To deal with the high burden of mental health disorders resulting from consequences of the
1994 genocide against Tutsis, the Rwanda Ministry of Health (MoH) considers mental health
as a priority intervention. For the last 20 years, Ministry of Health focused on rebuilding a
national and equity-oriented mental health program responding to the population needs in
mental health. Mental health services are now decentralized and integrated in the national
health system, from the community level up to the referral level.
This study assessed the situation of mental health services in one rural district in Rwanda. It
was aimed at assessing the progress of implementation of mental health care at the
decentralized level, focusing on resource implications and processes.
This study is based on interviews conducted with key stakeholders, using the World Health
Organization's Assessment Instrument for Mental Health Systems (WHO-AIMS).
Findings show that human resources for mental health care and community-based mental
health services of the assessed district remain extremely limited. Mental health professionals
face limitation regarding the ability to provide emergency management of psychiatric patients
and to ensure continuity of psychopharmacological treatment of patients with chronic
conditions.
To improve the implementation process of mental health interventions and activities, a
planning process based on community needs and the involvement of representatives of
families and users in planning process should be considered.
The Bugesera case study on the situation of mental health services can serve as a baseline for
improvement of the mental health program in Rwanda, in terms of quality care services,
infrastructure and equipment, human and financial resources.