Isuzuma ry’uruhare rwa
gahunda ya PEPFAR
(2012–2017)

Komite ishinzwe gusuzuma gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima muri Repubulika y'u Rwanda mu rwego rwa Gahunda ya Perezida w'Amerika igamije gutanga ubufasha bwihuse mu kurwanya SIDA (PEPFAR)

Inama y'ubutegetsi ya Global Health

Ishami rishinzwe ubuzima n'ubuvuzi

Raporo y'ubushakashatsi yumvikanweho ya

THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

THE NATIONAL ACADEMIES PRESS 500 Fifth Street, NW, Washington, DC 20001

Iki gikorwa cyatewe inkunga binyujijwe mu masezerana yashyizweho umukono hagati y'ikigo cya National Academy of Sciences na U.S. Centers for Disease Control and Prevention. Ibitekerezo byose, ibyavuye mu bushakashatsi, imyanzuro cyangwa ibyifuzo bikubiye muri iki gitabo ntibigomba gufatwa ko ari ibitekerezo by'umuryango cyangwa ikigo cyateye inkunga uyu mushinga.

International Standard Book Number-13: 978-0-309-67205-4
International Standard Book Number-10: 0-309-67205-8
Intangakintu y'ikoranabuhanga: https://doi.org/10.17226/25687

Izindi nyandiko zitari nyinshi zikubiyemo iyi ncamake ziboneka muri Health and Medicine Division, 500 Fifth Street, NW, Washington, DC 20001.

Inyandiko z'igitabo Evaluation of PEPFAR's Contribution (2012–2017) to Rwanda's Human Resources for Health Program, cyavanwemo iyi ncamake, zishobora kugurirwa muri National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 cyangwa kuri (202) 334-3313; http://www.nap.edu.

Uburenganzira bw'umwanditsi 2020 bwa National Academy of Sciences.
Uburenganzira bwose burakomye.

Cyacapiwe muri Leta Zunze Ubumwe z'Amerika

Amagambo yifashishijwe: National Academies of Sciences, Engineering, and Medicine. 2020. Isuzumwa ry'uruhare rwa gahunda ya PEPFAR (2012–2017) mu kongera ubushobozi bw'abakozi bo mu rwego rw'ubuzima mu Rwanda. Washington, DC: The National Academies Press. https://doi.org/10.17226/25687.

Ikigo National Academy of Sciences cyashyizweho mu 1863 n'Itegeko rya Kongere, ryashyizweho umukono na Perezida Lincoln, nk'ikigo cyigenga kitegamiye kuri Leta kugira ngo kijye kigira Leta inama ku bibazo byerekeranye n'ubumenyi n'ikoranabuhanga. Abayigize batorwa na bagenzi babo kubera kuba indashyikirwa mu bushakashatsi. Dr. Marcia McNutt ni we uyibereye Perezida.

Ikigo National Academy of Engineering cyashyizweho mu 1964 hakurikijwe ibisabwa n'Itegeko rishyiraho National Academy of Sciences kugira ngo kigire inama igihugu binyujijwe mu bikorwa by'ubuhanga. Abayigize batorwa na bagenzi babo kubera uruhare rudasanzwe bagize mu byerekeranye n'ubwubatsi. Dr. John L. Anderson ni we uyibereye Perezida.

Ikigo National Academy of Medicine (cyahoze cyitwa Institute of Medicine) cyashyizweho mu 1970 hakurikijwe ibisabwa n'itegeko rishyiraho National Academy of Sciences kugira ngo kigire inama igihugu mu bibazo byerekeranye n'ubuvuzi n'ubuzima. Abayigize batorwa na bagenzi babo kubera uruhare rudasanzwe bagize mu bijyanye n'ubuvuzi n'ubuzima. Dr. Victor J. Dzau ni we uyibereye Perezida.

