Spec
ialis
tA
1/A
0
Indu
ction
of l
abor
for p
rolo
nged
pr
egna
ncy
XX
XX
Gyn
ecol
ogy
&
Obs
tetr
icia
n, M
idw
ifeSp
ecia
list
A1/
A0
Acti
ve m
anag
emen
t of 3
rd st
age
labo
r to
pre
vent
pos
tpar
tum
hem
orrh
age
XX
XX
Mid
wife
Spec
ialis
tA
1/A
0
Cont
rolle
d co
rd tr
actio
nX
XX
XG
ynec
olog
y &
O
bste
tric
ian,
Mid
wife
Spec
ialis
tA
1/A
0
Epis
ioto
my
XX
XX
XG
P, S
peci
alis
t,M
idw
ife/C
ertifi
edN
urse
Spec
ialis
tA
1 (E
MO
NC)
Pude
ndal
ane
sthe
sia
XX
XX
Ane
sthe
siol
ogis
t,A
nest
hetis
t und
er
supe
rvis
ion
of
Ane
sthe
siol
ogis
t
Spec
ialis
tA
1/A
0
Repa
ir p
erin
eal t
ears
(3rd
& 4
th d
egre
em
anag
ed b
y sp
ecia
list)
XX
XX
Gyn
ecol
ogy
&
Obs
tetr
icia
n, G
P,
Mid
wife
Spec
ialis
tA
1/A
0
Am
nioc
ente
sis
XX
XX
Gyn
ecol
ogy
&
Obs
tetr
icia
nSp
ecia
list w
ith
trai
ning
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201716
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Scre
en &
man
age
HIV
(if n
ot a
lread
yte
sted
)X
XX
XX
XX
GP,
FP,
Gyn
ecol
ogy
&
Obs
tetr
icia
n, M
idw
ifeA
0, S
peci
alis
tA
1
Man
agem
ent o
f mal
pres
enta
tion
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Mid
wife
Spec
ialis
t
Basi
c Em
erge
ncy
Obs
tetr
ic C
are
Man
ual r
emov
al o
f pla
cent
aX
XX
XG
Ynec
olog
y &
Obs
tetr
icia
n, M
idw
ifeSp
ecia
list
A1/
A0
Ass
iste
d va
gina
l del
iver
yX
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Mid
wife
Spec
ialis
tA
1/A
0
Rem
oval
of r
etai
ned
prod
ucts
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Mid
wife
Spec
ialis
tA
1/A
0
Com
preh
ensi
veEm
erge
ncy
Obs
tetr
ic C
are
C-se
ction
: Pro
phyl
actic
anti
bioti
csX
XX
XG
ynec
olog
y &
Obs
tetr
icia
n /G
PSp
ecia
list
Man
agem
ent o
f pos
t- p
artu
m
hem
orrh
age:
Pre
scri
ption
of
Bloo
d tr
ansf
usio
n
XX
XX
Gyn
ecol
ogy
&
Obs
tetr
icia
n or
GP
Spec
ialis
t
Post
nata
l car
e:ne
wbo
rnIm
med
iate
ther
mal
car
eX
XX
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian,
Spec
ialis
t
Brea
stfee
ding
with
in 1
st h
our
XX
XX
XX
XPe
diat
rici
an,
Gyn
ecol
ogy
&
Obs
tetr
icia
n, M
idw
ife
Spec
ialis
tA
1/A
0
Hyg
ieni
c co
rd &
ski
n ca
reX
XX
XX
XPe
diat
rici
an,
Gyn
ecol
ogy
&
Obs
tetr
icia
n M
idw
ife
Spec
ialis
tA
1/A
0
Hep
atitis
scr
eeni
ng &
imm
uniz
ation
XX
XX
XX
All
phys
icia
nsA
0 an
dSp
ecia
list
Neo
nata
l res
usci
tatio
nX
XX
XX
XG
ynec
olog
y &
O
bste
tric
ian,
Pe
diat
rici
an, M
idw
ives
Spec
ialis
tA
0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 17
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Kang
aroo
mot
her
care
for
prem
atur
ene
onat
esX
XX
XX
Pedi
atri
cian
,M
idw
ife, N
urse
Spec
ialis
tA
1/A
0
Surf
acta
nt to
pre
vent
RD
SX
XX
XPe
diat
rici
anSp
ecia
list
CPA
P to
man
age
neon
ates
with
RD
SX
XX
Pedi
atri
cian
/A
nest
hesi
olog
ist
Spec
ialis
t
Man
agem
ent o
f neo
nata
l sep
sis,
men
ingi
tis, &
pne
umon
iaX
XX
XX
Pedi
atri
cian
Spec
ialis
t
Man
agem
ent o
f new
born
s w
ithja
undi
ceX
XX
XPe
diat
rici
anSp
ecia
list
Prop
hyla
ctic
ARV
for
new
born
s ex
pose
dto
HIV
XX
XX
All
Phys
icia
ns,
Mid
wife
Spec
ialis
t/A
0/ A
1
Mal
e ci
rcum
cisi
on, n
ewbo
rnX
XX
XX
Pedi
atri
cian
, Tra
ined
GP
Spec
ialis
t
Post
nata
l car
e:M
othe
rN
utri
tion
coun
selin
gX
XX
XX
XA
ll Ph
ysic
ians
,M
idw
ife/N
urse
A0,
Spe
cial
ist
A1
HIV
trea
tmen
tX
XX
XX
XA
ll Ph
ysic
ians
,M
idw
ife/N
urse
A0,
Spe
cial
ist
A1
Man
agem
ent o
f pos
t-pa
rtum
sep
sis
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian
Spec
ialis
t
Fam
ily P
lann
ing
Adv
ice
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
se/
Mid
wife
A1/
A0
Hor
mon
al &
bar
rier
met
hods
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
se/
Mid
wife
A1/
A0
Child
Hea
lth
New
born
sCo
nsul
tatio
nX
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Eval
uatio
n an
d m
anag
emen
t of h
ealth
yne
wbo
rns
XX
XX
XX
Pedi
atri
cian
and
GP
unde
r su
perv
isio
n of
Pedi
atri
cian
.
A0,
Spe
cial
ist
Eval
uatio
n an
d m
anag
emen
t of
unco
mpl
icat
ed p
edia
tric
cas
es, w
ith n
o ap
pare
nt th
reat
to li
fe
XX
XX
XPe
diat
rici
an a
nd G
Pun
der
supe
rvis
ion
ofPe
diat
rici
an
A0,
Spe
cial
ist
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201718
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Eval
uatio
n &
man
agem
ent o
fun
com
plic
ated
pre
mat
ure
infa
ntX
XX
XX
Pedi
atri
cian
Spec
ialis
t
Eval
uatio
n &
man
agem
ent o
f ser
ious
lyill
or
mor
e co
mpl
icat
ed p
edia
tric
pati
ents
XX
XX
Pedi
atri
cian
Spec
ialis
t
Supr
a-pu
bic
blad
der
tap
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Care
and
man
agem
ent i
n N
eona
tal
Inte
nsiv
e Ca
re U
nit (
NIC
U)
XX
Pedi
atri
cian
/ N
eona
tolo
gist
Spec
ialis
t
Diar
rhea
Pn
eum
onia
M
alar
ia M
easl
es
Mal
nutr
ition
HIV
M
enin
gitis
Inte
grat
ed m
anag
emen
t of c
hild
hood
ill
ness
es (I
MCI
)
Men
ingi
tis to
be
man
aged
in h
ospi
tals
an
d sp
ecia
lty h
ospi
tals
exc
lusi
vely
XX
XX
XX
XX
All
Phys
icia
ns, N
urse
A0,
Spe
cial
ist
A1/
A0
Gro
wth
mon
itori
ngX
XX
XX
XX
XA
ll Ph
ysic
ians
,/N
urse
sA
0, S
peci
alis
tA
1/A
0
Expa
nded
Prog
ram
on
Imm
uniza
tions
(EPI
)
Routi
ne im
mun
izati
ons
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
ses
A0,
Spe
cial
ist
A1/
A0
Child
-frie
ndly
serv
ices
1
Fund
amen
tal a
nd c
hild
rig
hts
Dig
nity
Parti
cipa
tion
Equi
tabl
e ac
cess
to q
ualit
y ca
reBe
st in
tere
sts
of th
e ch
ild
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
ses
A0,
Spe
cial
ist
A1/
A0
Inte
rnal
Med
icin
e
Gen
eral
Dia
gnos
is &
man
agem
ent o
f un
com
plic
ated
med
ical
con
ditio
nsA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Inde
pend
ent c
are
of m
ore
com
plic
ated
gene
ral m
edic
ine
prob
lem
s, w
hich
may
be
life
-thr
eate
ning
Inte
rnis
tSp
ecia
list
1 Co
unci
l of E
urop
e. G
uide
lines
of t
he C
omm
ittee
of M
inis
ters
of t
he C
ounc
il of
Eur
ope
on c
hild
-fri
endl
y he
alth
car
e. 2
1 Se
pt 2
011.
Ava
ilabl
e at
: htt
p://
ww
w.c
oe.in
t/t/
dg3/
heal
th/G
uide
lines
_on_
child
_fri
endl
y_he
alth
_car
e En
glis
h_ve
rsio
n_.p
df
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 19
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Com
mun
icab
le D
isea
ses
Gen
eral
Cons
ulta
tion,
regu
lar
chec
kup
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
seA
0, S
peci
alis
tA
1/A
0
Post
-exp
osur
e pr
ophy
laxi
sX
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
A0,
Spe
cial
ist
A1/
A0
Not
e: M
edic
ation
for
HIV
, TB,
Mal
aria
not
ava
ilabl
e to
pri
vate
HFs
Tube
rcul
osis
TB s
cree
ning
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
seA
0, S
peci
alis
tA
1/A
0
Prev
entiv
e tr
eatm
ent
XX
XX
XX
All
Phys
icia
nsA
0,Sp
ecia
list
TB tr
eatm
ent
XX
XX
XX
All
Phys
icia
ns
Mal
aria
Prev
entio
nX
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
A0,
Spe
cial
ist
A1/
A0
Trea
tmen
tX
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
A0,
Spe
cial
ist
A1/
A0
HIV/
STIs
HIV
testi
ng &
cou
nsel
ing
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
seA
0, S
peci
alis
tA
1/A
0
HIV
trea
tmen
tX
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Prev
entio
n of
Mot
her-
to-C
hild
Tran
smis
sion
(PM
TCT)
XX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Prov
ider
-initi
ated
testi
ng (P
IT)
XX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Acut
e re
spira
tory
dise
ases
Trea
tmen
t of A
RIX
XX
XX
XX
All
Phys
icia
ns,
Nur
seA
0, S
peci
alis
tA
1/A
0
Pneu
mon
iaX
XX
XX
XX
All
hysi
cian
s,
Nur
seA
0, S
peci
alis
tA
1/A
0
Skin
infe
ction
sD
iagn
osis
& m
anag
emen
t of g
ener
alsk
in in
fecti
ons
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
A0,
Spe
cial
ist
A1/
A0
Para
site
sPa
rasi
tic d
ewor
min
gX
XX
XX
XX
All
Phys
icia
ns,
Nur
seA
0, S
peci
alis
tA
1/A
0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201720
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
ns
Non
-com
mun
icab
le D
isea
ses
Gen
eral
Gen
eral
/ini
tial c
onsu
ltatio
nX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Onc
olog
yO
ncol
ogy
cons
ulta
tion
XX
XX
Onc
olog
y Sp
ecia
list
Spec
ialis
t
Bone
mar
row
asp
iratio
nX
XX
XM
O, O
ncol
ogis
tSp
ecia
list
Chem
othe
rapy
XX
XX
Diff
eren
t tra
ined
spec
ialis
t dep
endi
ng
whe
re d
iagn
osed
Spec
ialis
t
PUVA
pho
to-c
hem
othe
rapy
XX
XX
Diff
eren
t tra
ined
spec
ialis
t dep
endi
ng
whe
re d
iagn
osed
Spec
ialis
t
Neu
rolo
gica
l con
ditio
nsQ
ualifi
catio
nsN
euro
logi
cal c
onsu
ltatio
nX
XX
XX
XG
P an
d Sp
ecia
list
Spec
ialis
t
Lum
bar p
unct
ure
XX
XX
GP
and
Spec
ialis
tSp
ecia
list
Elec
troe
ncep
halo
gram
(EEG
)X
XX
XPs
ychi
atri
stSp
ecia
list
Elec
trom
yogr
aphy
XX
XX
Psyc
hiat
rist
Spec
ialis
tIn
trat
heca
l adm
inis
trati
on o
fm
edic
ation
sX
XSp
ecia
list
Mus
cle
biop
syX
XX
XSp
ecia
list
Mye
logr
aphy
/art
erio
grap
hyX
XX
XRa
diol
ogis
tSp
ecia
list
Tran
scut
aneo
us a
ngio
grap
hy o
f the
ce
rebr
al v
esse
lsX
XRa
diol
ogis
tSp
ecia
list
Resp
irato
ry c
ondi
tions A
sthm
aX
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Chro
nic
Obs
truc
tive
Pulm
onar
y D
isea
se(C
OPD
)X
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Thor
acen
tesi
sX
XA
nest
hesi
olog
ist
Spec
ialis
t
Ches
t tub
e pl
acem
ent
XX
Ane
sthe
siol
ogis
tSp
ecia
list
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 21
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
nsIn
tuba
tion
XX
Ane
sthe
siol
ogis
tSp
ecia
list
ACLS
trai
ned
Venti
lato
r m
anag
emen
tX
XA
nest
hesi
olog
ist
Spec
ialis
t
Trac
heot
omy
XX
Ane
sthe
siol
ogis
tSp
ecia
list
Lung
bio
psy,
med
iasti
num
or
pleu
ral
with
per
cuta
neou
s ne
edle
XX
Pulm
onol
ogis
t, S
urge
onSp
ecia
list
Bron
chos
copy
, rem
oval
of f
orei
gn o
bjec
tX
XEN
T Su
rgeo
nPu
lmon
olog
ist
Spec
ialis
t
Bron
chos
copy
, with
tran
s-br
onch
ial
biop
syX
XEN
T Su
rgeo
nPu
lmon
olog
ist
Spec
ialis
t
Chem
ical
ple
urod
esis
XX
Pulm
onol
ogis
tSp
ecia
list
Inte
rpre
tatio
n of
pul
mon
ary
func
tion
stud
ies
XX
Pulm
onol
ogis
tSp
ecia
list
Poly
som
nogr
aphy
XX
Pulm
onol
ogis
tSp
ecia
list
Swan
-Gan
z ca
thet
er p
lace
men
tX
XPu
lmon
olog
ist
Card
iolo
gist
Ane
sthe
siol
ogis
t
Spec
ialis
t
Tran
s-tr
ache
al a
spira
tion
XX
Pulm
onol
ogis
tSp
ecia
list
Tube
thor
acos
tom
y pl
acem
ent
XX
Pulm
onol
ogis
tSp
ecia
list
Cent
ral I
V-lin
e pl
acem
ent
XX
Pulm
onol
ogis
tCa
rdio
logi
stA
nest
hesi
olog
ist
Spec
ialis
t
Card
iova
scul
ar c
ondi
tions
Scre
enin
g an
d fo
llow
up
XX
XX
XX
XX
Nur
seA
1/A
0
Elec
troc
ardi
ogra
m (E
CG)
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Hyp
erte
nsio
nX
XX
XX
XX
XA
ll Ph
ysic
ians
, Nur
se.
A0,
Spe
cial
ist
A1/
A0
Stro
keX
XX
XCa
rdio
logi
stSp
ecia
list
Myo
card
ial i
nfar
ction
XX
Card
iolo
gist
Spec
ialis
t
Rheu
mati
c he
art d
isea
seX
XCa
rdio
logi
stSp
ecia
list
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201722
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
nsCa
rdio
vasc
ular
exe
rcis
e st
udy
XX
XX
XG
P an
d sp
ecia
list
Spec
ialis
t
Cent
ral I
V-lin
e pl
acem
ent
XX
Pulm
onol
ogis
t,Ca
rdio
logi
stA
nest
hesi
olog
ist
Spec
ialis
t
Swan
-Gan
z ca
thet
er p
lace
men
tX
XPu
lmon
olog
ist
Card
iolo
gist
, A
nest
hesi
olog
ist
Spec
ialis
t
Defi
brill
ation
XX
Hea
lth w
orke
rs tr
aine
d in
adva
nced
life
sup
port
A0,
Spe
cial
ist
Gyne
colo
gica
l con
ditio
ns
Gyn
ecol
ogic
al c
ondi
tions
, inc
ludi
ngse
xual
ly tr
ansm
itted
dis
ease
sX
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
.A
0, S
peci
alis
tA
1/A
0
Pap
smea
rs &
pel
vic
exam
sX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Inse
rt In
trau
teri
ne d
evic
e (IU
D)
XX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Rem
ove
IUD
sX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Cerv
ical
bio
psie
s &
pol
ypec
tom
yX
XX
XG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list
Endo
met
rial
bio
psie
sX
XX
XX
Gyn
ecol
ogy
& O
bste
tric
ian
Spec
ialis
t
Culd
ocen
tesi
sX
XX
XG
ynec
olog
y &
Obs
tetr
icia
n an
d G
PSp
ecia
list
Bart
holin
cys
t dra
inag
e or
mar
supi
aliz
ation
XX
XX
XG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list
Dia
gnos
tic a
nd th
erap
eutic
dila
tion
and
cure
ttag
eX
XX
XX
Gyn
ecol
ogy
&O
bste
tric
ian
Spec
ialis
t
Colp
osco
pyX
XX
XX
Gyn
ecol
ogy
& O
bste
tric
ian
Spec
ialis
t
Hys
tero
scop
y, d
iagn
ostic
XX
XX
XG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list
Loop
ele
ctro
surg
ical
exc
isio
n pr
oced
ure
(LEE
P)X
XX
XX
Gyn
ecol
ogy
& O
bste
tric
ian
Spec
ialis
t
Gyn
ecol
ogic
al c
ance
rX
XX
XG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 23
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
nsFe
rtilit
y se
rvic
esX
XX
XX
XG
ynec
olog
y &
Obs
tetr
icia
n/U
rolo
gist
Spec
ialis
t
Gen
der-
base
d vi
olen
ceX
XX
XX
XA
ll Ph
ysic
ians
GP,
Spe
cial
ist
Repr
oduc
tive
Endo
crin
olog
yX
XX
XX
XG
ynec
olog
y &
Obs
tetr
icia
nSp
ecia
list
Ultr
asou
ndX
XX
XX
XG
P/ G
ynec
olog
y &
Obs
tetr
icia
nG
P, S
peci
alis
t
Biop
sy b
reas
t mas
s (s
impl
e, n
on-fi
xed,
less
than
3cm
)X
XX
XG
ynec
olog
y &
Obs
tetr
icia
n an
d Su
rgeo
nSp
ecia
list
Gas
troi
ntes
tinal
(GI)
cond
ition
sG
astr
oent
eriti
sX
XX
XX
XX
XA
ll Ph
ysic
ians
, Nur
seA
0, S
peci
alis
tA
1/A
0
Para
cent
esis
XX
XX
Gas
troe
nter
olog
ist
Spec
ialis
t
Flex
ible
sig
moi
dosc
opy
XX
XX
Gas
troe
nter
olog
ist
Spec
ialis
t
Esop
hago
gast
rodu
oden
osco
py (E
GD
),di
agno
stic,
low
risk
, out
patie
ntX
XX
XG
astr
oent
erol
ogis
tSp
ecia
list
Colo
nosc
opy,
snar
e po
lype
ctom
y w
ithca
uter
y, d
iagn
ostic
, low
risk
, out
patie
ntX
XX
XG
astr
oent
erol
ogis
tSp
ecia
list
Uro
logy
/ N
ephr
olog
y Unc
ompl
icat
ed u
rina
ry tr
act c
ondi
tions
XX
XX
XX
XX
All
Phys
icia
ns, N
urse
A0,
Spe
cial
ist
A1/
A0
Perc
utan
eous
rena
l bio
psy
XX
Nep
hrol
ogis
tSp
ecia
list
Acu
te h
emod
ialy
sis c
athe
ter i
nser
tion
XX
Nep
hrol
ogis
tSp
ecia
list
Peri
tone
al d
ialy
sis
XX
Nep
hrol
ogis
tSp
ecia
list
Plas
map
here
sis
XX
Nep
hrol
ogis
tSp
ecia
list
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201724
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
ENT
SURG
ERY
Ear
Ear
was
hout
xX
XX
XX
XX
Phys
icia
n, N
urse
Spec
ialis
t, A
0A
1
Cath
eter
izati
onX
XX
XX
ENT
Surg
eon
Spec
ialis
t
Kelo
id e
xcis
ion
XX
XX
XEN
T Su
rgeo
n, G
PSp
ecia
list,
GP
Pre-
auri
cula
r si
nus
exci
sion
XX
XX
XEN
T Su
rgeo
nSp
ecia
list
Exci
sion
XX
XX
ENT
Surg
eon
Spec
ialis
t
Myr
ingo
tom
y +/
- Ven
tilati
on tu
bein
serti
onX
XX
XEN
T Su
rgeo
nSp
ecia
list
Mas
toid
ecto
my
XX
XEN
T Su
rgeo
nSp
ecia
list
Tym
pano
plas
tyX
XX
ENT
Surg
eon
Spec
ialis
t
Stap
edec
tom
yX
XEN
T Su
rgeo
nSp
ecia
list
Faci
al n
erve
dec
ompr
essi
onX
ENT
Surg
eon
Spec
ialis
t
Endo
lym
phati
c sa
c de
com
pres
sion
XEN
T Su
rgeo
nSp
ecia
list
Aco
ustic
neu
rom
a ex
cisi
onX
ENT
Surg
eon
Spec
ialis
t
Glo
mus
tum
or e
xcis
ion
XEN
T Su
rgeo
nSp
ecia
list
Impl
anta
ble
hear
ing
devi
ces
XX
ENT
Surg
eon
Spec
ialis
t
Hea
ring
aid
fitti
ngX
XX
XX
XA
udio
logi
st,
Aud
iom
etri
stA
0
Aud
iom
etry
- dia
gnos
ticX
XX
XX
Aud
iolo
gist
, A
udio
met
rist
A0
Elec
tron
ysta
gmog
raph
y/ve
stibu
lom
etry
XX
XX
XA
udio
logi
stA
0
Tym
pano
met
ry +
Sta
pedi
al R
eflex
esX
XX
XX
ENT
Surg
eon,
A
udio
logi
stSp
ecia
list,
A0
Brai
nste
m-e
voke
d Re
spon
seA
udio
met
ryX
XX
XX
Aud
iolo
gist
A0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 25
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
OA
Es -
diag
nosti
cX
XX
XX
Aud
iolo
gist
A0
OA
Es –
scr
eeni
ngX
XX
XX
XX
Aud
iolo
gist
, A
udio
met
rist
, Re
gist
ered
nur
se
A0,
A1
Fore
ign
body
ext
racti
onX
XX
XX
XX
Phys
icia
n, N
urse
s, E
NT
Surg
eon
Spec
ialis
t, A
0,A
1
Ear r
epai
rX
XX
XX
XX
Phys
icia
n, N
urse
s, E
NT
Surg
eon
Spec
ialis
t, A
0,A
1
Ear/
Nos
eIn
cisi
on &
dra
inag
eX
XX
XX
XX
Phys
icia
n, N
urse
s, E
NT
Surg
eon
Spec
ialis
t, A
0,A
1
Head
and
Nec
kIn
cisi
on &
Dra
inag
eX
XX
XX
ENT
Surg
eon
Spec
ialis
t
Exci
sion
XX
XX
ENT
Surg
eon
Spec
ialis
t
Nas
al e
ndos
copy
& b
iops
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Exci
sion
XX
XX
ENT
Surg
eon
Spec
ialis
t
Paro
tidec
tom
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Trac
heos
tom
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Subl
ingu
al g
land
exc
isio
nX
XX
XEN
T Su
rgeo
nSp
ecia
list
Dila
tatio
n W
hart
on’s/
Ste
nsen
’s d
uct
XX
XX
ENT
Surg
eon
Spec
ialis
t
Subm
andi
bula
r Gla
nd E
xcis
ion
XX
XX
ENT
Surg
eon
Spec
ialis
t
Endo
-buc
cal e
xtra
ction
of s
aliv
ary
calc
ulus
XX
XX
ENT
Surg
eon
Spec
ialis
t
Lary
ngec
tom
yX
XEN
T Su
rgeo
n, S
peec
hTh
erap
ist
Spec
ialis
t
Phar
ynge
ctom
yX
XEN
T Su
rgeo
n, S
peec
hTh
erap
ist
Spec
ialis
t
Lym
ph n
ode
biop
syX
XX
XEN
T Su
rgeo
nSp
ecia
list
Exci
sion
XX
XX
ENT
Surg
eon
Spec
ialis
t
Exci
sion
ranu
laX
XX
XEN
T Su
rgeo
nSp
ecia
list
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201726
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
Glo
ssec
tom
yX
XEN
T Su
rgeo
n, M
axill
o-fa
cial
Sur
geon
, Spe
ech
Ther
apis
t
Spec
ialis
t
Nec
k di
ssec
tion
XX
XX
E NT
Surg
eon
Spec
ialis
t
Para
thyr
oid
surg
ery
XX
XX
E NT
Surg
eon
Spec
ialis
t
Thyr
oide
ctom
yX
XX
XE N
T Su
rgeo
nSp
ecia
list
Lary
ngo-
Bro
ncho
- es
opha
geal
Esop
hago
scop
y +
extr
actio
n/re
mov
alX
XX
XE N
T Su
rgeo
nSp
ecia
list
Bron
chos
copy
+ e
xtra
ction
/rem
oval
XX
E NT
Surg
eon
Spec
ialis
t
Dire
ct la
ryng
osco
pyX
XX
XE N
T Su
rgeo
nSp
ecia
list
Lary
nxFl
exib
le n
asop
hary
ngol
aryn
gosc
opy
XX
XX
XE N
T Su
rgeo
nSp
ecia
list
Phon
omic
rosu
rger
yX
XX
XEN
T Su
rgeo
n, S
peec
hTh
erap
ist
Spec
ialis
t
Med
ializ
ation
/lar
yngo
plas
ty/
Late
raliz
ation
XX
XX
E NT
Surg
eon
Spec
ialis
t
Exci
sion
Lar
yngo
cele
XX
XX
ENT
Surg
eon
Spec
ialis
t
Max
illo-
Faci
alLa
ryng
otra
chea
l rec
onst
ructi
onX
XEN
T Su
rgeo
nSp
ecia
list
Nos
eFa
cial
bon
e fr
actu
res
- red
uctio
nX
XX
XEN
T Su
rgeo
n, M
axill
o-fa
cial
Spec
ialis
t
Nas
al R
epai
r cu
tsX
XX
XX
XX
ENT
Surg
eon
Spec
ialis
t
Syne
chia
e re
leas
eX
XX
XEN
T Su
rgeo
nSp
ecia
list
Tum
or B
iops
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Dia
ther
mo-
coag
ulati
on (S
MD
)X
XX
XEN
T Su
rgeo
nSp
ecia
list
Func
tiona
l end
osco
pic
sinu
s su
rger
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Turb
inec
tom
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Post
erio
r nas
al p
acki
ngX
XX
XX
ENT
Surg
eon
Spec
ialis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 27
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
Sept
opla
sty
XX
XX
ENT
Surg
eon
Spec
ialis
t
Choa
nopl
asty
XX
XX
ENT
Surg
eon
Spec
ialis
t
Ant
erio
r na
sal p
acki
ngX
XX
XX
XX
Phys
icia
ns, N
urse
s,EN
T Su
rgeo
nSp
ecia
list,
A0,
A1
Redu
ction
nas
al b
one
frac
ture
XX
XX
ENT
Surg
eon
Spec
ialis
t
Sinu
sFo
reig
n bo
dy e
xtra
ction
XX
XX
XX
XPh
ysic
ian,
Nur
ses,
EN
TSu
rgeo
nSp
ecia
list,
A0,
A1
Ant
ral w
asho
utX
XX
XEN
T Su
rgeo
nSp
ecia
list
Fron
tal S
inus
Tre
phin
ation
XX
XX
ENT
Surg
eon
Spec
ialis
t
Cald
wel
l –Lu
cX
XX
XEN
T Su
rgeo
nSp
ecia
list
Thro
atA
ntro
stom
yx
XX
XEN
T Su
rgeo
nSp
ecia
list
Inci
sion
& d
rain
age
XX
XX
XEN
T Su
rgeo
nSp
ecia
list
Rele
ase
XX
XX
XX
XPh
ysic
ian,
Nur
ses,
EN
TSu
rgeo
nSp
ecia
list,
A0,
A1
Ade
noid
ecto
my
XX
XX
ENT
Surg
eon
Spec
ialis
t
Tons
illec
tom
yX
XX
XEN
T Su
rgeo
nSp
ecia
list
Uvu
lopa
lato
phar
yngo
plas
tyX
XX
XEN
T Su
rgeo
nSp
ecia
list
Oph
thal
mol
ogy
Gen
eral
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
seA
0, S
peci
alis
tA
1/A
0
Ant
erio
r seg
men
t (al
lerg
y,co
njun
ctivi
tis, C
hala
zion
)X
XX
XO
phth
alm
olog
ist,
Nur
seSp
ecia
list
A1/
A0
Post
erio
r seg
men
tX
XX
XO
phth
alm
olog
ist
Spec
ialis
t
Pedi
atri
cX
XX
XO
phth
alm
olog
ist
Spec
ialis
t
Ocu
lo-p
lasti
cX
XX
XO
phth
alm
olog
ist
Spec
ialis
t
Neu
ro-o
phth
alm
olog
yX
XX
XO
phth
alm
olog
ist
Spec
ialis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201728
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
Rheu
mat
olog
y
Art
hriti
s an
d go
utX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Conn
ectiv
e tis
sues
dis
ease
s, e
.g.