Ibi bigo uko ari bitatu bikorera hamwe nka National Academies of Sciences, Engineering, and Medicine kugira ngo bikore isesengura ryigenga ritagira aho ribogamiye binagire igihugu inama ndetse no kugira ngo bikore ibindi bikorwa bigamije gukemura ibibazo binyuranye no kugira uruhare mu ifatwa ry'ibyemezo byo mu rwego rwa politiki. Ibi bigo by'igihugu binashishikariza kwiga no gukora ubushakashatsi, bikagaragaza abagize uruhare rw' indashyikirwa mu bumenyi, kandi bigafasha abaturage kurushaho gusobanukirwa ibibazo byerekeranye n'ubumenyi, ubuhanga n'ubuvuzi.

Andi makuru yerekeranye na National Academies of Sciences, Engineering, and Medicine mwayasanga kuri uru rubuga www.nationalacademies.org.

Consensus Study Reports (Raporo z'ubushakashatsi zumvikanweho) zitangazwa na National Academies of Sciences, Engineering, and Medicine zikubiyemo amakuru y'imvaho yumvikanweho ku mishinga y'ubushakashatsi buteganywa gukorwa iba yateguwe na komite y'impuguke. Akenshi usanga izi raporo zikubiyemo ibyavuye mu bushakashatsi, imyanzuro n'ibyifuzo bishingiye ku makuru yakusanyijwe n'iyo komite n'ibyemezo abayigize bafashe. Buri raporo isuzumwa mu buryo bucukumbuye n'izindi mpuguke zigenga kandi ni yo igaragaza umwanzuro w'Ibigo by'igihugu bishinzwe ubushakashatsi (National Academies) ku mushinga w'ubushakashatsi buteganywa gukorwa.

Proceedings (Inyandikomvugo) zitangazwa na National Academies of Sciences, Engineering, and Medicine zitangaza ibyigiwe mu nama n'ibiganiro byatangiwe mu mahugurwa, inama z'impuguke cyangwa izindi nama zateguwe na National Academies. Imyanzuro n'ibitekerezo bikubiye mu nyandikomvugo aba ari iby'abitabiriye inama ubwabo bitavuze ko babihuriyeho n'abandi bitabiye inama, komite yaziteguye cyangwa National Academies.

Kugira ngo mubone amakuru yerekeranye n'inyandiko n'ibikorwa bya National Academies, musabwe gusura www.nationalacademies.org/about/whatwedo.

KOMITE ISHINZWE GUSUZUMA GAHUNDA YO KONGERERA UBUSHOBOZI ABAKOZI BO MU RWEGO RW'UBUZIMA MURI REPUBULIKA Y'U RWANDA MU RWEGO RWA GAHUNDA YA PEREZIDA W'AMERIKA IGAMIJE GUTANGA UBUFASHA BWIHUSE MU KURWANYA SIDA (PEPFAR)

ANN E. KURTH (Perezida), Linda Koch Lorimer Professor and Dean, Yale School of Nursing

TILL BÄRNIGHAUSEN, Alexander von Humboldt University Professor and Director, Heidelberg Institute of Global Health, University of Heidelberg, Ubudage; Adjunct Professor of Global Health, Harvard T.H. Chan School of Public Health

ERAN BENDAVID, Associate Professor of Medicine, Stanford University

CARLA CASTILLO-LABORDE, Assistant Professor, Centro de Epidemiología y Políticas de Salud, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile

ELVIN H. GENG, Professor of Medicine, Division of Infectious Diseases, and Director of the Center for Dissemination and Implementation at the Institute for Public Health, Washington University in St. Louis

FASTONE M. GOMA, Dean and Associate Professor, University of Zambia School of Medicine, Lusaka, Zambiya

LAURA HOEMEKE, Global Health Policy Consultant; Adjunct Professor, Gillings School of Global Public Health, University of North Carolina at Chapel Hill

ANGELINA KAKOOZA-MWESIGE, Senior Lecturer and Pediatric Neurologist, Department of Pediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda

EMMANUEL B. K. LUYIRIKA, Executive Director, African Palliative Care Association, Kampala, Uganda

MOSA MOSHABELA, Dean and Head, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, Afurika y’Epfo

DENIS NASH, Distinguished Professor and Executive Director, CUNY Institute for Implementation Science in Population Health, City University of New York Graduate School of Public Health and Health Policy

CHARLES OK PANNENBORG, Retired Chief Health Advisor and Chief Health Scientist, The World Bank Group

DEREK J. SLOAN, Senior Clinical Lecturer and Consultant Infectious Diseases Physician, University of St. Andrews, Ekose

SHEILA D. TLOU, Perezida, Global HIV Prevention Coalition; Yahoze ari Director of the Regional Support Team for Eastern and Southern Africa, UNAIDS (kugeza muri Gicurasi 2019)

Abakozi bakoze mu bushakashatsi

SUSAN F. E. MILNER, Study Director

CECILIA MUNDACA SHAH, Senior Program Officer (kugeza mu Ukuboza 2018)

KATYE M. MAGEE, Associate Program Officer (kugeza muri Gashyantare 2019)

EMMA FINE, Associate Program Officer (kuva muri Gicurasi 2019)

T. ANH TRAN, Research Associate (kugeza muri Werurwe 2020)

ZARIA FYFFE, Senior Program Assistant (kuva muri Werurwe 2020)

MICHELLE KVALSUND, National Academy of Medicine Fellow in Osteopathic Medicine

JULIE A. PAVLIN, Senior Director, Board on Global Health

Impuguke

BRIDGET B. KELLY, Principal Consultant, Burke Kelly Consulting

Itsinda ry’impuguke rya EnCompass LLC

SARAH SMITH LUNSFORD, Team Lead and Senior Evaluation Specialist

SIMON HILTEBEITEL, Monitoring and Evaluation Specialist II

KELSEY SIMMONS, Evaluation Specialist II

AMY BHOPAL, Special Projects Associate

REBECCA K. CATHCART, Impuguke ikorera mu Rwanda

SYLVESTRE MUSENGIMANA, Impuguke ikorera mu Rwanda

Abakosoye raporo

Inyandiko y'iyi Raporo y'ubushakashatsi yumvikanweho (Consensus Study Report) yakosowe n'abantu batoranyijwe kubera ubuhanga n'ubunararibonye bunyuranye bwabo. Iri suzuma ryigenga rigamije gutanga ibitekerezo bicukumbuye bizafasha inzego za National Academies of Sciences, Engineering, and Medicine mu gutuma buri raporo zitangaza ijyamo amakuru nyayo bishoboka kandi ikubahiriza amabwiriza y'inzego zibishinzwe mu byerekeranye n'ireme, ukutabogama, amakuru nyakuri no kubahiriza imyanzuro yatanzwe n'abashinzwe ubushakashatsi. Ibitekerezo byatanzwe mu kuyikosora n'inyandiko z'umwimerere bigirwa ibanga mu rwego rwo kubungabunga umutekano w'ibitekerezo byatanzwe mu gihe cyo gukosora iyi raporo.

Turashimira abantu bakurikira kubera uruhare bagize mu gukosora iyi raporo:

Nubwo abakosoye raporo bamaze kuvugwa batanze ibitekerezo n'ibyifuzo byubaka byinshi, ntabwo basabwe kwemeza ko bashyigikiye imyanzuro cyangwa ibyifuzo bikubiye muri iyi raporo yewe nta nubwo babonye inyandiko iheruka yayo mbere yo gutangazwa. Ikosorwa ry'iyi raporo ryakurikiranywe na KRISTINE M. GEBBIE, Flinders University School of Nursing and Midwifery, na ANN M. ARVIN, Stanford University School of Medicine. Uko ari babiri bari bashinzwe kureba neza ko isuzumwa ryigenga ry'iyi raporo ryakozwe hakurikijwe amabwiriza ya National Academies kandi ko ibitekerezo byose byatanzwe mu kuyikosora byitaweho neza. Komite yari ishinzwe kwandika iyi raporo na National Academies ni bo bonyine babazwa ibikubiyemo.