syst
emic
lupu
s er
ythe
mat
osus
&sc
lero
derm
a
XX
XX
Rheu
mat
olog
ist
Rheu
mat
olog
ist
Spec
ialis
t
Regi
onal
pai
n sy
ndro
mes
, e.g
.te
ndon
itis,
bur
sitis
, dis
c di
seas
eX
XX
XX
XRh
eum
atol
ogis
tA
0 , S
peci
alis
t
Syst
emic
vas
culiti
sX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Rayn
aud’
s syn
drom
eX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Ost
eopo
rosi
sX
XX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Bone
den
sity
mea
sure
men
tX
XX
XA
ll Ph
ysic
ians
A0,
Spe
cial
ist
Intr
a-ar
ticul
ar in
jecti
ons
XX
XX
XX
Ort
hope
dic
Surg
eon
Spec
ialis
t
Ger
iatr
ics
Ass
essm
ent o
f phy
sica
l and
men
tal
capa
biliti
es E
xerc
ise
prog
ram
s So
cial
ass
essm
ent
Envi
ronm
enta
l saf
ety
devi
ces
&ed
ucati
on
XX
XX
XX
XX
All
Phys
icia
ns, N
urse
sSp
ecia
list
A1/
A0
Derm
atol
ogy
Unc
ompl
icat
ed b
asal
& s
quam
ous
cell
carc
inom
asX
XX
XD
erm
atol
ogis
t, G
ener
al
Surg
eon
or a
rea
Spec
ialis
tSp
ecia
list
Routi
ne b
iops
y of
der
mat
olog
ical
pr
oble
m, s
kin
canc
er, m
elan
oma
XX
XX
Der
mat
olog
ist
Spec
ialis
t
Routi
ne e
xcis
ion
& d
rain
age
of
cyst
s,X
XX
XX
XA
ll Pr
actiti
oner
sA
0, A
1,Sp
ecia
lists
X-ra
y th
erap
y fo
r der
mat
olog
yX
XX
XD
erm
atol
ogis
t, R
adia
tion
Onc
olog
ist
Spec
ialis
t
MO
H’s
mic
rogr
aphi
c su
rger
yX
XX
XD
erm
atol
ogis
t and
Pla
stic
Surg
eon
and
Certi
fied
Gen
eral
Sur
geon
Spec
ialis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 29
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
CO2
lase
rX
XX
XD
erm
atol
ogis
t and
Pla
stic
Surg
eon
and
Certi
fied
Gen
eral
Sur
geon
Spec
ialis
t
Lipo
sucti
onX
XX
XD
erm
atol
ogis
t and
Pla
stic
Surg
eon
and
Certi
fied
Gen
eral
Sur
geon
Spec
ialis
t
Hai
r tra
nspl
anta
tion
XX
XX
Certi
fied
Tech
nici
an a
ndD
erm
atol
ogis
t, S
urge
onSp
ecia
list
Mic
rolip
o in
jecti
onX
XX
XD
erm
atol
ogis
t, S
urge
onSp
ecia
list
Inje
ction
s for
trea
ting
scar
sX
XX
XD
erm
atol
ogis
t, S
urge
onSp
ecia
list
Der
mab
rasi
on &
face
pee
lsX
XX
XD
erm
atol
ogis
t, S
urge
onSp
ecia
list
Der
mat
o su
rger
yX
XX
XD
erm
atol
ogis
tSp
ecia
list
Cure
ttag
e (s
ebor
rhei
c ke
rato
sis)
XX
XX
Der
mat
olog
ist
Spec
ialis
t
Caut
ery
XX
XX
Der
mat
olog
ist
Spec
ialis
t
Cryo
surg
ery
(war
ts a
nd o
ther
ski
nle
sion
s)X
XX
XD
erm
atol
ogis
tSp
ecia
list
Der
mat
o al
lerg
olog
yX
XX
XD
erm
atol
ogis
tSp
ecia
list
Phot
othe
rapy
XX
XX
Der
mat
olog
ist
Spec
ialis
t
Der
mat
olog
ic p
atho
logy
XX
XX
Der
mat
olog
ist
Spec
ialis
t
Men
tal H
ealth
Men
tal h
ealth
diso
rder
sA
sses
smen
t, in
clud
ing
post
trau
mati
cdi
stre
ss s
yndr
ome
XX
XX
XX
XX
All
Phys
icia
ns, C
linic
alPs
ycho
logi
st, N
urse
A0,
A1,
Spec
ialis
tsA
1/A
0
Clin
ical
psy
chol
ogy
and
coun
selli
ngX
XX
XX
XX
XA
ll Ph
ysic
ians
, Clin
ical
Psyc
holo
gist
, Nur
seA
0, A
1,Sp
ecia
lists
A1/
A0
Men
tal h
ealth
and
psy
chos
ocia
l su
ppor
tX
XX
XX
XX
XA
ll Ph
ysic
ians
, Clin
ical
Psyc
holo
gist
, Nur
seA
0, A
1,Sp
ecia
lists
A1/
A0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201730
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
nPs
ychi
atric
illn
ess
Adu
lt ps
ychi
atry
XX
XX
Psyc
hiat
rist
Spec
ialis
tCh
ild a
nd a
dole
scen
t psy
chia
try
XX
XX
Psyc
hiat
rist
Spec
ialis
t
Liai
son
psyc
hiat
ryX
XX
XPs
ychi
atri
stSp
ecia
list
Dent
alG
ener
alX
XX
XX
XA
ll Ph
ysic
ians
A0/
Spec
ialis
t
Pros
theti
cs a
nd o
rtho
donti
csX
XX
XD
enta
l Sur
geon
Spec
ialis
t
Den
tal i
mag
ing
XX
XX
Den
tal S
urge
onSp
ecia
list
Rest
orati
ve d
entis
try
XX
XX
Den
tal S
urge
onSp
ecia
list
Pedi
atri
c de
ntist
ryX
XX
XD
enta
l Sur
geon
Spec
ialis
t
Ora
l sur
gery
XX
XX
Den
tal S
urge
onSp
ecia
list
Peri
odon
tolo
gyX
XX
XD
enta
l Sur
geon
Spec
ialis
t
Acci
dent
and
Inju
ryRe
cepti
on a
nd tr
iage
XX
XX
XX
XX
All
Phys
icia
ns,
Nur
ses.
A0/
Spec
ialis
t,A
1/A
0
Phys
ical
Tra
uma
and
Frac
ture
sSc
reen
ing
for
abus
eX
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
sA
0/Sp
ecia
list,
A1/
A0
Care
of s
prai
ns, s
trai
ns a
nd c
ontu
sion
sX
XX
XX
XX
XA
ll Ph
ysic
ians
,N
urse
sA
0/Sp
ecia
list,
A1/
A0
Sim
ple
clos
ed fr
actu
res
& d
islo
catio
nsX
XX
XSu
rgeo
ns a
nd G
Ps
whe
re p
ossi
ble
Spec
ialis
t
Mas
sive
trau
ma
man
agem
ent
XX
All
GPs
and
Sur
geon
sA
0, S
peci
alis
t
Ches
t tub
e in
serti
onX
XX
XSu
rgeo
nsSp
ecia
list
Smal
l Lac
erati
ons
Sutu
ring
XX
XX
XX
XX
XA
ll Ph
ysic
ians
Nur
ses
/ M
idw
ifeA
0/Sp
ecia
list
A1/
A0
Med
ical
Em
erge
ncie
sCo
nvul
sion
sA
dmin
istr
ation
of a
ntico
nvul
sant
sX
XX
XX
XX
XX
All
Phys
icia
nsN
urse
s/ M
idw
ifeA
0/Sp
ecia
list
A1/
A0
Drug
ove
rdos
eTr
eatm
ent o
f dru
g ov
erdo
seX
XEm
erge
ncy
Phys
icia
nSp
ecia
list
Diab
etic
keto
acid
osis
Man
agem
ent o
f dia
betic
ket
oaci
dosi
sX
XX
XIn
tern
ist
Spec
ialis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 31
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
nPu
lmon
ary
embo
lism
Man
agem
ent o
f mas
sive
pul
mon
ary
embo
lism
XX
Inte
rnis
t/ P
ulm
onol
ogis
tSp
ecia
list
Card
iac
Emer
genc
ies
Myo
card
ial i
nfar
ction
, con
gesti
ve
hear
t fai
lure
or s
trok
eX
XX
XCa
rdio
logi
stSp
ecia
list
Resu
scita
tion
Basi
c lif
e su
ppor
t (BL
S)X
XX
XX
XX
XX
All
Hea
lth C
are
Prof
essi
onal
sTr
aine
d in
BLS
Pedi
atri
c ad
vanc
ed li
fe s
uppo
rt (P
ALS
)X
XPe
diat
rici
an/ N
urse
sSp
ecia
list
A1
trai
ned
inPA
LS
Adv
ance
d ca
rdia
c lif
e su
ppor
t (AC
LS)
XX
Card
iolo
gist
,A
nest
hesi
olog
ist,
Cri
tical
Ca
re S
peci
alis
ts, C
ritic
al C
are
Nur
ses
Spec
ialis
t,tr
aine
d in
ACL
S
Adv
ance
d tr
aum
a lif
e su
ppor
tX
XSu
rgeo
ns (c
ertifi
ed)
Spec
ialis
tAm
bula
nce
Tran
sfer
pati
ents
to o
ther
faci
lities
XX
XX
XX
XX
Nur
ses
A1/
A0
Tran
spor
t cri
tical
ly il
l pati
ents
XX
XX
XX
XX
Nur
ses.
A1/
A0
Surg
ical
Pro
cedu
res
Min
or S
urge
rySi
mpl
e ab
sces
s in
cisi
on a
nd d
rain
age
XX
XX
XX
XX
All
Phys
icia
ns, R
egis
tere
dN
urse
A0,
Spe
cial
ist
Mal
e ci
rcum
cisi
on, a
dult
XX
XX
XX
XX
All
Phys
icia
ns, R
egis
tere
dN
urse
A0,
Spe
cial
ist
Burn
sFi
rst d
egre
eX
XX
XX
XX
XA
ll Ph
ysic
ians
, Nur
seA
0, S
peci
alis
tA
1/A
0
Seco
nd d
egre
eX
XX
XX
All
Phys
icia
nsA
0, S
peci
alis
t
Third
deg
ree,
ski
n gr
aphs
XX
Gen
eral
Sur
geon
Spec
ialis
t
Burn
uni
tX
XG
ener
al S
urge
onSp
ecia
list
Anes
thes
iaPr
e-an
esth
etic
care
XX
XX
Ane
sthe
siol
ogis
t/N
urse
Ane
sthe
tist
Spec
ialis
t
Intr
a-op
erati
ve c
are
XX
XX
Ane
sthe
siol
ogis
t/N
urse
Ane
sthe
tist
Spec
ialis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201732
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
Post
-ope
rativ
e ca
re (r
ecov
ery)
XX
XX
Ane
sthe
siol
ogis
t/N
urse
Ane
sthe
tist
Spec
ialis
t
Pain
man
agem
ent
XX
XX
XX
All
heal
th c
are
prov
ider
sA
0, S
peci
alis
t,A
1, A
0
Palli
ative
care
XX
XX
XX
XX
All
heal
th c
are
prov
ider
sTr
aine
d in
palli
ative
car
e
Med
ical
Imag
ing
Gen
eral
radi
ogra
phy
(che
st,
abdo
men
, ske
leto
n)X
XX
XRa
diog
raph
er T
echn
icia
nA
0, S
peci
alis
t,A
1,
Fluo
rosc
opy
XX
XX
Radi
olog
ist,
Radi
ogra
pher
A0,
Spe
cial
ist,
Ultr
ason
ogra
phy
XX
XX
XA
ll Ph
ysic
ians
Radi
olog
yte
chni
cian
A1,
A
0 Sp
ecia
list,
M
edic
al O
ffice
r
Mam
mog
raph
yX
XX
XRa
diol
ogis
t,Ra
diog
raph
erSp
ecia
list i
nRa
diol
ogy
Com
pute
d to
mog
raph
y (C
T) s
can
XX
XX
Radi
olog
ist,
Radi
ogra
pher
Spec
ialis
t in
Radi
olog
y
Mag
netic
reso
nanc
e im
agin
g (M
RI) s
can
XX
XX
Radi
olog
ist,
Radi
ogra
pher
Spec
ialis
t in
Radi
olog
y
Ang
iogr
aphy
XX
XX
Radi
olog
ist,
Radi
ogra
pher
Spec
ialis
t in
Radi
olog
y
Med
ical
Phy
sics
Nuc
lear
med
icin
eX
XRa
diol
ogis
t,Ra
diog
raph
erN
ucle
arm
edic
ine
phys
icia
n
Path
olog
y/La
bora
tory
Phle
boto
my
Phle
boto
my
XX
XX
XX
XX
Nur
se/
Lab
Tech
nici
anA
1/A
0
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 33
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
Hem
atol
ogy
Hem
oglo
bin
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Hem
atoc
rit
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Com
plet
e bl
ood
coun
tX
XX
XX
XX
XLa
b Te
chni
cian
A1/
A0
Bloo
d ty
ping
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Blee
ding
and
clo
tting
tim
esX
XX
XX
XX
XLa
b Te
chni
cian
A1/
A0
Eryt
hroc
yte
sedi
men
tatio
n ra
te (E
SR)
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Bioc
hem
istry
Prot
einu
ria
and
Glu
cosu
ria
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
RDT
for
mal
aria
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Dru
g m
onito
ring
ass
ays
XX
XX
Lab
Tech
nici
anA
1/A
0
Rapi
d pr
egna
ncy
test
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Seru
m b
iliru
bin
XX
XX
XLa
b Te
chni
cian
A1/
A0
Bloo
d gl
ucos
eX
XX
XX
XX
Lab
Tech
nici
anA
1/A
0
Rapi
d pl
asm
a re
agin
(RPR
) for
test
fo
r sy
phili
sX
XX
XX
XX
XLa
b Te
chni
cian
A1/
A0
Rapi
d H
IV te
stX
XX
XX
XX
XLa
b Te
chni
cian
A1/
A2
Rapi
d he
patiti
s B&
C te
sts
XX
XX
XX
XX
Lab
Tech
nici
anA
1/A
2
Live
r fun
ction
test
sX
XX
XX
XX
Lab
Tech
nici
anA
1/A
2
Rena
l fun
ction
test
sX
XX
XX
XLa
b Te
chni
cian
A1/
A2
Alle
rgol
ogy
XX
XX
Spec
ialis
t
Mic
robi
olog
yPa
rasi
tolo
gyX
XX
XX
XX
XLa
b Te
chni
cian
A1/
A2
Myc
olog
yX
XX
XLa
b Te
chni
cian
A1/
A2
Bact
erio
logy
XX
XX
XX
Lab
Tech
nici
anA
1/A
2
Myc
obac
teri
olog
yX
XX
XX
XLa
b Te
chni
cian
A1/
A2
Cyto
logy
and
his
topa
thol
ogy
XX
XPa
thol
ogis
t
Mol
ecul
ar b
iolo
gy a
nd g
eneti
csX
XX
Path
olog
ist
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201734
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
nQ
ualifi
catio
n
Phar
mac
y*D
ispe
nsin
g ph
arm
acy
XX
XX
XPh
arm
acis
t, N
urse
/
Med
ical
Ass
ista
nt
A1/
A2
Clin
ical
pha
rmac
yX
XCl
inic
al P
harm
acis
tA
0
Dru
g po
ison
info
rmati
on s
ervi
ces
XX
Toxi
colo
gist
A0
ARV
dis
trib
ution
XX
XX
XX
Nur
seA
1/A
0
Onc
olog
y re
cons
tituti
ons
XX
Onc
olog
ist
Mas
ter i
n
Onc
olog
y
Phys
ioth
erap
yQ
ualifi
catio
nEx
erci
se (s
tren
gth
& b
alan
ce)
XX
XX
Phys
ioth
erap
ist
A1/
A0
Hyd
roth
erap
yX
XX
XPh
ysio
ther
apis
tA
1/A
0
Infr
ared
mas
sage
XX
XX
Phys
ioth
erap
ist
A1/
A0
Ultr
avio
let
XX
XX
Phys
ioth
erap
ist
A1/
A0
Cere
bral
pal
syX
XX
XPh
ysio
ther
apis
tA
1/A
0
Nut
ritio
nal c
ouns
ellin
gX
XX
XX
XN
utri
tioni
st/D
ietiti
anA
1/A
0
Ther
apeu
tic n
utri
tion
reha
bilit
ation
XX
XN
utri
tioni
st/D
ietiti
anA
1/A
0
* Th
e M
inis
teri
al O
rder
s in
dica
te th
at d
ispe
nsar
ies,
med
ical
pra
ctice
, med
ical
, den
tal a
nd a
nten
atal
car
e cl
inic
s ke
ep e
mer
genc
y m
edic
ation
s bu
t oth
erw
ise
do p
rovi
de p
harm
acol
ogic
al s
ervi
ces;
list
s to
be
appr
oved
by
the
Min
istr
y of
Hea
lth
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 35
Tabl
e 4:
Sur
gery In
terv
entio
nsD
MP
MC
SCP
HSH
ANN
HAn
esth
esia
De
scrip
tion
Qua
lifica
tion
Neu
rosu
rger
yHe
adD
ebri
dem
ent,
sutu
ring
(Cle
an th
ew
ound
to re
mov
e al
l for
eign
bod
ies
and
clos
e th
e w
ound
)
XX
XX
XX
GA
, LRA
, se
datio
n,
anal
gesi
cs
Nur
se, G
P, a
nySu
rgeo
n
Hem
osta
sis
XX
Ana
lges
ics o
r se
datio
n, G
A.
Defi
nitiv
em
anag
emen
tto
be
done
by
aN
euro
surg
eon.
Elev
ation
, deb
ride
men
tX
XG
AN
euro
surg
eon
Elev
ation
XX
GA
Neu
rosu
rgeo
n
Cran
iect
omy,
cra
niot
omy
and
cran
iost
omy
XX
GA
Neu
rosu
rgeo
n
Cran
iect
omy
XX
GA
Neu
rosu
rgeo
n
Ane
urys
m c
lippi
ngX
XG
AN
euro
surg
eon
Art
erio
veno
us m
alfo
rmati
on e
xcis
ion
XX
GA
Neu
rosu
rgeo
n
Base
of s
kull
brai
n tu
mor
exc
isio
nX
XG
AN
euro
surg
eon
Bila
tera
l chr
onic
sub
dura
l hem
atom
aev
acua
tion
(bur
r hol
es)
XX
GA
Neu
rosu
rgeo
n
Brai
n tu
mor
bio
psy
XX
GA
Neu
rosu
rgeo
nBu
rr h
oles
for d
rain
age
of b
rain
absc
ess
XX
GA
Neu
rosu
rgeo
n
Burr
hol
e an
d ve
ntri
culo
stom
yX
XG
AN
euro
surg
eon
Chro
nic
subd
ural
hem
atom
aev
acua
tion
(bur
r hol
es)
XX
GA
Neu
rosu
rgeo
n
Chro
nic
subd
ural
hem
atom
acr
anio
tom
yX
XG
AN
euro
surg
eon
Cran
iopl
asty
XX
GA
Neu
rosu
rgeo
n
Cran
ioto
my
and
base
of t
he s
kull
drill
ing
XX
GA
Neu
rosu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201736
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Anes
thes
ia
Desc
riptio
nQ
ualifi
catio
n
Cran
ioto
my
for b
rain
tum
or (c
onve
xity
tum
or)
XX
GA
Neu
rosu
rgeo
n
Cran
ioto
my
for d
rain
age
of b
rain
absc
ess
XX
GA
Neu
rosu
rgeo
n
Cran
ioto
my
for d
rain
age
of e
pidu
ral
empy
ema
XX
GA
Neu
rosu
rgeo
n
Cran
ioto
my
for d
rain
age
of s
ubdu
ral e
mpy
ema
XX
GA
Neu
rosu
rgeo
n
Dep
ress
ed s
kull
frac
ture
deb
ride
men
t(t
raum
a)X
XG
AN
euro
surg
eon
Ence
phal
ocel
es re
pair
XX
GA
Neu
rosu
rgeo
n
Endo
scop
ic a
ppro
ach
XG
AN
euro
surg
eon
Epid
ural
hem
atom
a ev
acua
tion
cran
ioto
my
(tra
uma)
XX
GA
Neu
rosu
rgeo
n
Exci
sion
intr
acer
ebra
l tum
orX
XG
AN
euro
surg
eon
Exci
sion
of p
ost f
ossa
tum
orX
XG
AN
euro
surg
eon
Exci
sion
of s
kull
tum
orX
XG
AN
euro
surg
eon
Fasc
ia h
arve
sting
and
dur
apla
sty
XX
GA
Neu
rosu
rgeo
n
Glo
mus
jugu
lare
tum
or e
xcis
ion
XX
GA
Neu
rosu
rgeo
n
Min
i-lap
arot
omy
+ tu
nnel
ing
cath
eter
Neu
rosu
rgeo
nX
XG
AN
euro
surg
eon
Pine
al re
gion
tum
or e
xcis
ion
XX
GA
Neu
rosu
rgeo
n
Stri
p cr
anie
ctom
ies
XX
GA
Neu
rosu
rgeo
n
Vent
ricu
lo-p
erito
neal
shun
t rev
isio
nX
XG
AN
euro
surg
eon
Vent
ricu
lo-p
erito
neal
shun
tX
XG
AN
euro
surg
eon
Vent
ricu
lar t
apX
XN
AN
euro
surg
eon
Shun
t res
ervo
ir ta
pX
XG
AN
euro
surg
eon
Exte
rnal
ven
tric
ular
dra
inag
eX
XG
A, L
RAN
euro
surg
eon
Om
may
a re
serv
oir i
nser
tion
XX
Neu
rosu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 37
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Anes
thes
ia
Desc
riptio
nQ
ualifi
catio
n
Spin
eA
nter
ior c
ervi
cal d
ecom
pres
sion
XX
GA
Neu
rosu
rgeo
n
Ant
erio
r tho
raci
c de
com
pres
sion
XX
GA
Neu
rosu
rgeo
nA
nter
ior t
hora
co-lu
mba
r de
com
pres
sion
XX
GA
Neu
rosu
rgeo
n
Bone
har
vesti
ng a
nd g
raft
ing
XX
GA
Neu
rosu
rgeo
n
Clos
ed re
ducti
on (t
raum
a - c
ervi
cal)
XX
GA
Neu
rosu
rgeo
n
Ant
erio
r cer
vica
l fixa
tion
and
fusi
onX
XG
AN
euro
surg
eon
Post
erio
r cer
vica
l fixa
tion
and
fusi
onX
XG
AN
euro
surg
eon
Lum
bar -
sacr
al fi
xatio
n an
d fu
sion
XX
GA
Neu
rosu
rgeo
n
Thor
acic
fixa
tion
and
fusi
onX
XG
AN
euro
surg
eon
Thor
aco-
lum
bar fi
xatio
n an
d fu
sion
XX
GA
Neu
rosu
rgeo
n
Hal
o’s
redu
ction
XX
GA
Neu
rosu
rgeo
n
Hal
o’s
trac
tion
(tra
uma
- cer
vica
l)X
XG
AN
euro
surg
eon
Kyph
opla
sty
XX
GA
Neu
rosu
rgeo
nLa
min
ecto
my
for d
rain
age
of s
pina
lep
idur
al a
bsce
ssX
XG
AN
euro
surg
eon
Lam
inec
tom
y fo
r dra
inag
e of
spi
nal
subd
ural
abs
cess
XX
GA
Neu
rosu
rgeo
n
Late
ral m
ass
scre
ws
inse
rtion
and
fusi
onX
XG
AN
euro
surg
eon
Lum
bar C
SF m
anom
etry
XX
GA
Neu
rosu
rgeo
n
Lum
bar d
isce
ctom
yX
XG
AN
euro
surg
eon
Lum
bar d
isce
ctom
y: m
ultip
le le
vel
XX
GA
Neu
rosu
rgeo
n
Lum
bar d
rain
inse
rtion
XX
GA
Neu
rosu
rgeo
nLu
mba
r pos
teri
or d
ecom
pres
sion
XX
GA
Neu
rosu
rgeo
n
Lum
bar p
oste
rior
fusi
onX
XG
AN
euro
surg
eon
Lum
bo p
erito
neal
shu
nt in
serti
onX
XG
AN
euro
surg
eon
Man
ipul
ation
of s
pine
und
er c
-arm
XX
GA
Neu
rosu
rgeo
n
Men
ingo
cele
repa
irX
XG
AN
euro
surg
eon
Mye
lo-m
enin
goce
le re
pair
XX
GA
Neu
rosu
rgeo
n
Lipo
-men
ingo
cele
repa
irX
XG
AN
euro
surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201738
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Pilo
nida
l sin
us e
xcis
ion
XX
GA
Neu
rosu
rgeo
n
Occ
ipita
l cer
vica
l dec
ompr
essi
onX
XG
AN
euro
surg
eon
Odo
ntoi
d sc
rew
inse
rtion
XX
GA
Neu
rosu
rgeo
n
Post
erio
r cer
vica
l dec
ompr
essi
onX
XG
AN
euro
surg
eon
Post
erio
r lum
bar s
acra
lX
XG
AN
euro
surg
eon
deco
mpr
essi
on
Post
erio
r tho
raci
c de
com
pres
sion
XX
GA
Neu
rosu
rgeo
n
Post
erio
r tho
raco
-lum
bar
deco
mpr
essi
onX
XG
AN
euro
surg
eon
Skul
l tra
ction
XX
GA
Neu
rosu
rgeo
nSp
ine
fusi
on o
ne le
vel
XX
GA
Neu
rosu
rgeo
n
Spin
e tu
mor
exc
isio
nX
XG
AN
euro
surg
eon
Spin
e: re
mov
al d
isc
plus
spi
nal f
usio
non
e le
vel
XX
GA
Neu
rosu
rgeo
n
Tran
sfor
amin
al lu
mba
r int
erbo
dyfu
sion
(t-li
f)X
XG
AN
euro
surg
eon
Tran
sfor
amin
al n
erve
infil
trati
onX
XG
AN
euro
surg
eon
Face
t infi
ltrati
onX
XG
AN
euro
surg
eon
Plas
tic S
urge
ry a
nd O
rgan
Face
Abb
é ty
pe fl
apX
XG
A o
r LA
Plas
tic S
urge
on
Skin
Ace
llula
r der
mal
allo
graft
XX
GA
Plas
tic S
urge
on
Leg
Ach
illes
tend
on re
pair
XX
GA
or R
egio
nal b
lock
Plas
ticSu
rgeo
n/
Ort
hope
dic
Surg
eon
Face
Alv
eola
r per
iost
eal o
r oth
er fl
aps
for
arch
cl
osur
eX
XG
APl
astic
Surg
eon/
O
rtho
donti
st,
Max
illo-
Faci
al
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 39
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Benn
ett fr
actu
re-d
islo
catio
n re
ducti
on
unde
r GA
and
fixa
tion
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Face
Blep
haro
plas
ty: u
pper
lid
for
impr
ovem
ent i
n fu
nctio
n (u
nila
tera
l)X
XG
A o
r LA
Plas
tic S
urge
on
Nec
kBr
achi
al p
lexu
s ex
plor
ation
and
repa
irX
XG
APl
astic
Sur
geon
Arm
sBr
achi
opla
sty
XX
GA
Plas
tic S
urge
on
Brea
stBr
east
aug
men
tatio
nX
XG
APl
astic
Sur
geon
Brea
st a
ugm
enta
tion
with
fat t
rans
fer
XX
GA
Plas
tic S
urge
on
Brea
st re
cons
truc
tion:
latis
sim
us d
orsi
flap,
with
out p
rost
hetic
impl
ant
XX
GA
Plas
tic S
urge
on
Brea
st re
cons
truc
tion:
touc
h-up
sX
XG
A o
r LA
Plas
tic S
urge
on
Brea
st re
cons
truc
tion:
tran
sver
se re
ctus
ab
dom
inis
myo
cuta
neou
s flap
(tra
m),
sing
le p
edic
le (s
utur
e of
don
or s
ite
incl
uded
)
XX
GA
Plas
tic S
urge
on
Brea
st re
ducti
onX
XG
APl
astic
Sur
geon
Butt
ocks
Butt
ock
augm
enta
tion
XX
GA
Plas
tic S
urge
on
Butt
ock
liftX
XG
APl
astic
Sur
geon
Eyel
idCa
ntho
plas
tyX
XG
A o
r LA
Plas
ticSu
rgeo
n/
Oph
thal
mol
ogis
t
Fing
ers
Caps
ulec
tom
y di
gita
l joi
ntX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
/ O
rtho
pedi
c Su
rgeo
n5t
Wris
tCa
rpal
tunn
el sy
ndro
me
rele
ase
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201740
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Any
Chan
ge o
f dre
ssin
g un
der
anes
thes
ia,
any
type
XX
GA
Plas
tic
Surg
eon/
Any
Su
rgeo
n
Exam
inati
on u
nder
ane
sthe
sia
XX
GA
Plas
tic
Surg
eon/
Any
Su
rgeo
n
Face
Cleft
lip
repa
ir: u
nila
tera
lX
XG
APl
astic
Surg
eon
Cleft
lip
repa
ir: b
ilate
ral
XX
GA
Plas
tic
Surg
eon
Cleft
pal
ate
repa
irX
XG
APl
astic
Surg
eon
Cleft
lip
subs
eque
nt to
uch-
ups
XX
GA
or L
APl
astic
Surg
eon
Cleft
rhin
opla
sty
XX
GA
Plas
tic
Surg
eon
Clos
ure
of a
nter
ior n
asal
floo
rX
XG
APl
astic
Sur
geon
/M
axill
o- F
acia
l Su
rgeo
n
Colu
mel
la re
cons
truc
tion
orle
ngth
enin
gX
XG
A o
r LA
Plas
ticSu
rgeo
n
Any
Com
plex
deb
ride
men
tX
XG
A o
r Reg
iona
l blo
ckPl
astic
Surg
eon
Com
plex
ped
icle
d or
per
fora
tor
flaps
XX
GA
Plas
ticSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 41
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Skin
Com
posi
te g
raft
XX
GA
or L
APl
astic
Surg
eon
Face
Cros
s fa
cial
ner
ve g
raft
XX
GA
Plas
ticSu
rgeo
n
Fing
ers
Cros
s fin
ger fl
apX
XG
A o
r Reg
iona
l blo
ckPl
astic
Surg
eon
Any
Sim
ple
debr
idem
ent
XX
GA
or R
egio
nal b
lock
Plas
ticSu
rgeo
n/ A
ny
Surg
eon
Skin
Split
thic
knes
s sk
in g
raft
XX
GA
or R
egio
nal b
lock
Plas
ticSu
rgeo
n
Full
thic
knes
s ski
n gr
aftX
XG
A o
r Reg
iona
l blo
ckPl
astic
Surg
eon
Face
Der
mab
rasi
onX
XG
APl
astic
Surg
eon
Face
or h
ands
Der
mal
fille
rsX
XLA
Plas
ticSu
rgeo
n
Any
Dis
tant
flap
, lik
e gr
oin
flap
XX
GA
or R
egio
nal b
lock
Plas
ticSu
rgeo
n
Face
Dra
inag
e of
intr
a-or
al a
bsce
ssX
XG
APl
astic
Surg
eon/
Max
illo-
Faci
al, E
NT
Surg
eon
Hand
Dup
uytr
en’s
con
trac
ture
:fa
scie
ctom
yX
XG
A o
r Reg
iona
l blo
ckPl
astic
Su
rgeo
n/
Ort
hope
dic
Surg
eon
Dup
uytr
en’s
con
trac
ture
:fa
scio
tom
yX
XG
A o
r Reg
iona
l blo
ckPl
astic
Surg
eon/
O
rtho
pedi
c Su
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201742
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Face
Entr
opio
n or
ect
ropi
on re
pair
by
free
ski
n, m
ucos
al g
raft
ing
or fl
apX
XG
A o
r LA
Plas
ticSu
rgeo
n
Epic
anth
al fo
lds
corr
ectio
nX
XG
A o
r LA
Plas
ticSu
rgeo
n
Skin
Epid
erm
oid
cyst
exc
isio
nX
XLA
Plas
ticSu
rgeo
n/ A
nySu
rgeo
n
Face
Estla
nder
type
flap
XX
GA
or L
APl
astic
Surg
eon
Skin
Exci
sion
bio
psy
of s
kin
tum
ors
XX
GA
or L
APl
astic
Surg
eon/
Any
Su
rgeo
n
Inci
sion
bio
psy
of s
kin
tum
ors
XX
LAPl
astic
Surg
eon/
Any
Surg
eon
Hand
Exci
sion
of a
sim
ple
poly
dact
yly
XX
GA
or L
APl
astic
Surg
eon/
O
rtho
pedi
c Su
rgeo
n
Exci
sion
of a
com
plex
pol
ydac
tyly
XX
GA
or L
APl
astic
Surg
eon
Skin
Exci
sion
of k
eloi
d w
ith p
rim
ary
clos
ure
XX
LAPl
astic
Surg
eon/
Any
Surg
eon
Exci
sion
of k
eloi
d w
ith s
kin
graft
XX
GA
or L
APl
astic
Surg
eon/
Any
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 43
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Any
Exci
sion
of p
erip
hera
l neu
rom
aX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
Expl
orati
on a
nd e
xcis
ion
of a
fist
ula
abov
e de
ep fa
scia
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Any
Sur
geon
Expl
orati
on a
nd e
xcis
ion
of a
fist
ula
deep
to d
eep
fasc
iaX
XG
A o
r LA
Plas
tic S
urge
on/
Any
Sur
geon
Face
Expl
orati
on o
f fac
ial n
erve
: ex
tra
tem
pora
l exp
lora
tion
and
repa
ir o
f the
fa
cial
ner
ve w
ithou
t ner
ve g
raft
XX
GA
Plas
tic S
urge
on
Any
Exte
nsiv
e de
brid
emen
t (co
mpl
ex
invo
lvin
g m
ore
than
one
lim
b)X
XG
APl
astic
Sur
geon
/ A
ny S
urge
on
Face
Eyel
id la
cera
tion
repa
irX
XG
A o
r LA
Plas
tic S
urge
on/
phth
alm
olog
ist
Face
lift
XX
GA
Plas
tic S
urge
on
Faci
al b
otul
inum
toxi
nX
XLA
Plas
tic S
urge
on
Faci
al fa
t gra
ftin
gX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
Faci
al im
plan
ts fo
r cos
meti
cpu
rpos
eX
XG
APl
astic
Sur
geon
Faci
al la
cera
tion
expl
orati
on a
nd
clos
ure
XX
GA
or L
APl
astic
Sur
geon
/ A
ny S
urge
on
Faci
al n
erve
pal
sy c
orre
ction
with
loca
l reg
iona
l mus
cle
flap
XX
GA
Plas
tic S
urge
on
Faci
al ti
ssue
def
ect r
econ
stru
ction
XX
GA
Plas
tic S
urge
on
Any
Fat g
raft
ing
XX
GA
or R
egio
nal b
lock
Plas
ticSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201744
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Fing
ertip
cov
er w
ith a
hom
odig
ital n
euro
vasc
ular
isla
nd fl
apX
XG
A o
r Reg
iona
l blo
cPl
astic
Sur
geon
Flex
or te
ndon
gra
ft u
sing
sila
stic
rod
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Any
Flap
div
isio
n an
d in
set o
r any
subs
eque
nt st
age
in fl
ap re
cons
truc
tion
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on
Hand
Flex
or te
ndon
free
ing
oper
ation
fo
llow
ing
free
tend
on g
raft
or
sutu
reX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
Face
Floo
r of t
he m
outh
reco
nstr
uctio
nw
ith d
ista
nt p
edic
led
flap
XX
GA
Plas
tic S
urge
on
Fore
head
lift
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on
Frac
ture
: nos
e an
d se
ptum
, ope
nre
ducti
onX
XG
APl
astic
Sur
geon
Any
Free
flap
har
vesti
ngX
XG
APl
astic
Sur
geon
Free
flap
inse
t and
mic
rova
scul
aran
asto
mos
isX
XG
APl
astic
Sur
geon
Abdo
men
Full
abdo
min
opla
sty
XX
GA
Plas
tic S
urge
on
Face
Full
thic
knes
s lip
lace
ratio
n de
brid
emen
t and
clo
sure
XX
LAPl
astic
Sur
geon
/
Nos
e re
cons
truc
tion
first
sta
geX
XG
APl
astic
Sur
geon
Nos
e re
cons
truc
tion
subs
eque
ntst
age
XX
GA
or L
APl
astic
Sur
geon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 45
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Gan
glio
n ex
cisi
onX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
/ O
rtho
pedi
c Su
rgeo
n
Brea
stG
ynec
omas
tia c
orre
ction
bila
tera
lX
XG
APl
astic
Sur
geon
Hand
Han
d te
ndon
s: o
ppon
ens t
endo
n tr
ansf
erX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
/ O
rtho
pedi
c Su
rgeo
n
Har
vesti
ng o
f car
tilag
e gr
aftX
XG
APl
astic
Sur
geon
Any
Har
vesti
ng o
f non
-vas
cula
rize
d bo
ne
graft
XX
GA
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Face
Har
vesti
ng o
f fas
cia
lata
gra
ftX
XG
A o
r LA
WH
O?