Iriburiro

Isi ikeneye abakozi bo mu rwego rw'ubuzima benshi. Aba bakozi bakenewe cyane mu bihugu bikennye usanga bifite umubare munini w'ababana n'ubwandu bwa virusi itera SIDA, twavuga nko muri Afurika yo munsi y'Ubutayu bwa Sahara. Aka karere gafite abaturage bangana na 11% by'abatuye isi, 24% by'abarwaye indwara zibasira isi n'abarenga 70% by'abanduye virusi itera SIDA,¹ ariko kakaba gafite abakozi bo mu rwego rw'ubuzima bangana na 3% by'abakozi bo mu rwego rw'ubuzima ku isi, gakeneye rwose ibikorwa bishya n'ishoramari mu rwego rwo kongera umubare w'abakozi bo mu rwego rw'ubuzima (HRH).² Kubera iyi mpamvu, Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima mu Rwanda yabaye urugero rwiza, rushingiye ku bihe byihariye, igihugu kikiva muri Jenoside gikeneye gusanwa, intambwe ikomeye mu bijyanye n'ibipimo by'ibanze by'ubwandu bwa virusi itera SIDA, n'ubuyobozi buhamye bwiyemeje guteza imbere urwego rw'ubuzima mu Rwanda binyujijwe mu ishyirwaho ry'urwego rw'ubuzima ruhamye kandi rufite ubushobozi buhagije.

Gahunda ya Perezida w'Amerika igamije gutanga ubufasha bwihuse mu kurwanya SIDA (PEPFAR) n'abayobozi bayo bakorera mu Biro by'Umuhuzabikorwa ushinzwe ibikorwa mpuzamahanga bigamije gukumira

___________________

¹ Kharsany, A. B. M., na Q. A. Karim. 2016. HIV infection and AIDS in sub-Saharan Africa: Current status, challenges and opportunities. Open AIDS 10.

² IFC (International Finance Corporation). 2019. Sub-Saharan Africa: Health and education.https://www.ifc.org/wps/wcm/connect/REGION__EXT_Content/IFC_External_Corporate_Site/Sub-Saharan+Africa/Priorities/Health+and+Education (yasuwe mu ku itariki ya 6 Ugushyingo 2019).

virusi itera SIDA muri Amerika bafite inshingano zo gukumira ubwandu bwa virusi itera SIDA, kandi na Leta y'u Rwanda yiyemeje kuboneza serivisi z'ubuzima ku baturarwanda bose. Izi ntego zishobora gusa n'izigongana, kwibanda ku ndwara imwe no gukoresha uburyo rusange mu kubaka ubushobozi bw'urwego rw'ubuzima rushobora gukemura ibibazo by'ibanze byose abaturage baba bafite mu rwego rw'ubuzima. Hashize igihe abantu bungurana ibitekerezo ku byerekeranye no gutegura gahunda zihariye cyangwa gahunda rusange; ariko, bitewe n'ibibazo biterwa n'indwara zitandura bikomeje kwiyongera (umubare w'abo zihitana ungana na 71% by'abapfa ku isi)³ n'iterambere ry'ubuvuzi bw'indwara ya SIDA nk'indwara abantu babana na yo ijyana n'indwara nyinshi z'ibyuririzi na zo zihitana abantu, birashoboka ko abantu bagenda barushaho gukomatanya izi gahunda. Muri uru rwego, birakwiye ko dushima igitekerezo gishya cya PEPFAR na Leta y'u Rwanda cyo gufatanya mu gushyiraho iyi gahunda yihariye.