Hand
Hav
ersti
ng o
f ten
don
graft
XX
GA
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Brea
stIm
med
iate
bre
ast r
econ
stru
ction
with
bre
ast i
mpl
ant,
bila
tera
lX
XG
APl
astic
Sur
geon
Imm
edia
te b
reas
t rec
onst
ructi
onw
ith b
reas
t im
plan
t, u
nila
tera
lX
XG
APl
astic
Sur
geon
Low
er li
mb
Infr
apat
ella
r or q
uadr
icep
s te
ndon
re
pair
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Hand
Intr
insi
c te
ndon
rele
ase
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Join
t lig
amen
t rec
onst
ructi
on o
r su
ture
: di
gita
l joi
nt li
gam
ent
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201746
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Face
Lacr
imal
duc
t rep
air
XX
GA
or L
APl
astic
Sur
geon
/ O
phth
alm
olog
ist
Any
Larg
e ne
rve
repa
ir w
ith n
erve
gra
ftX
XG
APl
astic
Sur
geon
Larg
e ne
rve
repa
ir w
ithou
t gra
ftX
XG
APl
astic
Sur
geon
Face
Lid
oper
ation
for f
acia
l ner
vepa
raly
sis
incl
udin
g ta
rsor
rhap
hyX
XG
A o
r LA
Plas
tic S
urge
on
Lip
cont
ract
ure
rele
ase
and
cove
rX
XG
APl
astic
Sur
geon
Any
Lipo
sucti
onX
XG
APl
astic
Sur
geon
Face
Blep
haro
plas
tyX
XG
A o
r LA
Plas
tic S
urge
on
Any
Maj
or c
ompa
rtm
enta
l dec
ompr
essi
onX
XG
APl
astic
Sur
geon
Brea
stM
asto
pexy
XX
GA
Plas
tic S
urge
on
Mas
toto
my
with
exp
lora
tion,
drai
nage
of a
bsce
ss o
r rem
oval
of
mam
mar
y im
plan
t
XX
GA
Plas
tic S
urge
on
Any
Mic
rova
scul
ar a
nast
omos
is, a
nyX
XG
APl
astic
Sur
geon
Abdo
men
Min
i abd
omin
opla
sty
XX
GA
Plas
tic S
urge
on
Hand
Tend
on tr
ansf
ers
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eons
Face
Nec
k lift
XX
GA
Plas
tic S
urge
on
Brea
stN
ippl
e an
d ar
eola
reco
nstr
uctio
nX
XG
APl
astic
Sur
geon
Face
Obl
itera
tion
of fr
onta
l sin
us w
ithpe
ricr
ania
l flap
XX
GA
Plas
tic S
urge
on
Leg
Ope
n el
onga
tion
Ach
illes
tend
onX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
/ O
rtho
pedi
c Su
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 47
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Ope
n re
ducti
on o
f a d
islo
catio
n(h
and)
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Tors
oO
pen
ster
num
reco
nstr
uctio
nX
XG
APl
astic
Sur
geon
Hand
Ori
f han
d bo
nes
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Hand
Ost
eoto
my:
met
acar
pal a
nd p
hala
nx:
corr
ectiv
e fo
r mal
unio
n or
rota
tion
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Ears
Oto
plas
tyX
XG
A o
r LA
Plas
tic S
urge
on
Parti
al e
ar re
cons
truc
tion
XX
GA
Plas
tic S
urge
on
Upp
er li
mb
Pect
oral
is m
ajor
or l
atiss
imus
dor
si
tran
sfer
to b
icep
s te
ndon
XX
GA
Plas
tic S
urge
on
Peni
sPe
nis
reco
nstr
uctio
nX
XG
APl
astic
Sur
geon
Hand
Polli
ciza
tion
of th
e fin
ger
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on
Exte
nsor
tend
on re
pair
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Flex
or te
ndon
repa
irX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
/ O
rtho
pedi
c Su
rgeo
n
Eyel
idPt
osis
cor
recti
onX
XG
A o
r LA
Plas
tic S
urge
on/
Oph
thal
mol
ogis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201748
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Radi
cal e
xcis
ion
of n
ailb
edX
XRe
gion
al b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Reco
nstr
uctio
n of
pul
ley
for
flexo
r te
ndon
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Redu
ction
car
pal b
one
frac
ture
un
der g
ener
al a
nest
hetic
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Any
Rem
oval
of d
eep
fore
ign
body
us
ing
c-ar
mX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
Rem
oval
of f
orei
gn b
ody
supe
rfici
al to
dee
p fa
scia
in h
ands
, fe
et o
r fac
e
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Any
Sur
geon
Hand
Repa
ir o
f bou
tonn
ière
def
orm
ity
or m
alle
t fing
er w
ith g
raft
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Repa
ir o
f nai
l bed
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Face
Repa
ir o
f oro
nasa
l fist
ula
incl
udin
g re
do o
f cle
ft li
pX
XG
APl
astic
Sur
geon
Rhin
opla
sty
XX
GA
or L
APl
astic
Sur
geon
Skin
Scar
revi
sion
XX
GA
or L
APl
astic
Sur
geon
Hand
Skin
con
trac
ture
rele
ases
of
finge
rsX
XG
APl
astic
Sur
geon
Any
Skin
con
trac
ture
rele
ase
of a
big
join
t with
z-p
last
y an
d sk
in g
raft
XX
GA
Plas
tic S
urge
on
Face
Skin
resu
rfac
ing
XX
GA
Plas
tic S
urge
on
Any
Slou
ghec
tom
yX
XG
APl
astic
Sur
geon
/A
ny S
urge
on
Hand
Synd
acty
ly re
leas
eX
XG
A o
r Reg
iona
l blo
ckPl
astic
Sur
geon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 49
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Low
er li
mb
Thig
h lift
XX
GA
Plas
tic S
urge
on
Hand
Thum
b or
gre
at to
e du
plic
ation
co
rrec
tion
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Skin
Tiss
ue e
xpan
der i
nser
tion
XX
GA
Plas
tic S
urge
on
Tiss
ue e
xpan
der r
emov
al, e
xcis
ion
of le
sion
and
inse
tX
XG
APl
astic
Sur
geon
Ears
Tota
l ear
reco
nstr
uctio
nX
XG
APl
astic
Sur
geon
Upp
er li
mb
Tran
spos
ition
of u
lnar
ner
veX
XG
A o
r LA
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Hand
Trig
ger fi
nger
rele
ase
XX
GA
or R
egio
nal b
lock
Plas
tic S
urge
on/
Ort
hope
dic
Surg
eon
Gen
eral
Sur
gery
and
Org
an
Airw
ayTr
ache
osto
my
XX
LA, G
AA
ny S
urge
on
Cric
o-th
yroi
doto
my
XX
LA, G
AA
ny S
urge
on
Effus
ion
Thor
acic
dra
inag
e/Ch
est t
ube
inse
rtion
XX
LA, G
AA
ny S
urge
on
Trau
ma
Cons
erva
tive
man
agem
ent o
f rib
frac
ture
XA
nalg
esic
s. G
A, L
RAA
ny s
urge
on
Flai
l che
st m
anag
emen
tX
GA
, LRA
Thor
acic
Surg
eon/
Gen
e ra
l Sur
geon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201750
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Brea
stIn
cisi
on o
f a b
reas
t abs
cess
XX
GA
Gen
eral
Sur
geon
Lum
pect
omy
of b
reas
t tum
or(b
enig
n), b
iops
yX
XG
A, L
RAG
ener
al S
urge
on
Mas
tect
omy
(mal
igna
nt tu
mor
), bi
opsy
XX
XG
A, L
RAG
ener
al S
urge
on
Thyr
oid
and
Nec
k M
asse
s and
Soft
Ti
ssue
s Inj
urie
s
Thyr
oid
lobe
ctom
yX
XX
GA
, LRA
Gen
eral
Sur
geon
/E
NT
Surg
eon
Tota
l thy
roid
ecto
my
XX
GA
Gen
eral
Surg
eon
/EN
T Su
rgeo
n
Thor
axLu
ng d
ecor
ticati
onEl
oess
er fl
apX
XX
GA
Thor
acic
Surg
eon
(Nee
d fo
r ICU
)
Pneu
mec
tom
y lo
bect
omy,
wed
gelu
ng re
secti
on, m
asse
s re
secti
onX
XG
ATh
orac
icSu
rgeo
n (N
eed
for I
CU)
Esop
hage
al re
plac
emen
t,se
gmen
tal r
esec
tion
and
anas
tom
osis
,X
XG
ATh
orac
icSu
rgeo
n (N
eed
for I
CU)
Sten
ting
or d
ilatio
nX
XX
GA
/LRA
Thor
acic
Peri
card
ial d
ecor
ticati
onX
XG
ATh
orac
ic
Surg
eon
Fist
ula
ligati
on, e
soph
agos
tom
yX
XG
ATh
orac
icSu
rgeo
n
Peri
card
ial w
indo
wX
XG
ATh
orac
ic
Surg
eon/
G
ener
al S
urge
on
Emer
genc
y th
orac
otom
yX
XG
ATh
orac
icSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 51
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Abdo
men
Lapa
roto
my
XX
XG
AG
ener
al S
urge
on
Abd
omin
al h
erni
a re
pair
XX
XG
AG
ener
al S
urge
on
Dia
phra
gmati
c he
rnia
repa
irX
XG
AG
ener
al S
urge
on/
Thor
acic
Sur
geon
(m
ay n
eed
ICU
)
Ingu
inal
her
nia
repa
irX
XX
GA
, LRA
Gen
eral
Sur
geon
Stra
ngul
ated
her
nia
repa
irX
XX
GA
,G
ener
al S
urge
on
Um
bilic
al h
erni
a re
pair
XX
XG
A, L
RAG
ener
al S
urge
on
Abd
omin
al in
cisi
onal
her
nia
repa
irX
XX
GA
, LRA
Gen
eral
Sur
geon
Repa
ir o
f tra
umati
zed
abdo
min
alw
all o
r org
ans.
XX
XG
A,
Gen
eral
Sur
geon
Inse
rtion
of a
sup
ra-p
ubic
cath
eter
XX
XG
A, L
RAA
ny S
urge
on
Stom
ach
&du
oden
umG
astr
osto
my
(ope
n or
end
osco
pic
ally
)X
XX
GA
, LRA
Gen
eral
Sur
geon
Repa
ir o
f a p
erfo
ratio
n of
duod
enal
or g
astr
ic u
lcer
XX
XG
AG
ener
al S
urge
on
Repa
ir o
f a g
astr
ic o
r duo
dena
lbl
eedi
ng u
lcer
XX
GA
Gen
eral
Sur
geon
Duo
deno
-duo
deno
stom
y fo
r du
oden
al
atre
sia
XX
GA
Gen
eral
Sur
geon
Gas
trec
tom
y (s
ubto
tal o
ran
trec
tom
y)X
XX
GA
Gen
eral
Sur
geon
Vago
tom
y pl
usPy
loro
plas
ty/g
astr
oent
eros
tom
yX
XX
GA
.G
ener
al S
urge
on
Gas
troe
nter
asto
my
XX
XG
ener
al S
urge
onTo
tal G
astr
ecto
my
XX
GA
Gen
eral
Sur
geon
Pylo
rom
ytom
yX
XX
GA
, LRA
Gen
eral
Sur
geon
(r
equi
res
Ane
sthe
si o
logi
st)
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201752
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Gal
lbla
dder
&Bi
liary
trac
t,Ch
olec
yste
ctom
y, o
pen/
lapo
rosc
opic
, ste
nting
XX
XG
AG
ener
al S
urge
on
CBD
exp
lora
tion
XX
XG
AG
ener
al S
urge
on
(Req
uire
s Im
age
inte
nsifi
er)
Kasa
i pro
cedu
reX
XG
AG
ener
al S
urge
on
Bilia
ry b
y-pa
ss s
urge
ryX
XG
AG
ener
al S
urge
on
Panc
reas
Whi
pple
pro
cedu
reX
XX
GA
Gen
eral
Sur
geon
Panc
reati
c ps
eudo
cyst
dra
inag
eX
XX
GA
Gen
eral
Sur
geon
Smal
l int
estin
eSu
ture
of a
n in
testi
nal p
erfo
ratio
nX
XX
GA
Gen
eral
Sur
geon
Rese
ction
, sto
ma
or a
nast
omos
isX
XX
GA
Gen
eral
Sur
geon
Peri
toni
tis /L
apar
otom
yX
XX
GA
Gen
eral
Sur
geon
Inte
stina
l obs
truc
tion
XX
XG
AG
ener
al S
urge
on
Appe
ndix
App
ende
ctom
yX
XX
GA
, LRA
Gen
eral
Sur
geon
App
endi
cula
r abs
cess
XX
XG
AG
ener
al S
urge
on
Colo
nCo
lost
omy
XX
XG
AG
ener
al S
urge
on
Segm
ente
ctom
yX
XX
GA
Gen
eral
Sur
geon
Hem
i-col
ecto
my
XX
XG
AG
ener
al S
urge
on
Sigm
oide
ctom
y.X
XX
GA
Gen
eral
Sur
geon
Sigm
oid
dero
tatio
nX
XX
GA
Gen
eral
Sur
geon
Reco
nstr
uctio
n of
col
on a
fter
Har
tman
’s p
roce
dure
XX
XG
AG
ener
al S
urge
on
Pull
thro
ugh
XX
GA
Gen
eral
Sur
geon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 53
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Rect
umRe
cto
sigm
oide
ctom
yX
XX
GA
Gen
eral
Sur
geon
Abd
omin
o pe
rine
al R
esec
tion,
XX
GA
Gen
eral
Sur
geon
Low
er a
nter
ior r
esec
tion,
XX
GA
Gen
eral
Sur
geon
Rect
al b
iops
yX
XX
GA
Gen
eral
Sur
geon
Anus
Hem
orrh
oide
ctom
yX
XX
GA
, LRA
Gen
eral
Sur
geon
Ana
l fiss
ure
XX
XG
A, L
RAW
HO
?
Ana
l fist
ula
repa
irX
XX
GA
, LRA
Uro
logi
st/
Gen
eral
Sur
geon
Inci
sion
of a
n is
chio
-rec
tal a
bsce
ssX
XX
GA
, LRA
Gen
eral
Sur
geon
Anor
ecta
lm
alfo
rmati
onPS
ARP
, ASA
RP, a
nopl
asty
, Ana
ldi
latio
n, c
loac
a re
pair
XX
GA
, LRA
Gen
eral
Sur
geon
Lim
bSt
ripp
ing,
art
eria
l ven
ous
fistu
la,
vasc
ular
repa
irX
XX
GA
& L
RAG
ener
al S
urge
on
Soft
tiss
ues
Lipo
mec
tom
y, C
yste
ctom
y,Ex
cisi
on a
nd In
cisi
on, D
rain
age,
D
ebri
dem
ent,
Sur
gica
l &Su
turi
ng,
Ther
apeu
tic c
ircu
mci
sion
, Ski
n gr
aft, N
ail e
xtra
ction
, Ten
don
repa
ir,
Fasc
ioto
my
XX
XG
A &
LRA
Gen
eral
Sur
geon
Uro
logy
surg
ery/
orga
n
Adre
nals
Adr
enal
ecto
my
XX
GA
Uro
logi
st
Peni
sA
mpu
tatio
n of
pen
is (p
artia
l)X
XG
A o
r Sp
inal
A
nest
hesi
aU
rolo
gist
Am
puta
tion
of p
enis
(tot
al)
XX
GA
or S
pina
l A
nest
hesi
aU
rolo
gist
Arti
ficia
l uri
nary
sph
inct
er im
plan
tX
XG
A o
r Spi
nal
Ane
sthe
sia
Uro
logi
st
Epid
idym
isBi
opsy
of e
pidi
dym
isX
XLo
cal A
nest
hesi
a or
GA
Uro
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201754
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Blad
der
Blad
der d
iver
ticul
um re
secti
onX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Blad
der n
eck
inci
sion
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Blad
der n
eck
reco
nstr
uctio
nX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Blad
der e
xstr
ophy
repa
irX
XG
AU
rolo
gist
Blad
der n
eck
rese
ction
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Boar
i flap
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Burc
h co
lpos
uspe
nsio
nX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Peni
sCi
rcum
cisi
on a
dult
XX
LAA
ll Su
rgeo
ns
Cond
ylom
aex
cisi
on/e
lect
roco
agul
ation
XX
LAG
ener
al S
urge
on
Der
mat
olog
ist
Uro
logi
st
Vagi
naCo
lova
gino
plas
ty fo
r vag
inal
reco
nstr
uctio
nX
XG
A o
r Spi
nal A
nest
hesi
aO
bste
tric
Gyn
ecol
ogis
tU
rolo
gist
Cyst
ecto
my
parti
alX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Blad
der
Cyst
ecto
my
radi
cal
XX
GA
Uro
logi
st
Cyst
ocel
e re
pair
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
stO
bste
tric
Gyn
ecol
ogis
t
Cyst
olith
olap
axy
(tra
nsur
ethr
al)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Cyst
olith
olap
axy
perc
utan
eous
su
prap
ubic
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Cyst
olith
otom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Cyst
opla
sty
augm
enta
tion
XX
GA
Uro
logi
st
Cyst
opla
sty
ileo/
colo
plas
tyX
XG
AU
rolo
gist
Cyst
osco
py fo
r clo
ts re
mov
alX
XG
AU
rolo
gist
Cyst
osco
py u
nder
GA
XX
Ga
Uro
logi
stCy
stos
copy
und
er la
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Cyst
osto
my
(ope
n)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Cyst
osto
my
(pun
ctur
e)X
XLA
Uro
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 55
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Scro
tum
Deb
ride
men
t for
four
nier
sga
ngre
neX
XG
AU
rolo
gist
Sper
mati
c co
rdD
etor
sion
for t
orsi
on o
f the
testi
s+
cont
rala
tera
l tes
tis fi
xatio
nX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Pros
tate
Dra
inag
e of
pro
stati
c ab
sces
s(p
erin
eal)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Rena
l pel
vis
Endo
pyel
otom
yX
XG
AU
rolo
gist
Epid
idym
isEp
idid
ymal
cys
t exc
isio
n(b
ilate
ral)
XX
GA
Uro
logi
st
Epid
idym
al c
yst e
xcis
ion
(uni
late
ral)
XX
GA
Uro
logi
st
Epid
idym
al fn
aX
XLA
Uro
logi
st
Epid
idym
al sp
erm
retr
ieva
lX
XG
AU
rolo
gist
Epid
idym
ecto
my
(bila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Epid
idym
ecto
my
(uni
late
ral)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thra
Epis
padi
as re
pair
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Epis
padi
as re
pair
(com
plex
)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Kidn
eyEx
cisi
on o
f ren
al c
yst
XX
GA
Uro
logi
st
Blad
der
Exci
sion
of u
rach
us a
nd re
pair
of
blad
der
XX
GA
Uro
logi
st
Ingu
inal
cana
lH
erni
otom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
/Gen
eral
Sur
geon
Scro
tum
Hyd
roce
lect
omy
(bila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Hyd
roce
lect
omy
(uni
late
ral)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201756
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Ure
thra
Hyp
ospa
dias
repa
irX
XG
A o
r Sp
inal
Ane
sthe
sia
Uro
logi
st/
Hyp
ospa
dias
repa
ir c
ompl
exX
XG
AU
rolo
gist
Urin
ary
Ileal
con
duit
XX
GA
Uro
logi
st
dive
rsio
nIle
oure
tera
l sub
stitu
tion
XX
GA
Uro
logi
st
Peni
sIm
plan
tatio
n of
pen
ile p
rost
hesi
sfo
r tr
eatm
ent o
f im
pote
nce
XX
GA
or
Spin
al A
nest
hesi
aU
rolo
gist
Scro
tum
Inci
sion
and
dra
inag
e of
scr
otum
absc
ess
unde
r G
AX
XG
AU
rolo
gist
Ure
thra
Inte
rnal
ure
thro
tom
yX
XG
A o
r Sp
inal
Ane
sthe
sia
Uro
logi
st
Blad
der
Intr
aves
ical
inje
ction
(Bot
ox,
silic
on, e
tc.)
XX
GA
or
Spin
al A
nest
hesi
aU
rolo
gist
Kidn
eyKi
dney
cys
t res
ectio
nX
XG
AU
rolo
gist
Peni
sLa
peyr
onie
dis
ease
repa
irX
XG
A o
r Sp
inal
Ane
sthe
sia
Uro
logi
st
Blad
der
Lase
r tr
eatm
ent o
f bla
dder
can
cer
XX
GA
or
Spin
al A
nest
hesi
aU
rolo
gist
Lym
ph n
odes
Lym
phad
enec
tom
y (b
ilate
ral i
ngui
nal)
XX
GA
Uro
logi
st
Lym
phad
enec
tom
y (b
ilate
ral p
elvi
c)X
XG
AU
rolo
gist
Lym
phad
enec
tom
y (r
etro
peri
tone
al)
XX
GA
Uro
logi
st
Lym
phad
enec
tom
y (u
nila
tera
l in
guin
al)
XX
GA
Uro
logi
st
Lym
phad
enec
tom
y (u
nila
tera
l pel
vic)
XX
GA
Uro
logi
st
Urin
ary
dive
rsio
nM
ainz
pou
ch ii
XX
GA
Uro
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 57
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Ure
thra
Mea
toto
my
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Mea
topl
asty
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
ter
Meg
aure
ter r
epai
rX
XG
AU
rolo
gist
Kidn
eyN
ephr
ecto
my
lapa
rosc
opic
XX
GA
Uro
logi
st
Nep
hrec
tom
y pa
rtial
(ope
n,la
paro
scop
ic, t
rans
per
itone
al o
r re
trop
erito
neal
)
XX
GA
Uro
logi
st
Nep
hrec
tom
y ra
dica
lX
XG
AU
rolo
gist
Ure
ter
Nep
hrou
rete
rect
omy
(ope
n or
lapa
rosc
opic
)X
XG
AU
rolo
gist
Kidn
eyN
ephr
ecto
my
(don
or)
XX
GA
Uro
logi
st
Infe
rior v
ena
cava
Cava
thro
mbe
ctom
yX
XG
AU
rolo
gist
Kidn
eyN
ephr
ecto
my
(sim
ple)
XX
GA
Uro
logi
st
Nep
hrol
ithot
omy
(ope
n)X
XG
AU
rolo
gist
Nep
hros
tom
y (b
ilate
ral
perc
utan
eous
)X
XG
AU
rolo
gist
Nep
hros
tom
y (o
pen)
XX
GA
Uro
logi
st
Nep
hros
tom
y (u
nila
tera
lpe
rcut
aneo
us)
XX
GA
Uro
logi
st
Nep
hros
copy
XX
GA
Uro
logi
st
Testi
sO
rchi
dect
omy
(bila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Orc
hide
ctom
y (u
nila
tera
l rad
ical
ingu
inal
)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Orc
hide
ctom
y (u
nila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201758
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Orc
hido
pexy
for u
ndes
cend
edte
stis
(bila
tera
l)X
XG
AU
rolo
gist
Orc
hido
pexy
for u
ndes
cend
edte
stis
(uni
late
ral)
XX
GA
Uro
logi
st
Peni
sPe
nile
frac
ture
repa
irX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Peni
le p
rost
hesi
sX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Para
phym
osis
redu
ction
XX
GA
Uro
logi
st/
Gen
eral
Sur
geon
Ure
ter
Perc
utan
eous
ant
egra
de st
ent
repl
acem
ent
XX
GA
Uro
logi
st
Kidn
eyPe
rcut
aneo
us n
ephr
olith
otri
psy
(pcn
l)X
XG
AU
rolo
gist
Ure
thra
Peri
neos
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Peri
-ure
thra
l col
lage
n in
jecti
onfo
r inc
ontin
ence
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pros
tate
Plas
ma
vapo
riza
tion
of th
e pr
osta
teX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
thra
Post
erio
r ure
thra
l val
ves
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
fulg
urati
on
Peni
sPr
iapi
sm m
anag
emen
t(a
spira
tion,
inje
ction
of t
he c
orpu
s ca
vern
osum
)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pria
pism
ope
ratio
n (w
inte
r shu
nt)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pria
pism
ope
ratio
n (e
l gho
rab)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pria
pism
ope
ratio
n (g
rayh
ack)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pria
pism
ope
ratio
n (s
elec
tive
embo
lizati
on, o
r lig
ation
)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 59
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Pros
tate
Pros
tate
bio
psy
(any
app
roac
h)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Pros
tate
ctom
y (r
adic
al)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pros
tate
ctom
y fo
r ben
ign
pros
tate
hy
pert
roph
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Pros
tatic
sten
ting
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Rena
l pel
vis
Pyel
olith
otom
yX
XG
AU
rolo
gist
Kidn
eyPy
elon
ephr
olith
otri
psy
XX
GA
Uro
logi
st
Pyel
onep
hrol
ithot
omy
XX
GA
Uro
logi
st
Rena
l pel
vis
Pyel
olith
otri
psy
XX
GA
Uro
logi
st
Pyel
opla
sty
XX
GA
Uro
logi
st
Pyel
osto
my
XX
GA
Uro
logi
st
Pyel
o ur
eter
opla
sty
XX
GA
Uro
logi
st
Rena
l tra
nspl
ant
XX
GA
Uro
logi
st
Kidn
eyRe
nal a
rter
ial g
raft
XX
GA
Uro
logi
st
Repa
ir o
f lac
erat
ed k
idne
yX
XG
AU
rolo
gist
Ure
ter
Repa
ir o
f ure
tera
lin
juri
es/t
rans
ectio
nsX
XG
AU
rolo
gist
Blad
der
Repa
ir o
f rup
ture
d bl
adde
rX
XG
AU
rolo
gist
Ure
ter
Retr
ogra
de p
yelo
grap
hyX
XG
AU
rolo
gist
Blad
der
Sacr
al n
erve
stim
ulati
onX
XG
AU
rolo
gist
Vas d
efer
ens
Sem
inal
vas
ecto
my
(bila
tera
l)X
XG
AU
rolo
gist
/
Blad
der
Psoa
s hi
tch
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Pubo
vagi
nal s
ling
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st/
obst
etri
c gy
neco
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201760
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Kidn
eySu
rger
y fo
r ren
al a
bsce
sses
XX
GA
Uro
logi
st
Peni
sSu
rger
y fo
r pye
roni
e di
seas
eX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Surg
ery
for c
onge
nita
l ure
thra
ldu
plic
ation
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thra
Surg
ery
for a
mbi
guou
s ge
nita
liaX
XG
AU
rolo
gist
Peni
sSu
rger
y fo
r ure
tero
cele
(tra
nsur
ethr
al u
nroo
fing)
XX
GA
Uro
logi
st
Ure
ter
Surg
ery
for d
uplic
ate
syst
em(e
ndos
copi
c de
com
pres
sion
)X
XG
AU
rolo
gist
Surg
ery
for d
uplic
ate
syst
em (o
pen
reco
nstr
uctio
n at
the
blad
der l
evel
)X
XG
AU
rolo
gist
Surg
ery
for d
uplic
ate
syst
em (o
pen
reco
nstr
uctio
n at
the
rena
l lev
el)
XX
GA
Uro
logi
st
Surg
ery
for d
uplic
ate
syst
em(c
ombi
ne a
ppro
ach)
XX
GA
Uro
logi
st
Kidn
eySy
mph
ysio
tom
y of
hor
sesh
oe k
idne
yX
XG
AU
rolo
gist
Vas d
efer
ens
Sem
inal
vas
ecto
my
(uni
late
ral)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Testi
sTe
stis
biop
sy: i
ngui
nal
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Testi
s bi
opsy
: scr
otal
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
ter
Tran
sure
tero
uret
eros
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Blad
der
Tran
s-ur
ethr
al re
secti
on o
f bla
dder
tu
mor
(one
)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Tran
s-ur
ethr
al re
secti
on o
f lar
gebl
adde
r tum
orX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Pros
tate
Tran
s-ur
ethr
al re
secti
on o
f the
pros
tate
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 61
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Kidn
eyU
rete
roca
licos
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
teri
c st
ent (
bila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
teri
c st
ent (
unila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
teri
c st
ent r
emov
alX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
litho
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
ter
Ure
tero
litho
trip
sy la
ser
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
tero
litho
trip
sy e
lect
rohy
drau
licX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tera
l dila
tatio
nX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
lysi
sX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
neoc
ysto
stom
y (b
ilate
ral)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
tero
neoc
ysto
stom
y (u
nila
tera
l)X
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
plas
tyX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
-pye
lolit
hoto
my
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
tero
pyel
olito
trip
syX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
rrha
phy
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
tero
scop
ic la
ser l
ithot
rips
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
scop
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
lysi
s for
retr
oper
itone
al fi
bros
isX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
scop
y an
d ba
sket
extr
actio
n of
sto
neX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
-sig
moi
dost
omy
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
tero
vesi
cal a
nast
omos
is,
reim
plan
tatio
nX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
colic
ana
stom
osis
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201762
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Ure
tero
ileal
con
duit
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
tero
uret
eros
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tere
ctom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
tero
stom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
thra
Ure
thra
l div
ertic
ulec
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
thra
l mea
toto
my
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thre
ctom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
thro
cuta
neou
s fist
ula
repa
irX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
thro
plas
ty fi
rst s
tage
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thro
plas
ty w
ith s
ubsti
tutio
n tis
sue
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thro
rrap
hy: a
nter
ior
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thro
rrap
hy: p
oste
rior
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thro
scop
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Urin
ary
dive
rsio
nU
rina
ry d
iver
sion
(Ind
iana
pou
ch)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Sper
mati
c co
rdVa
rico
cele
ctom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Peni
sVa
scul
ar s
urge
ry fo
r tre
atm
ent o
fim
pote
nce
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Vaso
-vas
osto
my:
bila
tera
lX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Vaso
-vas
osto
my:
uni
late
ral
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Vas d
efer
ens
Vaso
epi
didy
mos
tom
yX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Blad
der
Vesi
co-u
reth
rope
xy w
ith re
ctus
slin
gX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
/O
bste
tric
Gyn
ecol
ogis
t
Vesi
co-v
agin
al fi
stul
a(c
ompl
icat
ed)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st/
Obs
tetr
icG
ynec
olog
ist
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 63
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Vesi
co-v
agin
al fi
stul
a (c
ompl
ex)
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st/
Obs
tetr
ic
Gyn
ecol
ogis
t
Vesi
cost
omy
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Urin
ary
dive
rsio
nO
rtho
topi
c co
ntine
nt d
iver
sion
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
thra
Ure
thra
l dila
tatio
nX
XG
A o
r Spi
nal A
nest
hesi
aU
rolo
gist
Ure
ter
Ure
tero
cele
inci
sion
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Ure
teri
c re
impl
anta
tion
XX
GA
or S
pina
l Ane
sthe
sia
Uro
logi
st
Blad
der
Uro
dyna
mic
stud
yX
XLA
Uro
logi
st
Qm
axX
XLA
Uro
logi
st
Urin
ary
dive
rsio
nCo
ntine
nt p
ouch
esX
XG
AU
rolo
gist
Ort
hope
dic
Surg
ery/
Org
an
Abo
ve e
lbow
am
puta
tion
XX
XX
GA
or L
RAO
rtho
pedi
c su
rgeo
n/
gene
ral
surg
eon
Upp
er li
mb
Abo
ve e
lbow
am
puta
tion
stum
pre
fash
ioni
ngX
XX
XG
A o
r LRA
Ort
hope
dic
surg
eon/
ge
nera
l su
rgeo
n
Pelv
isA
ceta
bulu
m fr
actu
rere
cons
truc
tion
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Low
er li
mb
Am
puta
tion
abov
e kn
ee (w
ithou
ttu
mor
)X
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon/
G
ener
al
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201764
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Foot
Am
puta
tion
chop
art
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n/
Gen
eral
Sur
geon
Am
puta
tion
foot
: one
ray
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n/
Gen
eral
Sur
geon
Am
puta
tion
lisfr
anc
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
c Su
rgeo
n/
Gen
eral
Sur
geon
Am
puta
tion
of m
ultip
le fi
nger
s(t
rans
met
acar
pal)
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n/
Gen
eral
Sur
geon
Hand
Am
puta
tion
part
of o
r who
le o
ffin
ger
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon/
G
ener
al S
urge
on
Foot
Am
puta
tion
sym
e/pi
rogo
ff/c
hopa
rtX
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n/
Gen
eral
Sur
geon
Upp
er li
mb
Am
puta
tion
thro
ugh
shou
lder
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon/
G
ener
al S
urge
on
Foot
Am
puta
tion
toe
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon/
Gen
eral
Sur
geon
Am
puta
tion
tran
s m
etat
arsa
lX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon/
G
ener
al S
urge
on
Knee
join
tA
nter
ior c
ruci
ate
ligam
ent (
acl)
reco
nstr
uctio
nX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 65
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Ankl
e jo
int
Art
hrod
esis
ank
leX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Hand
/foo
tA
rthr
odes
is d
igita
l joi
ntX
XX
GA
OR
LRA
Ort
hope
dic
Surg
eon
Art
hrod
esis
hip
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Hip
join
tEx
cisi
on a
rthr
opla
sty
XX
Ort
hope
dic
Surg
eon
Knee
join
tA
rthr
odes
is k
nee
XX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Foot
Art
hrod
esis
stab
iliza
tion
of fo
otar
thro
desi
sX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Shou
lder
Art
hrop
last
y of
acr
omio
clav
icul
ar
join
tX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Foot
Trip
le a
rthr
odes
isX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Hip/
knee
/sh
ould
er/
ankl
e/el
bow
Deb
ride
men
t lar
ge jo
ints
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Knee
join
tA
rthr
osco
py k
nee
(dia
gnos
tic)
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Art
hros
copy
kne
e +
acl/
pcl r
epai
rX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Art
hros
copy
kne
e +
men
isce
ctom
y or
repa
irX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201766
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Upp
erlim
b/lo
wer
lim
bA
rthr
osco
py o
f elb
ow, w
rist
and
ankl
e +
any
repa
ir/s
urge
ryX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Hip
join
tA
rthr
osco
py o
f the
hip
/lab
ral
repa
irX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Shou
lder
/ elb
ow/
wris
t/ a
nkle
Art
hros
copy
shou
lder
, elb
ow,
wri
st, a
nkle
(dia
gnos
tic)
XX
XG
A, L
RA o
r SPI
NA
LA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Shou
lder
join
tA
rthr
osco
py sh
ould
er+a
ny
repa
irX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
All j
oint
sA
spira
tion
of jo
int
XX
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n/ G
ener
al
Surg
eon
All b
ones
Bone
bio
psy
less
read
ily
acce
ssib
leX
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Bone
bio
psy
open
read
ilyac
cess
ible
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon/
Gen
eral
Su
rgeo
n
Low
er li
mb
Bone
gra
ftin
g/in
tern
al fi
xatio
n of
tibi
aX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Bone
gra
ftin
g/in
tern
al fi
xatio
n:fe
mur
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er/
low
erlim
bBo
ne g
raft
ing/
inte
rnal
fixa
tion:
othe
r bon
esX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Low
er li
mb
Caps
ulec
tom
y an
kle
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Caps
ulec
tom
y el
bow
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Hip
join
tCa
psul
ecto
my
hip
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
c Su
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 67
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Knee
join
tCa
psul
ecto
my
knee
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
c Su
rgeo
n
Shou
lder
join
tCa
psul
ecto
my
shou
lder
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Wris
t joi
ntCa
rpal
bon
e re
plac
emen
tX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Hand
Carp
al-m
etac
arpa
l dis
artic
ulati
on o
f m
ultip
le fi
nger
sX
XX
GA
or L
RAO
rtho
pedi
c Su
rgeo
n/ G
ener
al
Surg
eon
Hand
Carp
al-m
etac
arpa
l dis
artic
ulati
onof
one
fing
erX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Hip
join
tCo
ngen
ital d
islo
catio
n of
hip
:op
en re
ducti
onX
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Cong
enita
l dis
loca
tion
of h
ip:
subs
eque
nt p
last
erX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Cong
enita
l dis
loca
tion
of h
ips:
clos
e re
ducti
onX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Hand
Cure
ttag
e of
a m
etac
arpa
l bon
eX
XX
GA
or L
RAO
rtho
pedi
c Su
rgeo
n/ G
ener
al
Surg
eon
Upp
er jo
int
Cure
ttag
e of
one
bon
e of
the
fore
arm
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Hand
Cure
ttag
e of
the
carp
al b
one
unde
r ga
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Upp
er/
low
erlim
bD
ecom
pres
sion
ope
ratio
n:
fasc
ioto
my
only
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Dra
inag
e re
amin
g an
d ir
riga
tion
(laut
enba
ch p
roce
dure
)X
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201768
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Elbo
w jo
int
Elbo
w a
rthr
odes
isX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Elbo
w a
rthr
olys
isX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Elbo
w a
rthr
opla
sty
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Knee
join
tEl
siem
trira
nt p
roce
dure
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Elbo
w jo
int
Elbo
w d
isar
ticul
ation
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Upp
er /
low
er li
mb
Epip
hysi
odes
is a
t one
leve
lX
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Exos
tosi
s: e
xcis
ion:
read
ily a
cces
sibl
e si
tes
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Hand
Fing
er a
mpu
tatio
n at
any
leve
lX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Upp
er/l
ower
lim
bFi
xatio
n po
st o
steo
tom
y (lo
ngbo
nes)
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Frac
ture
s: c
lose
d re
ducti
on w
ith
gene
ral a
nest
hesi
a +
pop
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon/
G
ener
al S
urge
on
Foot
Hal
lux
valg
us re
pair
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Cerv
ical
spin
eH
alo-
splin
t and
pop
jack
et in
cX
XX
LA (f
or p
ins)
Ort
hope
dic
Surg
eon
Pelv
is/l
ower
limb
Har
vesti
ng b
one
graft
(ilia
c cr
est/
fibul
a)X
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 69
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hip
join
tH
ip to
tal r
epla
cem
ent
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Upp
er li
mb
Hum
eral
cur
ettag
e un
der
gene
ral
anes
thes
iaX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
All j
oint
sIn
tra
artic
ular
inje
ction
XX
XX
GA
, LRA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n/
Gen
eral
Sur
geon
Intr
a-ar
ticul
ar in
jecti
on in
thea
tre
XX
XX
GA
, LRA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Knee
/sho
ulde
r jo
int
Join
t lig
amen
t rec
onst
ructi
onX
XX
GA
, LRA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Knee
join
tKn
ee: q
uadr
icep
spla
sty
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Knee
join
tKn
ee: t
otal
repl
acem
ent
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Knee
join
tLi
gam
ent a
ugm
enta
tion
proc
edur
eX
XX
GA
or
Spin
al A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Man
ipul
ation
und
er G
A +
k w
ires
dist
al ra
dius
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n/G
ener
alSu
rgeo
n
Upp
er/l
ower
lim
bM
anip
ulati
on: l
arge
join
t und
er c
-ar
mX
XX
XG
A, L
RA o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Mat
eria
l rem
oval
: scr
ews
XX
XX
GA
, LRA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Knee
Med
ial p
arap
atel
lar
ligam
ents
re
cons
truc
tion
XX
XG
A O
R SP
INA
L A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201770
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Upp
er li
mb
Met
aphy
seal
ost
eoto
my
of ra
dius
XX
XG
A, L
RA o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Foot
Mul
tiple
met
atar
sal o
steo
tom
ies
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Elbo
w jo
int
Mus
cle,
tend
ons,
and
fasc
iate
ndon
tran
sfer
at e
lbow
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Low
er li
mb
Nai
l rem
oval
fem
urX
XX
GA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Nai
l rem
oval
hum
erus
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Low
er li
mb
Nai
l rem
oval
tibi
aX
XX
GA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Shou
lder
join
tO
pen
redu
ction
and
fixa
tion
ofst
erno
-cla
vicu
lar
disl
ocati
onX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Shou
lder
join
tO
pen
redu
ction
and
fixa
tion
acro
mio
-cla
vicu
lar
disl
ocati
onX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Elbo
w jo
int
Ope
n re
ducti
on a
nd fi
xatio
n el
bow
di
sloc
ation
XX
XG
A, L
RAO
rtho
pedi
c Su
rgeo
n
Low
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
nfe
mur
: nec
k or
sha
ftX
XX
GA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re fe
mur
: sup
ra o
r in
tra
cond
ylar
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Hand
Ope
n re
ducti
on a
nd fi
xatio
n fr
actu
re o
f car
pal b
ones
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Shou
lder
join
tO
pen
redu
ction
and
fixa
tion
frac
ture
of c
lavi
cula
r fr
actu
reX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 71
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Upp
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f hum
erus
hea
dX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f hum
erus
sha
ftX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f ole
cran
onX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Hand
Ope
n re
ducti
on a
nd fi
xatio
n fr
actu
re
of o
ne m
etac
arpa
l and
pha
lanx
bon
eX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Pelv
isO
pen
redu
ction
and
fixa
tion
frac
ture
of p
elvi
sX
XG
A o
r Sp
inal
Ort
hope
dic
Surg
eon
Upp
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f rad
ial s
haft
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f rad
ius
and
ulna
sha
fts
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Hand
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f sca
phoi
dX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re o
f sca
pho-
luna
te d
islo
catio
nX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Upp
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
n fr
actu
re
of th
e di
stal
ext
rem
ity
of th
e ra
dius
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on a
nd fi
xatio
n fr
actu
re
of u
lna
shaft
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Low
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
re ti
bial
pla
teau
XX
XG
A o
r Spi
nal
Ane
sthe
sia
rtho
pedi
cur
geon
Ope
n re
ducti
on a
nd fi
xatio
nfr
actu
red
pate
llaX
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201772
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Upp
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
n of
epic
ondy
le o
r ep
itroc
hlea
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on a
nd fi
xatio
n of
frac
ture
-dis
loca
tion
of ra
dial
hea
dX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on a
nd fi
xatio
n of
Mon
tegg
ia fr
actu
re-d
islo
catio
nX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Hand
Ope
n re
ducti
on a
nd fi
xatio
n of
mul
tiple
met
acar
pal b
ones
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
n of
supr
acon
dyla
r fr
actu
re h
umer
usX
XX
GA
, LRA
thop
edic
geon
Ope
n re
ducti
on a
nd fi
xatio
n of
supr
a-co
ndyl
ar fr
actu
re o
f the
hum
erus
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on a
nd fi
xatio
n of
the
radi
al h
ead
or ra
dial
nec
kX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Pelv
isO
pen
redu
ction
and
fixa
tion
pubi
cdi
asta
sis
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Low
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
n tib
ial s
haft
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Shou
lder
Ope
n re
ducti
on a
nd fi
xatio
n (o
rf)
shou
lder
dis
loca
tion
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Hand
Ope
n re
ducti
on o
f a d
islo
cate
dfin
ger
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on o
f a fr
actu
re o
fon
e fin
ger
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Elbo
w jo
int
Ope
n re
ducti
on o
f a fr
actu
re-
disl
ocati
on o
f the
elb
owX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on o
f a re
cent
elb
ow
disl
ocati
onX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on o
f an
old
elbo
wdi
sloc
ation
(mor
e th
an th
ree
wee
ks)
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 73
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Ope
n re
ducti
on o
f fra
ctur
e of
mul
tiple
fing
ers
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Ope
n re
ducti
on o
f mul
tiple
finge
rs o
f one
han
dX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Ope
n re
ducti
on o
f mul
tiple
met
acar
pals
and
car
pals
dis
loca
tion
XX
XG
A, L
RAO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Ope
n re
ducti
on a
nd fi
xatio
n of
the
hum
eral
nec
kX
XX
GA
, LRA
Ort
hope
dic
Surg
eon
Foot
ORI
F ca
lcan
eus f
ract
ure
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Ankl
e jo
int
ORI
F fr
actu
re-d
islo
catio
n of
ank
leX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Foot
ORI
F jo
nes
frac
ture
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
ORI
F ot
her t
arsa
l bon
esX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
ORI
F ta
lar d
ome
frac
ture
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
ORI
F ta
lar n
eck
frac
ture
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
ORI
F ta
rsom
etat
arsa
l dis
loca
tion
(lisf
ranc
)X
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Low
er li
mb
ORI
F tib
ia w
ith o
r with
out fi
bula
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Foot
Ost
eoto
my
mul
tiple
met
atar
sals
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201774
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Hand
Ost
eosy
nthe
sis o
f the
car
pal b
one
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Low
er li
mb
Ost
eoto
my
fem
oral
: pro
xim
alX
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Ost
eoto
my
hum
eral
sha
ftX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Low
er li
mb
Ost
eoto
my
knee
regi
on: a
dult
sX
XX
GA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Ost
eoto
my
knee
regi
on: c
hild
ren
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Pelv
isO
steo
tom
y of
pel
vis
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Plat
e re
mov
al d
ista
l rad
ius
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Low
er li
mb
Plat
e re
mov
al fe
mur
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Upp
er li
mb
Plat
e re
mov
al h
umer
usX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Plat
e re
mov
al p
roxi
mal
radi
usX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Low
er li
mb
Plat
e re
mov
al ti
bia
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Upp
er li
mb
Plat
e re
mov
al u
lna
and
radi
usX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Knee
join
tPo
ster
ior c
ruci
ate
ligam
ent (
pcl)
reco
nstr
uctio
nX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 75
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Low
er li
mb
Reco
nstr
uctio
n of
fem
oral
cond
yle
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Shou
lder
join
tRe
cons
truc
tion
of re
curr
ent s
houl
der
disl
ocati
onX
XX
GA
or L
RAO
rtho
pedi
c Su
rgeo
n
Upp
er li
mb
Reco
nstr
uctio
n of
the
radi
al h
ead
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Low
er li
mb
Reco
nstr
uctio
n of
tibi
al p
ilon
XX
XG
A o
r Spi
nal A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Reco
nstr
uctio
n of
tibi
al p
late
auX
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Reco
nstr
uctio
n pa
tella
(com
min
uted
)X
XX
GA
or S
pina
l Ane
sthe
sia
Ort
hope
dic
Surg
eon
Hand
Refa
shio
ning
of a
fing
eram
puta
tion
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Refa
shio
ning
of t
hetr
ansm
etac
arpa
l fing
er a
mpu
tatio
nX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Hip
join
tRe
look
deb
ride
men
t-hi
p jo
ints
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
All j
oint
sRe
look
deb
ride
men
t-ot
her j
oint
sX
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Ankl
e jo
int
Rem
oval
ank
le m
etal
wor
kX
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er/l
ower
limb
Rem
oval
ext
erna
l fixa
tor
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Mul
tiple
orga
nsRe
mov
al o
f for
eign
bod
ies
requ
irin
g in
cisi
on u
nder
gen
eral
an
esth
esia
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon/
Gen
eral
Sur
geon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201776
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Elbo
w jo
int
Rem
oval
of i
ntra
mus
cula
ros
teom
a of
the
elbo
wX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Upp
er/
low
erlim
bRe
mov
al o
f k-w
ire
XX
XX
GA
, LRA
or S
pina
lA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Upp
er li
mb
Rem
oval
of s
ynos
tosi
s of t
he fo
re-
arm
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Rese
ction
of a
bon
e of
the
fore
arm
with
us
e bo
ne g
raft
or
pros
thes
isX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Rese
ction
of d
ista
l ext
rem
ity o
ful
naX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Rese
ction
of r
adia
l sty
loid
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Shou
lder
join
tRo
tato
r cuff
repa
irX
XX
GA
or L
RAO
rtho
pedi
cSu
rgeo
n
Knee
join
tRe
visi
on tk
r: p
olye
thyl
ene
liner
only
XX
XG
A o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Spin
e/pe
lvis
Sacr
o-ili
ac fu
sion
XX
XG
A o
r Spi
nal
Ort
hope
dic
Surg
eon
Upp
er/l
ower
limb
Sequ
estr
ecto
my
long
bon
es(f
emur
, tibi
a, h
umer
us)
XX
XG
A, L
RA o
r Spi
nal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Upp
er li
mb
Sequ
estr
ecto
my
shor
t bon
es(r
adiu
s, u
lna,
oth
er s
hort
bon
es)
XX
XG
A, L
RA o
r SPI
NA
LA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Shor
teni
ng o
f bot
h ul
na a
ndra
dius
XX
XG
A o
r LRA
Ort
hope
dic
Surg
eon
Shou
lder
join
tSt
erno
clav
icul
ar a
rthr
odes
isX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 77
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Upp
er li
mb
Supr
acon
dyla
r hu
mer
usm
anip
ulati
on u
nder
GA
+ k
wire
sX
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Surg
ery
for
hum
eral
tum
or w
ithbo
ne g
raft
ing
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Surg
ical
trea
tmen
t of e
pico
ndyl
algi
aX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Surg
ical
trea
tmen
t of e
lbow
chon
drom
atos
isX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Surg
ical
trea
tmen
t of h
umer
alm
alun
ion
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Surg
ical
trea
tmen
t of h
umer
alps
eudo
arth
rosi
sX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Surg
ical
trea
tmen
t of
pseu
doar
thro
sis
of o
lecr
anon
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Surg
ical
trea
tmen
t of a
met
acar
pal
pseu
doar
thro
sis
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Surg
ical
trea
tmen
t of o
ne fi
nger
pseu
doar
thro
sis
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Surg
ical
trea
tmen
t of
pseu
doar
thro
sis
of o
ne b
one
of th
e fo
re-a
rmX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Surg
ical
trea
tmen
t of t
heps
eudo
arth
rosi
s of
the
carp
al b
one
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Syno
vect
omy
elbo
wX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201778
Inte
rven
tions
DM
PM
CSC
PH
SHAN
NH
Desc
riptio
n an
dAn
esth
esia
Qua
lifica
tion
Wris
t joi
ntSy
nove
ctom
y of
the
wri
stX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
All j
oint
Syno
vect
omy:
larg
e jo
int
XX
XG
A, L
RA o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
All j
oint
sSy
nove
ctom
y: te
ndon
XX
XG
A, L
RA o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Foot
Tala
r do
me
open
redu
ction
fixati
on(o
rf)
XX
XG
A o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Foot
Tala
r ne
ck o
rfX
XX
GA
or
Spin
alA
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
Elbo
w jo
int
Tenn
is e
lbow
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Wris
t joi
ntTe
noly
sis
carp
al tu
nnel
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Hand
Teno
lysi
s fle
xor
tend
on fr
eein
gX
XX
GA
or
LRA
Ort
hope
dic
Surg
eon
Teno
lysi
s in
trin
sic
tend
on re
leas
epe
r fin
ger
XX
XG
A o
r LR
AO
rtho
pedi
cSu
rgeo
n
Hand
and
foot
Teno
lysi
s: o
pen
elon
gatio
nte
ndon
XX
XG
A, L
RA o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Upp
er/l
ower
lim
b
Tita
nium
end
er n
ails
inse
rtion
XX
XG
A, L
RA o
r Sp
inal
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Tita
nium
end
er n
ails
rem
oval
XX
XG
A, L
RA o
r Sp
inal
A
nest
hesi
aO
rtho
pedi
cSu
rgeo
n
All j
oint
sTu
mor
s: n
odul
ar sy
novi
tisX
XX
GA
, LRA
or S
pina
l
Ane
sthe
sia
Ort
hope
dic
Surg
eon
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 79
Tabl
e 5:
The
rape
utic
and
Diag
nosti
c Im
agin
g Se
rvic
es
Serv
ice
Leve
lTy
pes o
f Sta
ff
Serv
ice
Inte
rven
tions
MP
MC
SCP
HSH
IC*
Radi
olog
istIm
agin
gSp
ecia
list
Med
ical
Imag
ing
Offi
cer
Rad.