Igeragezwa rya Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima mu Rwanda ni igikorwa dusanga abantu bakwiye kuvanamo amasomo menshi mu bijyanye no gutegura no gushyira mu bikorwa gahunda zo kongerera ubushobozi abakozi zifasha gukumira ubwandu bwa virusi itera SIDA ndetse zikanafasha igihugu kugeza serivisi z'ubuzima ku baturage bose. Ibihugu byinshi n'abafatanyabikorwa babyo bashobora kwigira ku buryo Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima yateguwe, igashyirwa mu bikorwa, ikanakorerwa isuzumwa. By'umwihariko aya masomo aziye ku gihe bijyanye n'umwanzuro w'inama yerekeranye no kugeza serivisi z'ubuzima kuri bose (UHC) yahuje abayobozi bakuru b'Umuryango w'Abibumbye ku itariki ya 23 Nzeri 2019, yagaragaje ko ibihugu bikennye n'ibiri mu nzira y'amajyambere bifite ibibazo by'abakozi badahagije ndetse iyo nama igaragaza ko “hakenewe guhugura, kongera ubushobozi no kugumana abakozi bo mu rwego rw'ubuzima bashoboye,” cyane cyane “abaforomo n'abaforomokazi, ababyaza n'abajyanama b'ubuzima.”⁴

Wenda isomo rya mbere ry'urugero rwa Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima mu Rwanda ni uko iyi gahunda yamaze igihe gito, igihe yagombaga kumara cyagizwe kigufi kubera ko igihe cy'inkunga ya PEPFAR cyagabanyijweho imyaka 2. No mu itegurwa rya mbere rya Gahunda yagombaga kumara imyaka itageze ku icumi, hakagaragazwa ko itazamara imyaka icumi abantu babijyaho impaka bavuga ko iki gihe ari gito cyane ku buryo kitatuma haboneka abaganga b'impuguke bahagije, bashyira gahunda mu bikorwa bikagira ingaruka

___________________

³ WHO (World Health Organization). 2018. Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases (yasuwe ku itariki ya 6 Ugushyingo 2019).

⁴ United Nations. 2019. Political declaration of the high-level meeting on universal health coverage: “Universal health coverage: Moving together to build a healthier world.” New York: United Nations. https://undocs.org/en/A/RES/74/2 (yasuwe ku itariki ya 28 Mutarama 2020).

zifatika, ndetse bakaba bategura abandi baganga. Irindi somo rikomeye ni uko abantu batahaye agaciro gahagije urwego rw'impinduka mu nzego ikenewe kugira ngo haboneka ibisubizo birambye mu rwego rw'ubushobozi bw'inzego zita ku burezi bw'abakozi bo mu rwego rw'ubuzima. Na none, kongera ubushobozi bw'abarimu kugira ngo bazakomeze gukora aka kazi muri Kaminuza y'u Rwanda ntabwo byashyizwe muri gahunda y'ubufatanye uko byari bikwiye.

Kubera intego ya PEPFAR nka gahunda yihariye, intego yo kumenya niba inkunga yatewe Gahunda yo Kongerera ubushobozi bw'abakozi bo mu rwego rw'ubuzima yararushijeho gufasha abantu babana n'ubwandu bwa virusi itera Sida (PLHIV) irumvikana. Nka komite, twatekereje cyane ku buryo umuntu yashobora kugerageza gusubiza iki kibazo nk’ikibazo cy’isuzuma rireba inzego zinyuranye, kubera ko nta makuru ashingirwaho mu gihe runaka yari ahari, igihe gito cyane cy’ibikorwa byatewe inkunga, n’ibibazo byo guhuza mu buryo bwihariye ibyagezweho mu bijyanye no gukumira virusi itera SIDA na gahunda rusange yo kubaka ubushobozi bw’igihugu mu rwego rwo kongera ubushobozi bw’abakozi bo mu rwego rw’ubuzima. Umwanzuro wa nyuma komite yatanze wari uko bitashoboka kumenya impamvu yabiteye. Ariko kubera icyorezo cya SIDA gikomeje kwibasira Afurika yo munsi y'Ubutayu bwa Sahara, ndetse no kubera ikibazo cy’uburyo buboneye bwakoreshwa mu kugeza serivisi z’ubuzima kuri bose ku isi, iri suzuma ryatanze amahirwe yo kugaragaza akamaro ko kongera ubushobozi bw'abakozi bo mu rwego rw'ubuzima n’uburyo byagira ingaruka ku babana n’ubwandu bwa virusi itera SIDA, ndetse no ku buzima bwa buri wese.