Tech
nolo
gist
GEN
ERAL
RA
DIO
GRA
PHY
(Pla
in ra
diog
raph
ic
proc
edur
es)
Mus
culo
skel
etal
proc
edur
esX
XX
XX
XX
XX
X
Plai
n ab
dom
inal
proc
edur
esX
XX
XX
XX
XX
X
Resp
irato
rypr
oced
ures
XX
XX
XX
XX
XX
ULT
RASO
UN
D(S
onog
raph
y)A
bdom
ino-
pelv
icso
nogr
aphy
XX
XX
XX
XX
XX
X
Obs
tetr
ics
&gy
neco
logy
son
ogra
phy
XX
XX
XX
XX
X
Mus
culo
skel
etal
sono
grap
hyX
XX
XX
XX
X
Smal
l par
tsso
nogr
aphy
XX
XX
XX
XX
XX
Vasc
ular
son
ogra
phy
XX
XX
XX
XX
Card
iac
sono
grap
hy/
echo
card
iogr
aphy
XX
XX
XX
XX
FLU
ORO
SCO
PYH
yste
ro-
XX
XX
XX
XX
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201780
Serv
ice
Leve
lTy
pes o
f Sta
ff
Serv
ice
Inte
rven
tions
MP
MC
SCP
HSH
IC*
Radi
olog
istIm
agin
gSp
ecia
list
Med
ical
Imag
ing
Offi
cer
Rad.
Tech
nolo
gist
(Spe
cial
proc
edur
es)
salp
ingo
grap
hy
Uri
nary
trac
t
proc
edur
es (I
VU, U
CG)
XX
XX
XX
XX
X
Gas
troi
ntes
tinal
trac
t
stud
ies
XX
XX
XX
XX
X
Veno
grap
hyX
XX
XX
XX
XX
Sial
ogra
phy
&
fistu
logr
aphy
XX
XX
XX
XX
X
COM
PUTE
D TO
MO
GRA
PHY
(CT
Scan
ning
)
Mus
culo
skel
etal
CT
XX
XX
XX
XX
X
Abd
omin
o-pe
lvic
CT
XX
XX
XX
XX
X
Neu
ro-im
agin
gX
XX
XX
XX
XX
Card
io-r
espi
rato
ry C
TX
XX
XX
XX
XX
CT a
ngio
grap
hyX
XX
XX
XX
XX
MAG
NET
IC
RESO
NAN
CE
IMAG
ING
(MRI
)
Mus
culo
skel
etal
MRI
XX
XX
XX
XX
X
Abd
omin
o-pe
lvic
MRI
XX
XX
XX
XX
X
Neu
ro im
agin
gX
XX
XX
XX
XX
Card
iac
MRI
XX
XX
XX
XX
X
MR
angi
ogra
phy
XX
XX
XX
XX
X
MAM
MO
GRA
PHY
Mam
mog
raph
ic
proc
edur
esX
XX
XX
XX
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 81
Serv
ice
Leve
lTy
pes o
f Sta
ff
Serv
ice
Inte
rven
tions
MP
MC
SCP
HSH
IC*
Radi
olog
istIm
agin
gSp
ecia
list
Med
ical
Imag
ing
Offi
cer
Rad.
Tech
nolo
gist
DEN
TAL
RADI
OGR
APHY
Peri
-api
cal x
-ray
XX
XX
XX
XX
Occ
lusa
l X-r
ayX
XX
XX
XX
X
Ceph
alom
etric
XX
XX
XX
XX
X
Bite
win
g x-
ray
XX
XX
XX
XX
X
Ort
hopa
ntom
ogra
m(O
PG)
XX
XX
XX
XX
X
INTE
RVEN
TIO
NAL
RADI
OLO
GYIn
terv
entio
nal
proc
edur
esX
XX
XX
NU
CLEA
R M
EDIC
INE
Dia
gnos
ticra
dion
uclid
e pr
oced
ures
XX
XX
X
RADI
OTH
ERAP
YEx
tern
al b
eam
ther
apy
XX
XX
X
Brac
hyth
erap
yX
XX
XX
Radi
onuc
lide
ther
apy
XX
XX
X
*Im
agin
g Ce
nter
** A
dis
pens
ary
can
be a
llow
ed to
offe
r gen
eral
ab
dom
ono-
pelv
ic, o
bste
tric
s &
gyn
ecol
ogy
and
smal
l par
ts s
onog
raph
y pr
ovid
ed th
e st
aff re
ceiv
ed a
form
al tr
aini
ng a
nd a
re li
cens
ed to
do
so.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201782
Tabl
e 6:
Oph
thal
mic
Ser
vice
s
Serv
ice
Cate
gory
Inte
rven
tion
Leve
l of H
ealth
Fac
ility
Heal
thca
re S
taff
Com
men
ts
Visi
onCe
nter
Opt
omet
ryPr
actic
eEy
eCl
inic
Eye
Uni
tEy
eHo
spita
lDe
scrip
tion
Qua
lifica
tion
Refr
activ
e se
rvic
es
Full
refr
actio
n an
dpr
escr
iptio
n of
gl
asse
s
XX
XX
XCO
T, A
0 O
.T, A
0O
ptom
etri
st,
Oph
thal
mol
ogis
t
Certi
fied
OT,
A0
OT,
BSc
O
ptom
etry
, Sp
ecia
list
Certi
fied
opht
halm
ic
tech
nici
an is
a s
peci
al
cour
se fo
r A
1 O
T.
Pres
crip
tion
ofco
ntac
t len
ses
(soft
and
rig
id)
XX
Opt
omet
rist
A0,
BSc
Opt
om
Dis
pens
ing
glas
ses
XX
XO
ptom
etri
stBS
c O
ptom
Opti
cal w
orks
hop
XX
Qua
lified
Opti
cian
Dip
lom
a
Refr
activ
e su
rger
yX
Subs
peci
alis
tCo
rnea
and
refr
activ
e su
rger
y
Certi
fied
refr
activ
eSu
rgeo
n
Gla
ucom
a Se
rvic
es
Gla
ucom
a sc
reen
ing
(IOP)
XX
XX
XO
T, O
ptom
etri
st,
Spec
ialis
tA
1/ A
0/Sp
ecia
list
All
leve
ls o
f eye
care
sho
uld
be a
ble
to ta
ke in
trao
cula
r pr
essu
re
Gla
ucom
aCo
nfirm
ation
test
sX
XX
Oph
thal
mol
ogis
tSp
ecia
list
Pres
crip
tion
for
Gla
ucom
aX
XX
Oph
thal
mol
ogis
tSp
ecia
list
Gla
ucom
a Su
rger
yX
XO
phth
alm
olog
ist
Spec
ialis
t
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 83
Serv
ice
Cate
gory
Inte
rven
tion
Leve
l of H
ealth
Fac
ility
Heal
thca
re S
taff
Com
men
ts
Visi
onCe
nter
Opt
omet
ryPr
actic
eEy
eCl
inic
Eye
Uni
tEy
eHo
spita
lDe
scrip
tion
Qua
lifica
tion
Conj
uncti
vitis
Dia
gnos
ing
Conj
uncti
vitis
XX
XX
OT,
Oph
thal
mol
ogis
tA
1, A
0,Sp
ecia
list
Trea
tmen
t of
Conj
uncti
vitis
(all)
XX
XX
OT,
Oph
thal
mol
ogis
tA
1, A
0,Sp
ecia
list
Gen
eral
exa
min
ation
Slit
lam
p ex
amX
XX
XO
T,O
phth
alm
olog
ist
A1,
A0
Spec
ialis
t
Ant
erio
r seg
men
tph
otos
XX
XX
OT,
Opt
omet
rist
, O
phth
alm
olog
ist
A1,
A0,
Sp
ecia
list
Visi
on C
ente
rsse
nd p
hoto
s fo
r te
le-
cons
ulta
tion
Fund
osco
pyX
XX
Oph
thal
mol
ogis
tSp
ecia
list
Fund
us p
hoto
sX
XX
XO
T, O
ptom
etri
st,
Oph
thal
mol
ogis
tA
1, A
0,Sp
ecia
list
Phot
os a
re s
ent
for
tele
- con
sulta
tions
Spec
ial I
nves
tigati
ons
(Incl
udin
g st
rabi
smus
ass
essm
ent)
XX
XO
phth
alm
olog
ists
Spec
ialis
ts/
subs
peci
alis
tsO
T, O
ptom
etri
stca
n do
the
test
s bu
t the
Sp
ecia
list i
nter
pret
s
Oph
thal
mic
Sur
gery
Abs
cess
/St
y/Ch
alaz
ion
XX
XO
T,O
phth
alm
olog
ist
A1,
A0,
Spec
ialis
t
Lase
r tre
atm
ent
for
retin
aX
XX
Oph
thal
mol
ogis
tsSp
ecia
list
Intr
avitr
eal
inje
ction
sX
XX
Oph
thal
mol
ogis
tSp
ecia
list
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201784
Serv
ice
Cate
gory
Inte
rven
tion
Leve
l of H
ealth
Fac
ility
Heal
thca
re S
taff
Com
men
ts
Visi
onCe
nter
Opt
omet
ryPr
actic
eEy
eCl
inic
Eye
Uni
tEy
eHo
spita
lDe
scrip
tion
Qua
lifica
tion
Gen
eral
Sur
gery
Oph
thal
mol
ogy
(Cat
arac
t, S
impl
egl
auco
ma,
Tra
uma,
si
mpl
e lid
XX
Oph
thal
mol
ogis
tSp
ecia
list
Subs
peci
alty
Surg
ery
(ped
iatr
ic; c
orne
a an
d an
teri
or s
egm
ent
and
refr
activ
e; o
rbit
and
ocul
opla
stic;
gl
auco
ma;
vitr
eo-
retin
al
XX
Oph
thal
mol
ogis
tSu
bspe
cial
tytr
aine
dSk
ills
trai
ning
requ
ired,
not
aca
dem
ic
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 85
Specific Definitions of types of eye centers
Vision Center: It is a primary eye care center linked to an eye hospital. Visual screening for refractive errors, glaucoma screening and imaging for diabetic retinopathy or other retinal disease is performed. Tele-consultations services are available through the main hospital. If it is run by an optometrist, it can also have optical services in the package but no optical workshop. It can also be run by an ophthalmic technician (OT A1 level, if it is part of a referral network and A0 if it is a stand-alone practice). The OT can treat conjunctivitis at this level.
Optometry practice: It is a center offering full range of optical services including testing for glasses and contact lenses, optical shop for dispensing glasses, workshop for cutting lenses and fitting of glasses. It is run by qualified optometrist (Bachelor’s degree) with the assistance an optician for fitting the glasses.
Eye Clinic: A specialist clinic is run by an ophthalmologist who provides both diagnostic and therapeutic services of all eye diseases, and minor surgery. Eye clinics do not have optical shops or pharmacies.
Eye Unit: An eye unit is an eye clinic based in a general hospital that is managed by an ophthalmologist. All types of diagnostic and therapeutic services both medical and surgical are provided with no restrictions. The hospital can have optical services as well as pharmaceutical products.
Eye Hospital: An eye hospital is a specialized facility that provides high level eye care; for outpatients and inpatients along with an operating theater – it is a one-stop center for all ophthalmology services. For a center to qualify as an eye hospital, it needs to provide the main subspecialty services in ophthalmology: cornea and anterior segment; pediatric and strabismus; glaucoma; vitreo-retinal; oculoplastic and orbit as well general ophthalmology services. These services are provided by certified subspecialists.
Minimum requirement: 3 subspecialty services in addition to general ophthalmology running full time; their services may be offered on a part- time basis.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201786
Table 7: Ophthalmic Definitions
Minor surgery An operation on superficial structures of the body or a manipulative procedure or under normal circumstance does not a major hazard or s that does involve serious risk.
Ophthalmic Technician/ Ophthalmic Clinical Officer (OCO)
An Ophthalmic Clinical Officer (OCO) is a professional health worker who has completed three years training in ophthalmology from an accredited institution and obtained an advanced diploma or its equivalent.
An Ophthalmic Clinical Officer (OCO) should be able to provide appropriate preventive, curative and rehabilitative eye care services, and delivery to individuals and communities. An OCO can work in both public and private sector.
Ophthalmologist An ophthalmologist is a medical doctor who specializes in eye and vision care. An ophthalmologist is licensed to practice medicine and surgery. An ophthalmologist diagnoses and treats all eye diseases, performs eye surgery and prescribes and fits eyeglasses and contact lensesto correct vision problems.
Optician Opticians are technicians trained to design, verify and fit eyeglass lenses and frames, contact lenses, and other devices to correct eyesight. They use prescriptions supplied by ophthalmologists, Ophthalmic Clinical Officer or optometrists, but do not test vision or write prescriptions for visual correction. Opticians are not permitted todiagnose or treat eye disease.
Optometric technicians Optometric technicians work under the supervision of an optometrist or ophthalmologist. They perform a variety of duties including: patient pretesting such as visual acuity, color vision, depth perception, pupil reflexes, visual field testing, pressure inside the eye and blood pressure; frame and lens selection, eyeglass adjustment; and contact lens patient education.
Optometrist Optometrists are healthcare professionals who provide primary vision care ranging from sight testing and correction to the diagnosis, treatment, and management of vision changes. An optometrist is not a medical doctor. They are licensed to practice optometry, which primarily involves performing eye exams and vision tests, prescribing and dispensing corrective lenses, detecting certain eye abnormalities, and prescribing medications for certain eye diseases.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 87
Tabl
e 8:
Oph
thal
mic
Ser
vice
s2
Serv
ice
Inte
rven
tions
Oph
thal
mic
tech
s/ C
atar
act
Surg
eon
Opt
omet
rist
Oph
thal
mol
ogist
MP
MC
SCP
HSP
Oph
thal
mic
Tech
nici
anCl
inic
Eye
Exam
inati
ons
Routi
ne e
ye e
xam
:vi
sual
acu
ity, p
upil
asse
ssm
ent,
col
or v
isio
n,
tono
met
ry, e
ye m
uscl
e m
ovem
ents
XX
XX
X*
**
X
Oph
thal
mos
copy
(dire
ct o
r in
dire
ct)
XX
XX
X*
**
X
Scre
enin
g fu
ndus
phot
ogra
phy
XX
XX
XX
XX
X
Phot
ogra
phs
(e.g
.ex
tern
al o
cula
r)X
XX
XX
XX
XX
Scre
enin
g fo
r de
fect
s in
cent
ral o
r pe
riph
eral
fiel
d of
vis
ion
(arc
per
imet
er,
tang
ent s
cree
n or
co
mpu
teri
zed
auto
fiel
d an
alyz
er)
XX
XX
X*
**
X
2 O
nly
a cl
inic
al o
ptom
etri
st h
avin
g th
e ac
adem
ic q
ualifi
catio
n of
at l
east
A0
is a
llow
ed to
pre
scri
be a
nd s
ell m
edic
al e
yegl
asse
s or
con
tact
lens
es. A
n op
htha
lmol
ogis
t’s p
hysi
cian
pos
sess
ing
all t
he e
quip
men
t is
allo
wed
to p
resc
ribe
med
ical
eye
glas
ses
and
trea
t all
eye
rela
ted
dise
ases
but
not
to s
ell e
yegl
asse
s. (M
inis
teri
al In
stru
ction
s Li
cens
ing
Priv
ate
Hea
lth F
acili
ties
in R
wan
da).
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201788
Serv
ice
Inte
rven
tions
Oph
thal
mic
tech
s/ C
atar
act
Surg
eon
Opt
omet
rist
Oph
thal
mol
ogist
MP
MC
SCP
HSP
Oph
thal
mic
Tech
nici
anCl
inic
Mea
sure
men
t of l
ater
alor
ver
tical
imba
lanc
es
& n
ear
focu
sing
abi
lity
(pho
ropt
or, t
rial
lens
set,
or
phor
omet
er
XX
XX
X*
**
X
Oph
thal
mom
etry
tom
easu
re c
orne
al c
urva
ture
&
pre
senc
es o
f sca
rrin
g
XX
XX
X*
**
X
Corn
eal t
opog
raph
yX
XX
XX
**
*X
Cont
act l
ens
exam
XX
XX
XX
XX
X
Gla
ucom
a sc
reen
ing
XX
XX
X*
**
X
Pach
ymet
ryX
XX
XX
**
*X
Pedi
atri
c vi
sion
exa
ms
XX
XX
X*
**
X
Trea
tmen
tsPr
escr
ibe
and
fit e
yegl
asse
sX
XX
XX
XX
XX
Cont
act l
ens
fitting
XX
XX
XX
XX
Trea
tmen
t of
kera
toco
nus
XX
XX
XX
XX
Lacr
imal
duc
t im
plan
tsX
XX
XX
X
Blep
haro
plas
ty o
rbl
epha
ropt
osis
XX
XX
XX
X
Lase
r su
rger
yX
XX
**
*X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 89
Serv
ice
Inte
rven
tions
Oph
thal
mic
tech
s/ C
atar
act
Surg
eon
Opt
omet
rist
Oph
thal
mol
ogist
MP
MC
SCP
HSP
Oph
thal
mic
Tech
nici
anCl
inic
Trea
tmen
t of g
lauc
oma
XX
XX
XX
XX
X
Trea
tmen
t of
retin
al/u
veiti
s di
seas
esX
XX
XX
XX
XX
Pedi
atri
c ey
e ca
reX
XX
XX
XX
XX
Stra
bism
us s
urge
ryX
XX
XX
XX
Cata
ract
sur
gery
*X
XX
X*
**
X
Post
oper
ative
cat
arac
tca
reX
XX
XX
XX
XX
X
Emer
genc
y tr
eatm
ent
of e
ye in
juri
esX
XX
XX
XX
XX
*Und
er s
uper
visi
on o
f an
opht
halm
olog
ist
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201790
Tabl
e 9:
Oph
thal
mic
Equ
ipm
ent
Equi
pmen
tFa
cilit
y le
vel
Com
men
ts
Visi
onCe
nter
Opt
omet
ryPr
actic
eEy
e Cl
inic
Eye
Uni
tEy
e Ho
spita
l
Refr
actio
n ki
tX
XX
XX
Aut
o-re
frac
tom
eter
XX
XX
X
Non
-con
tact
tono
met
erX
XX
XX
Scre
enin
g of
gla
ucom
a
App
lana
tion
tono
met
erX
XX
Slit
lam
pX
XX
X
Opti
cal w
orks
hop
equi
pmen
tX
XO
nly
faci
lities
that
can
pro
duce
fitt
edgl
asse
s.
Dire
ct o
phth
alm
osco
peX
XX
X
Indi
rect
oph
thal
mos
cope
XX
X
Dia
gnos
tic le
nses
XX
X
Colo
r vis
ion
and
ster
eops
isX
XX
A S
can
ultr
asou
ndX
X
B Sc
an u
ltras
ound
XX
Visu
al fi
eld
anal
yzer
XX
X
Opti
cal C
oher
ence
Tom
ogra
phy
(OCT
)X
Hig
hly
spec
ializ
ed in
vesti
gatio
ns
Corn
ea T
opog
raph
y/To
mog
raph
yX
Hig
hly
spec
ializ
ed in
vesti
gatio
ns
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 91
Equi
pmen
tFa
cilit
y le
vel
Com
men
ts
Visi
onCe
nter
Opt
omet
ryPr
actic
eEy
e Cl
inic
Eye
Uni
tEy
e Ho
spita
l
Arg
on la
ser
XX
YAG
lase
rX
X
Exci
mer
lase
rX
Hig
h te
ch s
urge
ry
Ope
ratin
g m
icro
scop
eX
X
Phac
o m
achi
neX
XA
dvan
ced
cata
ract
sur
gery
Post
erio
r vitr
ecto
rX
X
Ant
erio
r vitr
ecto
rX
X
Colla
gen
cros
s-lin
king
mac
hine
XX
New
hig
h te
ch c
orne
a tr
eatm
ent
Diff
eren
t Ins
trum
ent s
ets
XX
Aut
ocla
ves
XX
Ethy
lene
oxi
de (E
tO) s
teri
lizer
XG
as s
teri
lizer
: to
hand
le w
ith e
xtre
me
care
.
Labo
rato
ry e
quip
men
t
Hem
atol
ogy
X
Bioc
hem
istr
yX
Mic
robi
olog
yX
Ort
hopti
c eq
uipm
ent
XX
Expe
rt a
sses
smen
t of o
cula
r m
ovem
ent
diso
rder
s.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201792
Tabl
e 10
: Den
tal S
ervi
ces
Type
of H
ealth
Wor
ker
Leve
l of F
acili
tySt
aff D
escr
iptio
nEq
uipm
ent
Serv
ice
Inte
rven
tions
Dent
alsu
rgeo
nDe
ntist
Ort
hodo
ntics
Dent
alth
erap
ist
Poly
clin
ic,
Hosp
ital,
Dent
al c
linic
Qua
lifica
tion
Hea
lthPr
omoti
on
Beha
vior
cha
nge
com
mun
icati
on (B
CC);
heal
th e
duca
tion
for
patie
nts
and
fam
ilies
XX
XX
XSp
ecia
list,
den
tal s
urge
on,
denti
st, d
enta
l the
rapy
Den
tal m
odel
s,to
othb
rush
, too
thpa
ste
Com
mun
ity h
ealth
mob
iliza
tion/
sens
itiza
ti on
XX
XX
Spec
ialis
t, d
enta
l sur
geon
,de
ntist
, den
tal t
hera
py
Scho
ol h
ealth
XX
XX
Spec
ialis
t, d
enta
l sur
geon
,de
ntist
, den
tal t
hera
py
Gen
eral
Cons
ulta
tion
X-ra
yX
XX
XX
Spec
ialis
t, d
enta
l sur
geon
,de
ntist
, den
tal t
hera
py
Den
tal c
hair
Den
tal f
urni
ture
Ligh
t
H
and
piec
es
Tabl
etop
au
tocl
ave
X-ra
y
Den
tal d
igita
l x-
ray
X-ra
y fil
mde
velo
per
with
da
rkro
om
X-
ray
view
er
D
igita
l cam
era
Lead
apr
on
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 93
Type
of H
ealth
Wor
ker
Leve
l of F
acili
tySt
aff D
escr
iptio
nEq
uipm
ent
Serv
ice
Inte
rven
tions
Dent
alsu
rgeo
nDe
ntist
Ort
hodo
ntics
Dent
alth
erap
ist
Poly
clin
ic,
Hosp
ital,
Dent
al c
linic
Qua
lifica
tion
Prev
entio
nCl
eani
ng; P
atien
t ed
ucati
on; U
se o
f fluo
ride
XX
XSp
ecia
list,
den
tal s
urge
on,
denti
st, d
enta
l the
rapy
Basi
c in
stru
men
tsM
agni
fier
gogg
les
Rest
orati
onFi
lling
s:Cl
asse
s 1,
2, 3
, 4, 5
XX
XX
XSp
ecia
list,
den
tal s
urge
on,
denti
st (D
enta
l the
rapy
A1
1&5
only
)
Am
alga
mat
orm
achi
neBa
sic
inst
rum
ent s
ets
Bond
ing
XX
XX
XSp
ecia
list,
den
tal s
urge
on,
denti
st, d
enta
l the
rapy
Basi
c in
stru
men
tse
ts, l
ight
cur
ed
Surg
ical
Ora
l & m
axill
ofac
ial
proc
edur
es;
lase
r pr
oced
ures
; im
pact
ed w
isdo
m te
eth;
com
plic
ated
faci
altr
aum
a, s
urgi
cal o
f tum
ors
X
This
can
be
done
in
spec
ialis
t de
ntal
clin
ic&
hos
pita
l onl
y
Max
illof
acia
l sur
geon
Lase
r m
achi
ne &
othe
r ad
vanc
ed
inst
rum
ents
Impa
cted
wis
dom
toot
h ex
trac
tion
set
Basi
c in
stru
men
tEx
trac
tions
XX
XX
XSp
ecia
list,
den
tal s
urge
on,
denti
st, d
enta
l the
rapy
Peri
odon
tal
trea
tmen
tX
XX
XX
Spec
ialis
t, d
enta
l sur
geon
,de
ntist
, den
tal t
hera
py
Ort
hodo
ntics
Ort
hodo
ntics
XX
Ort
hodo
ntics
onl
y
O
rtho
donti
csin
stru
men
ts
Endo
donti
csRo
ot c
anal
str
eatm
ent
XX
XD
enta
l sur
geon
, den
tist,
Root
can
altr
eatm
ent s
et
A
pice
ctom
y se
t
A
pex
loca
tor
Pros
thod
ontic
sD
entu
res
XX
XD
enta
l tec
hnol
ogis
ts
Pr
osth
odon
tics
Den
tal c
row
nsX
XX
lab
Den
tal b
ridg
esX
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201794
Tabl
e11:
Reh
abili
tatio
n Se
rvic
es
Serv
ice
Inte
rven
tions
Type
of H
ealth
care
Wor
ker
Leve
l of F
acili
tyRe
quire
d Eq
uipm
ent
PT (f
rom
BSc
PT
and
abov
e (M
Sc, P
hD)
Poly
clin
ic/
Hosp
ital
Priv
ate
Clin
ic
Phys
ioth
erap
yFu
nctio
nal a
sses
smen
tX
XX
Cryo
ther
apy
(col
d th
erap
y)X
X•
C
old
bath
s, s
tand
ard
size
Hea
t the
rapy
:•
H
ot p
acks
XX
(opti
onal
)•
H
ot b
aths
, sta
ndar
d si
ze
XX
(opti
onal
)•
C
ombi
natio
n th
erap
y un
it
•
Para
ffin
wax
bat
hsX
X (o
ption
al)
•
Para
ffin
bath
•
Infr
ared
hea
tX
X•
In
frar
ed la
mp
•
Ultr
asou
ndX
X•
U
ltras
ound
mac
hine
•
Dia
ther
my
X (o
ption
al)
X (o
ption
al)
•
Dia
ther
my
(sho
rtw
ave)
mac
hine
Hyd
roth
erap
yX
(opti
onal
)X
(opti
onal
)•
H
ydro
ther
apy
pool
Elec
tric
al s
timul
ation
XX
(opti
onal
)•
T
ENS
unit
X (o
ption
al)
X (o
ption
al)
•
Mul
tipur
pose
stim
ulat
or m
achi
ne
X (o
ption
al)
X (o
ption
al)
•
Ele
ctro
myo
grap
hy a
ppar
atus
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 95
Serv
ice
Inte
rven
tions
Type
of H
ealth
care
Wor
ker
Leve
l of F
acili
tyRe
quire
d Eq
uipm
ent
PT (f
rom
BSc
PT
and
abov
e (M
Sc, P
hD)
Poly
clin
ic/
Hosp
ital
Priv
ate
Clin
ic
Rang
e of
moti
on e
xerc
ises
X (o
ption
al)
X (o
ption
al)
•
E-Z
exe
rcis
e bo
ard
for
finge
rs
XX
•
Gon
iom
eter
XX
•
Tap
e m
easu
re
Ther
apeu
tic m
assa
ge
(ultr
avio
let a
nd in
frar
ed)
XX
•
Tre
atm
ent c
ouch
XX
(opti
onal
)•
V
ibro
mat
mac
hine
X (o
ption
al)
X (o
ption
al)
•
Ultr
avio
let l
amp
with
lens
es
X (o
ption
al)
X (o
ption
al)
•
Ultr
avio
let c
abin
et
Join
t mob
iliza
tion
XX
•
Bal
ls –
diff
eren
t siz
es
XX
•
Wob
ble
boar
d
X (o
ption
al)
X (o
ption
al)
•
Ank
le A
rc p
lus
XX
•
Dig
ital h
and
dyna
mom
eter
X (o
ption
al)
X (o
ption
al)
•
Ext
ensi
on b
ars,
wal
l bar
s
Join
t im
mob
iliza
tion
XX
(opti
onal
)•
I
nflat
able
air
spl
int f
or li
mbs
XX
(opti
onal
)•
P
last
er s
prea
der
XX
(opti
onal
)•
C
ast s
aw
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201796
Serv
ice
Inte
rven
tions
Type
of H
ealth
care
Wor
ker
Leve
l of F
acili
tyRe
quire
d Eq
uipm
ent
PT (f
rom
BSc
PT
and
abov
e (M
Sc, P
hD)
Poly
clin
ic/
Hosp
ital
Priv
ate
Clin
ic
XX
(opti
onal
)•
C
ast b
endi
ng fo
rcep
s
XX
(opti
onal
)•
P
last
er k
nife
cutt
er
XX
(opti
onal
)•
X
-ray
vie
wer
Gai
t tra
inin
g/as
sisti
ve
devi
se tr
aini
ng
XX
•
Exe
rcis
e ro
om
XX
•
Bar
s, v
ertic
al w
oode
n, w
all-m
ount
ed
XX
•
Wal
king
fram
e
XX
•
Cru
tche
s, a
lum
inum
X (o
ption
al)
X (o
ption
al)
•
Mob
ile c
raw
ler
(e.g
. PRO
NE)
X (o
ption
al)
X (o
ption
al)
•
Ped
iatr
ic s
tand
pos
ition
er
X (o
ption
al)
X (o
ption
al)
•
Pos
terio
r Ty
ke ro
ller
Mus
cle
stre
ngth
enin
gX
•
Exe
rcis
e m
ats
XX
•
Dum
b be
ll se
t
X(op
tiona
l)X(
optio
nal)
•
Exe
rcis
e w
heel
, woo
den,
wal
l-mou
nted
shou
lder
whe
el
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 97
Serv
ice
Inte
rven
tions
Type
of H
ealth
care
Wor
ker
Leve
l of F
acili
tyRe
quire
d Eq
uipm
ent
PT (f
rom
BSc
PT
and
abov
e (M
Sc, P
hD)
Poly
clin
ic/
Hosp
ital
Priv
ate
Clin
ic
XX
•
Wri
st ro
ll
XX
•
Pul
leys
X(op
tiona
l)X(
optio
nal)
•
Qua
dric
eps
benc
h
X(op
tiona
l)X(
optio
nal)
•
Ped
al e
xerc
iser
X(op
tiona
l)X(
optio
nal)
•
Con
tinuo
us p
assi
ve m
otion
(CPM
) for
low
er &
upp
er li
mbs
XX
•
Mec
hani
cal t
hera
py w
ith a
cces
sori
es
Ergo
nom
ic tr
aini
ngX
XN
o eq
uipm
ent n
eede
d
Bala
nce
exer
cise
sX
X•
B
alan
ce b
oard
, rol
ler
and
cush
ion
X (o
ption
al)
X (o
ption
al)
•
Tra
mpo
line
X (o
ption
al)
X (o
ption
al)
•
Sit
to s
tand
exe
rcis
er
Trac
tion
X (o
ption
al)
X (o
ption
al)
•
Trac
tion
tabl
e
X (o
ption
al)
X (o
ption
al)
•
Cerv
ical
trac
tion
unit,
doo
r fra
me
Tapi
ngX
X•
S
ciss
ors,
tape
s
Band
agin
gX
X•
B
anda
ges
Fitti
ng o
f ort
hotic
sX
X
Aer
obic
exe
rcis
eX
X•
E
rgo-
stati
onar
y bi
cycl
es
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 201798
Serv
ice
Inte
rven
tions
Type
of H
ealth
care
Wor
ker
Leve
l of F
acili
tyRe
quire
d Eq
uipm
ent
PT (f
rom
BSc
PT
and
abov
e (M
Sc, P
hD)
Poly
clin
ic/
Hosp
ital
Priv
ate
Clin
ic
XX
•
Ste
pper
s
XX
(opti
onal
)•
T
read
mill
XX
•
Spi
rom
eter
Patie
nt a
nd fa
mily
educ
ation
XX
Mot
or le
arni
ng a
ctivi
ties
XX
Han
d th
erap
y, s
mal
l ite
ms
Acti
vitie
s of
dai
ly li
ving
XX
(opti
onal
)•
S
tack
ing
cone
s
X (o
ption
al)
X (o
ption
al)
•
Upp
er li
mb
wor
ksta
tion
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 99
Tabl
e 12
: Nut
rition
and
Die
tetic
Ser
vice
s
Serv
ice
Inte
rven
tions
Serv
ice
Leve
lTy
pes o
f Sta
ffEQ
UIP
MEN
T
MP
MC
SCP
HSH
Nut
rition
istDi
etici
anN
utriti
onist
& D
ietic
ian
NU
TRIT
ION
Nut
ritio
nal
asse
ssm
ent/
scre
enin
g (a
nthr
opom
etri
c m
easu
rem
ents
, int
erpr
etati
on
of n
utri
tiona
l ind
ex, g
row
th
mon
itori
ng)
XX
XX
XX
A0,
Mas
ters
A0,
Mas
ters
A0,
Mas
ter
•
Bal
ance
•
Yar
d sti
ck•
Bi
oele
ctri
cal
impe
danc
e an
alyz
er•
M
etab
olic
car
t (in
dire
ct c
alor
imet
ry
to m
easu
re e
nerg
y ex
pend
iture
•
Ski
n fo
ld c
alip
er•
Co
okin
g de
mon
stra
tion
equi
pmen
t•
R
efri
gera
tor
•
Ribb
on d
iam
etri
c (f
orea
rm a
nd u
pper
ar
ms)
•
Refe
renc
e ta
bles
(B
MI:
girl
and
boy
)•
Fo
od c
ompo
sitio
n ta
bles
Nut
ritio
nal c
ouns
elin
g,X
XX
XX
XA
0, M
aste
rsA
0,M
aste
rsA
0, M
aste
r
•
Nut
ritio
nal,
reha
bilit
ation
of P
rote
in
Ener
gy M
alnu
triti
on
XX
XX
XX
A0,
Mas
ters
A0,
M
aste
rsA
0, M
aste
r
•
Die
t rec
all
(Ana
mne
sis)
and
die
t as
sess
men
t:•
D
iet t
hera
py: d
iabe
tes,
hy
pert
ensi
on,
Nep
hrop
athy
, Pro
tein
En
ergy
Mal
nutr
ition
, In
tens
ive
Care
Uni
t ca
ses,
bef
ore
and
after
su
rgic
al in
terv
entio
n or
othe
r...
XX
XX
XX
A0,
Mas
ters
A0,
Mas
ters
A0,
Mas
ter
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017100
Serv
ice
Inte
rven
tions
Serv
ice
Leve
lTy
pes o
f Sta
ffEQ
UIP
MEN
T
MP
MC
SCP
HSH
Nut
rition
istDi
etici
anN
utriti
onist
& D
ietic
ian
DIET
ETIC
S•
N
utri
tiona
las
sess
men
t/sc
reen
ing
(ant
hrop
omet
ric
mea
sure
men
ts,
inte
rpre
tatio
n of
nu
triti
onal
inde
x)•
Ana
mne
sis
and
diet
as
sess
men
t:•
D
iet c
ouns
elin
g•
Die
t the
rapy
: dia
bete
s,
hype
rten
sion
, N
ephr
opat
hy, P
rote
in
Ener
gy M
alnu
triti
on,
Inte
nsiv
e Ca
re U
nit
case
s, b
efor
e an
d aft
er
surg
ical
inte
rven
tion
or
othe
r...
XX
XX
XX
A0,
Mas
ters
A0,
Mas
ters
A0,
Mas
ters
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 101
NUTRITION/ DIETETIC EQUIPMENT
- Balance- Yard stick- Bioelectrical impedance analyzer- Metabolic cart (indirect calorimetry to measure energy expenditure- Skin fold caliper- Cooking demonstration equipment- Refrigerator- Ribbon diametric (forearm and upper arms)- Reference tables (BMI: girl and boy)- Food composition tables
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017102
Tabl
e 13
: Lab
orat
ory
Serv
ices
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
Med
ical
Prac
tice
(MP)
HEM
ATO
LOGY
Hem
oglo
bin
(Hb)
X
Eryt
hroc
yte
sedi
men
tatio
n ra
te (E
SR)
X
BIO
CHEM
ISTR
YU
rine
che
mis
try
usin
g st
rips
:•
Alb
umin
• G
luco
se
X
MIC
ROBI
OLO
GYSp
ecim
en c
olle
ction
, sto
rage
, and
tran
spor
tX
Mic
rosc
opic
exa
min
ation
& id
entifi
catio
n of
bloo
d pa
rasi
tes
X
Stoo
l and
uri
ne e
xam
inati
on fo
r pa
rasi
tes:
fres
h an
d aft
er s
tain
ing
with
Lug
oi’s
iodi
neX
Wet
pre
para
tion
X
IMM
UN
OSE
ROLO
GYRa
pid
test
s:•
H
IV•
Pre
gnan
cy te
st
X
Med
ical
Clin
ic(M
C)HE
MAT
OLO
GYM
anua
l and
aut
omat
ed m
etho
ds:
• F
ull B
lood
Cou
nt•
Red
blo
od c
ells
(RBC
s)•
Whi
te b
lood
cel
ls (W
BCs)
& d
iffer
entia
l co
unts
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 103
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
• H
emat
ocrit
• H
emog
lobi
n
Eryt
hroc
yte
sedi
men
tatio
n ra
te (E
SR)
XX
CHEM
ISTR
YFu
lly a
utom
ated
met
hodo
logy
with
ISE
mod
ule
for e
lect
roly
tes
XX
BIO
CHEM
ISTR
YU
rine
che
mis
try
usin
g st
rips
:•
A
lbum
in•
G
luco
se
XX
Bloo
d ch
emis
try
•
Kidn
ey fu
nctio
n te
sts
•
Live
r fun
ction
test
s•
Bl
ood
gluc
ose
XX
MIC
ROBI
OLO
GYSp
ecim
en c
olle
ction
, sto
rage
, and
tran
spor
tX
X
Mac
rosc
opic
exa
min
ation
XX
Mic
rosc
opic
exa
min
ation
& id
entifi
catio
n of
bloo
d, b
ody
fluid
and
spu
tum
: sta
inin
g (g
iem
sa, g
ram
, met
hyle
ne b
lue,
Zie
hl-
Nee
lson
)
XX
Stoo
l exa
min
ation
for
para
site
s: fr
esh
and
after
sta
inin
g w
ith L
ugoi
’s io
dine
(or
Kato
- Ka
tz, f
orm
ol-e
ther
)
XX
Wet
pre
para
tion
XX
Cyto
bact
erio
logi
cal e
xam
of u
rine
XX
Exam
inati
on o
f vag
inal
sw
abs
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017104
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
IMM
UN
OSE
ROLO
GYRa
pid
test
s:•
H
IV•
H
epati
tis B
•
Hep
atitis
C•
CR
P•
A
SLO
•
Rube
lla•
To
xopl
asm
osis
•
TPH
A•
Pr
egna
ncy
test
•
Rheu
mat
oid
fact
or
XX
Poly
clin
ic (P
C)HE
MAT
OLO
GYM
anua
l and
aut
omat
ed m
etho
ds:
• F
ull B
lood
Cou
nt•
Red
blo
od c
ells
(RBC
s)•
Whi
te b
lood
cel
ls (W
BCs)
& d
iffer
entia
l co
unts
• H
emat
ocri
t•
Hem
oglo
bin
XX
Eryt
hroc
yte
sedi
men
tatio
n ra
te (E
SR)
XX
Bloo
d gr
oup
and
rhes
usX
X
Coag
ulati
on te
sts:
• B
leed
ing
time
(BT)
• P
artia
l thr
ombo
plas
tin ti
me
(PTT
)•
Acti
vate
d PT
T (A
PTT)
• P
roth
rom
bin
time
(PT)
XX
CHEM
ISTR
YFu
lly a
utom
ated
met
hodo
logy
with
ISE
mod
ule
for
elec
trol
ytes
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 105
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
BIO
CHEM
ISTR
YU
rine
che
mis
try
usin
g st
rips
:•
A
lbum
in•
G
luco
se
XX
Bloo
d ch
emis
try
•
Kidn
ey fu
nctio
n te
sts
•
Live
r fun
ction
test
s•
Bl
ood
gluc
ose
XX
MIC
ROBI
OLO
GYSp
ecim
en c
olle
ction
, sto
rage
, and
tran
spor
tX
X
Mac
rosc
opic
exa
min
ation
XX
Mic
rosc
opy
XX
Mic
rosc
opic
exa
min
ation
& id
entifi
catio
n of
bloo
d, b
ody
fluid
and
spu
tum
: sta
inin
g (g
iem
sa,
gram
, met
hyle
ne b
lue,
Zie
hl- N
eels
on, I
ndia
ink/
Cr
ypto
cocc
us a
ntige
n te
st)
XX
Stoo
l exa
min
ation
for
para
site
s: fr
esh
and
after
sta
inin
g w
ith L
ugoi
’s io
dine
(or
Kato
- Ka
tz, f
orm
ol e
ther
)
XX
Wet
pre
para
tion
XX
Cyto
bact
erio
logi
cal e
xam
of u
rine
XX
Exam
inati
on o
f vag
inal
sw
abs
XX
MYC
OBA
CTER
IOLO
GYTB
rapi
d te
stX
X
Gen
eXpe
rtX
X
Fluo
resc
ent m
icro
scop
eX
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017106
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
IMM
UN
OSE
ROLO
GYRa
pid
test
s:•
H
IV•
H
epati
tis B
•
Hep
atitis
C•
CR
P•
A
SLO
•
Rube
lla•
To
xopl
asm
osis
•
TPH
A•
Pr
egna
ncy
test
•
Rheu
mat
oid
fact
or
XX
Hosp
ital (
H)HE
MAT
OLO
GYM
anua
l and
aut
omat
ed m
etho
ds:
• F
ull B
lood
Cou
nt•
Red
blo
od c
ells
(RBC
s)•
Whi
te b
lood
cel
ls (W
BCs)
& d
iffer
entia
l cou
nts
• H
emat
ocri
t•
Hem
oglo
bin
XX
X
Eryt
hroc
yte
sedi
men
tatio
n ra
te (E
SR)
XX
Bloo
d gr
oup
and
rhes
usX
X
CD4
coun
t (pe
rcen
t and
abs
olut
e va
lue)
XX
Retic
uloc
yte
coun
tX
X
Sick
le c
ell t
est
XX
Coag
ulati
on te
sts:
• B
leed
ing
time
(BT)
• P
artia
l thr
ombo
plas
tin ti
me
(PTT
)•
Acti
vate
d PT
T (A
PTT)
• P
roth
rom
bin
time
(PT)
XX
Com
patib
ility
testi
ngX
X
Coom
bs te
stX
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 107
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
CHEM
ISTR
YFu
lly a
utom
ated
met
hodo
logy
with
ISE
mod
ule
for e
lect
roly
tes
XX
Pola
rogr
aphy
XX
Bloo
d ga
s an
alys
isX
X
BIO
CHEM
ISTR
YU
rine
che
mis
try
usin
g st
rips
:•
A
lbum
in•
G
luco
se
XX
Bloo
d ch
emis
try
•
Kidn
ey fu
nctio
n te
sts
•
Live
r fun
ction
test
s•
Bl
ood
gluc
ose
XX
MIC
ROBI
OLO
GYSp
ecim
en c
olle
ction
, sto
rage
, and
tran
spor
tX
XX
Mac
rosc
opic
exa
min
ation
XX
Mic
rosc
opy
XX
Mic
rosc
opic
exa
min
ation
& id
entifi
catio
n of
bloo
d, b
ody
fluid
and
spu
tum
: sta
inin
g (g
iem
sa,
gram
, met
hyle
ne b
lue,
Zie
hl- N
eels
on, I
ndia
ink/
Cr
ypto
cocc
us a
ntige
n te
st)
XX
Stoo
l exa
min
ation
for
para
site
s: fr
esh
and
after
sta
inin
g w
ith L
ugoi
’s io
dine
(or
Kato
-X
X
Katz
, for
mol
eth
er)
Wet
pre
para
tion
XX
Cultu
re a
nd b
ioch
emic
al te
sts:
Cyto
bact
erio
logi
cal e
xam
of u
rine
XX
Exam
inati
on o
f vag
inal
sw
abs
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017108
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
MYC
OBA
CTER
IOLO
GYEx
tra-
pulm
onar
y TB
dia
gnos
isX
X
TB ra
pid
test
XX
Gen
eXpe
rtX
X
Fluo
resc
ent m
icro
scop
eX
X
IMM
UN
OSE
ROLO
GYIm
mun
oass
ay a
utom
ated
met
hodo
logy
:•
H
IV•
H
epati
tis B
& C
XX
Imm
unofl
uore
scen
ce te
chni
ques
XX
Rapi
d te
sts:
•
HIV
•
Hep
atitis
B•
H
epati
tis C
•
CRP
•
ASL
O•
Ru
bella
•
Toxo
plas
mos
is•
TP
HA
•
Preg
nanc
y te
st•
Rh
eum
atoi
d fa
ctor
XX
Ord
inar
yBi
omed
ical
La
bora
tory
(O
-BM
L)
HEM
ATO
LOGY
Man
ual a
nd a
utom
ated
met
hods
:•
Ful
l blo
od c
ount
• R
ed b
lood
cel
ls (R
BCs)
• W
hite
blo
od c
ells
(WBC
s) &
diff
eren
tial
coun
ts•
Hem
atoc
rit•
Hem
oglo
bin
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 109
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
Eryt
hroc
yte
sedi
men
tatio
n ra
te (E
SR)
XX
Bloo
d gr
oup
and
rhes
usX
X
Retic
uloc
yte
coun
tX
X
Sick
le c
ell t
est
XX
Coag
ulati
on te
sts:
• B
leed
ing
time
(BT)
• P
artia
l thr
ombo
plas
tin ti
me
(PTT
)•
Acti
vate
d PT
T (A
PTT)
• P
roth
rom
bin
time
(PT)
XX
Com
patib
ility
testi
ngX
X
Coom
bs te
stX
X
CHEM
ISTR
YFu
lly a
utom
ated
met
hodo
logy
with
ISE
mod
ule
for e
lect
roly
tes
XX
BIO
CHEM
ISTR
YU
rine
che
mis
try
usin
g st
rips
:•
A
lbum
in•
G
luco
se
XX
Bloo
d ch
emis
try
•
Kid
ney
func
tion
test
s
•
Liv
er fu
nctio
n te
sts
•
Blo
od g
luco
se
XX
MIC
ROBI
OLO
GYSp
ecim
en c
olle
ction
, sto
rage
, and
tran
spor
tX
X
Mac
rosc
opic
exa
min
ation
XX
Mic
rosc
opy
XX
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017110
Serv
ice
Leve
lSe
rvic
eLa
bora
tory
Tes
tsTy
pes o
f Sta
ff
Path
olog
ist/
Lab
spec
ialis
t (>A
0)La
b Sc
ienti
st (A
0)La
b te
ch (A
1/ A
0)
Mic
rosc
opic
exa
min
ation
& id
entifi
catio
n of
bloo
d, b
ody
fluid
and
spu
tum
: sta
inin
g (g
iem
sa,
gram
, met
hyle
ne b
lue,
Zie
hl- N
eels
on, I
ndia
ink/
Cr
ypto
cocc
us a
ntige
n te
st)
XX
Stoo
l exa
min
ation
for
para
site
s: fr
esh
and
after
sta
inin
g w
ith L
ugoi
’s io
dine
(or
Kato
- Kat
z, fo
rmol
et
her)
XX
Wet
pre
para
tion
XX
Cyto
bact
erio
logi
cal e
xam
of u
rine
XX
Exam
inati
on o
f vag
inal
sw
abs
XX
IMM
UN
OSE
ROLO
GYIm
mun
oass
ay a
utom
ated
met
hodo
logy
:•
H
IV•
H
epati
tis B
& C
XX
Rapi
d te
sts:
•
HIV
•
Hep
atitis
B•
H
epati
tis C
•
CRP
•
ASL
O•
R
ubel
la•
To
xopl
asm
osis
•
TPH
A•
P
regn
ancy
test
•
Rhe
umat
oid
fact
or
XX
NO
TE:
The
labo
rato
ry s
ervi
ces
in a
ll Sp
ecia
l Priv
ate
Hea
lth e
stab
lishm
ent
cate
gorie
s in
clud
ing
Spec
ial c
linic
(SC)
, Spe
cial
Hos
pita
l (SH
) and
Spe
cial
ized
Biom
edic
al la
bora
torie
s (S
-BM
L) h
ave
not
been
defi
ned
in t
he
tabl
e ab
ove.
It w
ill o
nly
be p
ossi
ble
if th
is s
peci
al p
riva
te h
ealth
est
ablis
hmen
t ha
s de
fined
its
scop
e of
ser
vice
s th
at in
tur
n w
ill b
e us
ed t
o de
term
ine
the
labo
rato
ry s
ervi
ces
and
the
type
of
staff
nee
ded
as
requ
ired
for d
eliv
ery
of s
peci
aliz
ed h
ealth
ser
vice
pac
kage
.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 111
Tabl
e 14
: Lab
orat
ory
Equi
pmen
t
Serv
ice
Met
hod
Equi
pmen
t Spe
cific
ation
Leve
l of F
acili
ty
MP
MC
PCH
O-B
ML
Qua
ntity
HEM
ATO
LOGY
Man
ual a
nd a
utom
ated
m
etho
ds.
Bino
cula
r mic
rosc
ope
11
11
Hem
oglo
bin
devi
ce2
11
11
Hem
atol
ogy
anal
yzer
or
othe
r in
stru
men
ts
11
11
UPS
11
11
CHEM
ISTR
YFu
lly a
utom
ated
met
hodo
logy
with
ISE
mod
ule
for e
lect
roly
tes,
Po
laro
grap
hy
Chem
istr
y an
alyz
er1
11
1
UPS
11
11
Bloo
d ga
s an
alyz
er1
Elec
trop
hore
sis
anal
yzer
MIC
ROBI
OLO
GYM
acro
scop
ic e
xam
inati
on
Mic
rosc
opy
Stai
ning
Elec
tric
bin
ocul
ar m
icro
scop
e
usin
g cl
ear
whi
te li
ght
11
11
Fluo
resc
ence
mic
rosc
ope
1
Elec
tric
cen
trifu
ge1
11
11
Ove
n1
11
11
Jars
(aer
obic
and
ana
erob
ic)
1
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017112
Serv
ice
Met
hod
Equi
pmen
t Spe
cific
ation
Leve
l of F
acili
ty
MP
MC
PCH
O-B
ML
Qua
ntity
Wet
pre
para
tion
Cultu
re a
nd b
ioch
emic
al te
sts
Wat
er b
ath
11
11
Elec
tric
or
gas
Buns
enbu
rner
s1
Chem
ical
hoo
d1
Prec
isio
n ba
lanc
e1
Incu
bato
r1
11
Aut
ocla
ves
(1 fo
r st
erili
zatio
n&
1 fo
r de
cont
amin
ation
)1
11
21
Safe
ty c
abin
et C
lass
II1
Hot
pla
te1
11
1
Refr
iger
ator
11
12
1
Free
zer
11
11
Sing
le c
hann
el m
icro
pipe
ttes
(2 e
ach
of 1
0-10
0ul,
20-
200u
l, 10
0-10
00ul
)
66
66
MYC
OBA
CTER
IOLO
GYG
eneX
pert
1
Fluo
resc
ent m
icro
scop
e1
IMM
UN
OSE
ROLO
GYIm
mun
oass
ay a
utom
ated
m
etho
dolo
gy,
Imm
unofl
uore
scen
ce
Aut
omat
ed im
mun
oass
ayan
alyz
ers
11
Imm
unofl
uore
scen
cem
icro
scop
e1
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 113
Serv
ice
Met
hod
Equi
pmen
t Spe
cific
ation
Leve
l of F
acili
ty
MP
MC
PCH
O-B
ML
Qua
ntity
Tech
niqu
es.
Benc
h to
p ce
ntri
fuge
11
11
Rota
tor/
stirr
er1
11
11
Klin
e ag
itato
r1
11
1
Refr
iger
ator
11
11
1
Free
zer
11
11
1
Sing
le c
hann
el m
icro
pipe
ttes
(2 e
ach
of 1
0-10
0ul,
100-
1000
ul)
44
Mul
ticha
nnel
mic
ropi
pett
es(2
eac
h of
20-
200u
l)2
2
Incu
bato
r1
1
HIV
CD4
mac
hine
1
ELIS
A re
ader
and
was
her
2
NO
TE:
The
labo
rato
ry e
quip
men
t in
all S
peci
al P
riva
te H
ealth
est
ablis
hmen
t cat
egor
ies i
nclu
ding
Spe
cial
Clin
ic (S
C), S
peci
al H
ospi
t al (
SH) a
nd S
peci
aliz
edBi
omed
ical
Lab
orat
orie
s (S
-BM
L) h
ave
not b
een
defin
ed in
the
tabl
e ab
ove.
It w
ill o
nly
be p
ossi
ble
if th
is s
peci
al p
riva
te h
ealth
est
ablis
hmen
t has
defi
ned
its
scop
e of
ser
vice
s th
at in
turn
will
be
used
to
dete
rmin
e th
e la
bora
tory
equ
ipm
ent n
eede
d as
requ
ired
for d
eliv
ery
of s
pe ci
aliz
ed h
ealth
ser
vice
pac
kage
.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017114
Tabl
e 15
: Lab
orat
ory
Smal
l Equ
ipm
ent
Item
Qua
lifica
tion
MP
MC
PCH
O-B
ML
Gas
cyl
inde
rs o
r el
ectr
icBu
nsen
bur
ners
XX
XX
96 w
ells
mic
ropl
ate
with
U-
shap
ed b
ottom
for
TPH
AX
XX
X
Sedi
men
tatio
n ra
te ra
ck20
pla
tes
each
XX
XX
X
Gla
ss p
ipett
e (W
este
rgre
ntu
bes
for E
SR)
XX
XX
X
Pipe
tte
bulb
XX
XX
X
Mic
ropi
pett
e ra
ckX
XX
XX
Plati
num
wire
loop
XX
XX
Mic
rolit
er c
alib
rate
dpl
atinu
m w
ire lo
op fo
r ba
cter
ial
coun
t in
urin
e
X
Woo
d cl
amps
XX
XX
X
Gla
ss fu
nnel
60 m
m d
iam
eter
XX
XX
Plas
tic b
eake
r50
, 100
and
250
ml
XX
XX
Boro
silic
ate
Erle
nmey
erLa
rge
neck
of 2
50m
l & 5
00m
lX
XX
X
Was
h bo
ttle
250
ml
XX
XX
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 115
Item
Qua
lifica
tion
MP
MC
PCH
O-B
ML
Gra
duat
ed p
lasti
cm
easu
ring
cyl
inde
rs5
,10,
25 a
nd 5
0 m
lX
XX
X
Volu
met
ric
flask
s10
0 m
l, 25
0 m
l, 50
0ml a
nd10
00 m
lX
XX
X
Slid
e bo
x10
0 sl
ides
XX
XX
X
Box
to s
tore
slid
es10
0 po
sitio
nsX
XX
XX
Dro
p co
unt v
ials
50 m
lX
XX
XX
Am
ber
glas
s dr
op c
ount
via
ls10
0 m
lX
XX
XX
Ther
mom
eter
s20
°C -
30°C
XX
XX
X
Spat
ula
XX
XX
X
Woo
den
tong
sX
XX
X
Gob
lets
XX
XX
X
Pairs
of s
ciss
ors
XX
XX
X
Dia
mon
d pe
ncil
XX
XX
X
Stan
ds fo
r tub
es2
for
hem
olys
is tu
bes,
2 fo
rte
st tu
bes,
2 fo
r ce
ntri
fuge
tu
bes
(rou
nd b
ottom
), 2
for
cent
rifu
ge tu
bes
(con
ical
bo
ttom
)
XX
XX
X
Hem
ocyt
omet
erM
odifi
ed N
euba
uer
XX
XX
Petr
i dis
hes
90x1
4 an
d 60
x14
in g
lass
and
pla
stic
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017116
Item
Qua
lifica
tion
MP
MC
PCH
O-B
ML
Tabl
e tr
ash
bins
for
slid
esan
d ne
edle
sX
XX
XX
Dro
p co
unt v
ials
for
para
ffin
oil
XX
XX
Alu
min
um fo
ilX
XX
XX
Ster
ile s
wab
sX
XX
XX
Stop
wat
ch60
min
utes
XX
XX
X
Slid
e bo
x10
0 po
sitio
nsX
XX
XX
Dry
er/s
trip
10 to
20
posi
tions
XX
XX
X
Stai
ning
rack
XX
XX
X
Stai
ning
bac
XX
XX
X
Slid
e ra
ck10
to 2
0 po
sitio
nsX
XX
XX
Tras
h bi
nX
XX
XX
Tips
(yel
low
, whi
te a
nd b
lue)
XX
XX
X
Man
ual c
ount
er1
key
XX
XX
X
Coun
ter
for
WBC
XX
XX
Vort
exX
XX
X
Mag
netic
bar
sD
iffer
ent s
izes
XX
Inve
rse
mir
ror
XX
Plas
tic w
eigh
ing
dish
Diff
eren
t siz
esX
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 117
Item
Qua
lifica
tion
MP
MC
PCH
O-B
ML
Biod
egra
dabl
e tr
ash
bags
(Aut
ocla
vabl
e an
d no
n au
tocl
avab
le)
XX
XX
X
Cool
box
esVa
riou
s si
zeX
XX
XX
Cryo
tube
s -
2 m
lX
XX
XX
Cryo
tube
s ra
cks
XX
XX
X
Spill
kit
For
each
ser
vice
XX
XX
X
Firs
t aid
kit
For
each
ser
vice
XX
XX
X
Eye
was
h ki
tFo
r ea
ch s
ervi
ceX
XX
XX
Mic
row
ave
XX
XX
X
Fire
exti
ngui
sher
For
each
ser
vice
XX
XX
X
Fire
bla
nket
XX
XX
X
Lab
coat
XX
XX
X
Spra
ys a
nd fo
rmal
dehy
deva
pori
zers
X
Uni
vers
al a
nd s
peci
alan
tidot
esX
XX
XX
Full
face
resp
irato
rsX
XX
Glo
ves
and
head
cov
erin
gX
XX
XX
Tool
s (h
amm
ers,
axe
s,sp
anne
rs, s
crew
driv
ers,
la
dder
s, ro
pes)
XX
XX
X
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017118
Table 16: Media and Culture Preparation Equipment that are required in hospital facility laboratories.
List Specifications
Distiller
Magnetic plate
Electric mixer
Hot plate
Refrigerator 2 compartments without automatic defrost(2- 8°C and –20°C) 400L
Autoclave 200 L
Precision balance 100 grams
Roberval balance with mass kit
pH meter
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 119
Recommendations from Team from Private Hospitals and Polyclinics
1. MoH needs to urgently approve and implement the suggested scope of work at different categories of health professionals to meet the international recognized standards
2. MoH needs to review the list of medications and equipment authorized in each category of private health facility with the support of professional societies. Emergency drugs and equipment need to be uniform at each category of health facility.
3. The coding list of medical procedures needs to comply with international recognized standards such as ICD-10 and be harmonized across all sectors public and private.
4. MoH needs to increase participation of the private facilities in decision making of policies, planning and implementation of health strategies.
5. The HMIS needs to be upgraded and include all specialties which are internationally recognized.
6. Some specialized procedures can be done by dental health practitioners that have been certified, e.g. a dentist should be allowed to extract impacted wisdom teeth if certified.(Needs to be reformulated instead include review the list).
7. The MoH should appoint physiotherapy practitioners according to the level and size of health facilities, respecting the international norms and standards of the World Confederation of Physical Therapy of which Rwanda is a member (e.g. a physiotherapy service at district hospital should be run by a BSc PT holders – A0 not A1; and the ratio of 1PT/ 10 patients should be respected).
8. There is need to have an anesthesiologist who is either part time or full time to support the major surgical interventions at private health facilities including Specialized Clinics, Hospitals and Specialized Hospitals. The facilities need to have well equipped recovery rooms for patients, especially children and elderly, who are likely to require an extended recovery period from sedation. There is need to have a clear written agreement with hospitals equipped ICU for transfer of patient.
9. Some specialized clinics that are willing to carry out major surgical procedures need to have more than one theatre room to avoid infection of patients. Furthermore, the equipment in these theatres should be periodically monitored for quality.
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017120
References1. Boltz M, Resnick B, Galik E. Interventions to prevent functional decline in the acute care setting. In: Boltz
M, Capezuti E, Fulmer T, Zwicker D, editor(s). Evidence-based geriatric nursing protocols for best practice. 4th ed. New York (NY): Springer Publishing Company; 2012. p. 104-21.
2. Interagency Task Team on Prevention of HIV Infection in Pregnant Women, Mothers and their Children. Guidance of global scale-up of the prevention of mother to child transmission of HIV: towards universal access for women, infants, and young children eliminating HIV and AIDS among children. 2007; revised 2013. World Health Organization: Geneva.
3. Ministerial Order No 14/02 Min 98 of March 26, 1998. Defining the Functioning Norms of Private Health Establishments in Rwanda.
4. WHO. Integrated Management of Childhood Illness: Chart Booklet. March 2014. World Health Organization: Geneva
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 121
Participant list
Names of participants Position title InsitutionsDr Umutoni Nathalie Director of Health Policies &
RegulationMOH
Rugira Guillaume Private Health Facilities Supervisor MOH
Dr Balinda Jean Paul MPH RBC/NCDS
Dr Banguti Paulin Anesthesiologist Rwanda Society of Anesthesiology
Dr Bayisenga Justin Surgeon Rwanda Surgical Society
Dr Bitwayiki Leandre Dental surgeon Rwanda Dental Association
Dr Bukara Emmanuel Orthopedic surgeon Rwanda Surgical Society
Dr Byiringiro J. Claude General Surgeon Rwanda Surgical Society
Dr G. Fundi Frederic Director of Rutongo Hospital Rutongo Hospital
Dr Gakumba Claude Anesthesiologist Rwanda Society of Anesthesiology
Dr Gasana Africa Guido Urolo Surgeon Rwanda Surgical Society
Dr Gasasira J. Baptiste GP Rwanda Health Care Federation
Dr Gashumba Diane Pediatrician Rwanda Pediatrics Association
Dr Gatare Suwaibu Transfusion Medecine RBC/NCBT
Dr Gatsiga Jean Dieudonne` Gynecologist & Obstetrician Rwanda Gynecology & Obstetrics Society
Dr Georgina Calderon Country Director SIDHARTE
Dr Kabayiza Jean Claude Senior Lecturer/ Pediatrician Rwanda Pediatric Association
Dr Kamanzi Immaculee Dentist Rwanda Dental Association
Dr Kamugundu David M.D. RFHP
Dr Kanyankore William GP Rubavu Hospital
Dr Karangwa Alphonse Dental surgeon Rwanda Dental Association
Dr Kayitesi Kayitankore Dermatologist Rwanda Dermatology Association
Dr Lule Joseph General Surgeon Rwanda Surgical Society
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017122
Names of participants Position title Insitutions
Dr Martins Ovberedjo Health Systems WHO
Dr Masu Adolphe Anesthesiologist Rwanda Society of Anesthesiology
Dr Mugabo Marie Family Health WHO
Dr Muhire Karama Ophthalmologist Rwanda Ophthalmological Society
Dr Muhizi Charles Ophthalmologist Rwanda Ophthalmological Society
Dr Mujyuwisha Louis Pediatrician Rwanda Pediatric Association
Dr Mukara Batamuliza Kaitesi ENT Surgeon Rwanda Surgical Society
Dr Muneza Severien Neuro surgeon Rwanda Surgical Society
Dr Murakatete Odile GP Rwamagana Hospital
Dr Musafiri Roger Family Medecine Kinihira Hospital
Dr Musiime Stephenson Pediatrician Rwanda Pediatric Association
Dr Mutangana Alexis Anesthesiologist Rwanda Society of Anesthesiology
Dr Mutangana Francis Ophthalmologist Rwanda Ophthalmology Society
Dr Muvunyi Zuberi Director of Bushenge Hosp Bushenge Hospital
Dr Muyombano Antoine GP Rwanda Private Healthcare Federation
Dr Muzungu Kumwami Pediatrician Rwanda Pediatric Association
Dr Namanya William Director of Kibungo Hospital Kibungo Hospital
Dr Ncogoza Isaie ENT Surgeon Rwanda Surgical Society
Dr Ndagijimana Sylvestre Director of Kibirizi Hospital Kibirizi Hospital
Dr Ndatinya Augustin Pediatrician Rwanda Pediatric Association
Dr Ndayisenga Albert Surgeon Rwanda Surgical Society
Dr Ndekezi Deogratias Gynecologist and Obstetrician Rwanda Society of Gynecology & Obstetrics
Dr Ndekezi Deogratias Director of Ruhengeri Hospital Ruhengeri Hospital
Dr Ndibanje Alain Jules Surgeon Rwanda Surgical Society
Dr Nduwimana JMV GP Rwanda Healthcare Federation
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017 123
Names of participants Position title Insitutions
Dr Ngaruye Sylvestre Anesthesiologist Kibungo Hospital
Dr Ngendahimana Gerald GP Rwanda Healthcare Federation
Dr Ngoga Eugene Gynecologist & Obstetrician Rwanda Society of Gynecology & Obstetrics
Dr Niyibizi Pretextate Pediatrician Rwanda Pediatric Association
Dr Nizeyimana Theoneste GP Nyagatare Hospital
Dr Nizeyimana Theophile M.D/MPH MOH
Dr Nkeramihigo Emmanuel Internist Rwanda Colleague of Physicians
Dr Nkuranga Jean Baptiste Director of Rwamagana Hospital Rwamagana Hospital
Dr Nkurikiye John Ophthalmologist Rwanda Ophthalmological Society
Dr Nkurikiye John Ophthalmologist Rwanda Ophthalmology Society
Dr Nkusi Agabe Emmy Neuro surgeon Rwanda Surgical Society
Dr Nshimyumuremyi Isaac Anesthesiologist Rwanda Anesthesiology Society
Dr Nshizirungu Placide Director of Gihundwe Hospital Gihundwe Hospital
Dr Ntaganda Evariste GP/MPH Rwanda Ophthalmology Society
Dr Nyemaji Alex Ophthalmologist Rwanda Ophthalmology Society
Dr Nzeyimana Isaie Program Director SIDHARTE
Dr Rugwizangoga Eugene Surgeon JHPIEGO
Dr Ruhamya Nathan Cardiologist Rwanda Colleague of Physicians
Dr Ruhungande Landoward General Surgeon Ruhengeri Hospital
Dr Rurangwa Theogene Gynecologist & Obstetrician Rwanda Gynecology & Obstetrics Society
Dr Rwamasirabo Emile Medical Director Rwanda Surgical Society
Dr Rwirangira Theogene Director of Kibuye Hospital Kibuye Hospital
Dr Sebatunzi Osee Director of Kibagabaga Hosp Rwanda Colleague of Physicians
Dr Sindayigaya Alphonse Physician Kibungo Hospital
Dr Subira Manzi Gynecologist & Obstetrician Rwanda Gynecology & Obstetrics Society
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017124
Names of participants Position title Insitutions
Dr Turate Innocent Quality Improvement Specialist MOH
Dr Twiringirimana Francois Regis Ophthalmologist Rwanda Ophthalmological Society
Dr Utumatwishima J. Nepo Director of Kinihira Hospital Kinihira Hospital
Dr Uwambazimana Jeanne d’Arc Anesthesiologist Rwanda Society of Anesthesiologist
Dr Uwineza Bonaventure Anesthesiologist Rwanda Society of Anesthesiologist
Dr Uyisabye Innocent General Surgeon Rwanda Surgical Society
Dr Uzabakiriho Raphael GP Gihundwe Hospital
Dushimimana Evodia MCH Specialist MOH
Gashayija Modeste Quality Health Specialist MOH
Mbonimpa Theodore Dental Therapist Rwanda Dental Association
Musabwasoni M. Grace Sandra Midwife Rwanda Nursing and Mid wife council
Dr Tuyisenge Lysine Pediatrician Rwanda Pediatric Association
Joy Atwine Principal Technical Advisor QI MSH
Joanne Ashton Consultant MSH
Dr Akishuri Dennis Senior Technical Advisor QI MSH
Laetitia Kakana Technical Advisor QI MSH
Dr Kalinda Viateur Technical Advisor QI MSH
Dr Ahabwe Moses Senior Technical Advisor Leadership andGovernance
MSH
Private Health Facil i t ies in Rwanda ● Health Service Packages ● January 2017126
RWANDA