Ugereranyije ubushakashatsi bwakozwe mu gihe cyihuse, ariko mu buryo bwatekerejweho neza kandi bucukumbuye. Kubera ko twari twiyemeje kumenya amakuru menshi ashoboka, tutirengagije inzitizi zijyana n’uburyo iyi gahunda ndetse n’isuzuma byakozwemo, komite yagaragaje ibyo iyi gahunda yagezeho ndetse n’ibyifuzo by’uko ubutaha ibikorwa nk’ibi byajya bitegurwa kugira ngo bibashe gufasha abantu kungukira muri icyo gikorwa amasomo arushijeho gusobanuka.

Turashima rwose akazi kakozwe n’abakozi bitanze, impuguke, abagize komite, ndetse cyane cyane abakozi bari bahagarariye Leta y’u Rwanda n’abakozi ba kaminuza, abarimu bagizemo uruhare binyujijwe mu nzego z’abafatanyabikorwa za Leta Zunze Ubumwe z’Amerika n’abandi bakorera mu gihugu cyose bagize uruhare muri iri suzuma. Turasaba uzasoma iyi raporo kureba uburyo yakurikiza aya masomo mu kazi ke kugira ngo ubuzima bw'abantu burusheho gutera imbere.

Ann E. Kurth, Perezida

Komite ishinzwe gusuzuma gahunda yo kongerera ubushobozi abakozi bo mu rwego rw’ubuzima muri Repubulika y’u Rwanda mu rwego rwa Gahunda ya Perezida w’Amerika igamije gutanga ubufasha bwihuse mu kurwanya SIDA (PEPFAR)

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Gushimira

Iyi Raporo y'ubushakashatsi yumvikanweho n'isuzumwa rya gahunda ntibyari gushoboka hatabayeho uruhare rugaragara abantu benshi babigizemo. Mbere na mbere, komite, impuguke n'abakozi bakoze mu bushakashatsi barashimira byimazeyo abantu 87 babajijwe batavuzwe amazina bigomwe umwanya wabo kugira ngo batange ibitekerezo byabo mu gihe cyo gukusanya amakuru ajyanye n'ubu bushakashatsi.

Turashimira byimazeyo abatanze ibiganiro, urutonde rwabo rukaba ruri mu mugereka B, n'abandi bitabiriye ibiganiro rusange byateguwe na Komite i Washington, DC, i Kigali, mu Rwanda, kubera umwanya bigomwe n'ubushake bagize bwo kutugezaho ibitekerezo binyuranye byabo.

Turanashimira Dr. Khama Rogo na Dr. Daniel Yumbya kubera ibitekerezo n'inama baduhaye ku byerekeranye n'inzego zigisha abakozi bo mu nzego z'ubuzima babigize umwuga n'uburyo bahabwa ibyemezo by'akazi muri Afurika y'Iburasirazuba.

Turashimira byimazeyo abayobozi n'abakozi ba Minisiteri y'Ubuzima mu Rwanda, Ikigo gishinzwe ubuzima mu Rwanda (RBC), Kaminuza y'u Rwanda, Ishyirahamwe ry'Abaganga mu Rwanda, n'Inama y'Igihugu y'abaforomokazi, abaforomo n'ababyaza kubera amakuru batanze agashyirwa muri ubu bushakashatsi no kubera ibitekerezo batanze n'ubufatanye bagaragaje. Iyi raporo ntiyari gukorwa tutabifashijwemo n'abantu bakurikira batubaye hafi kuri buri rwego: Dr. Diane Gashumba, Dr. Jean Pierre Nyemazi, Dr. Sabin Nsanzimana, Bwana Joseph Shema, Dr. Parfait Uwaliraye, Dr. Patrck Ndimubanzi, Dr. Jeanine Condo, Dr. Phil Cotton, Dr. David Ntirushwa, na Bwana Andre Gitembagara.

Turashimira tubikuye ku mutima ubwitange bwa Dr. Kristine Gebbie, wakurikiranye incuro ebyiri ikosorwa ry'inyandiko z'ubu bushakashatsi, mbere na mbere ku rwego rwa porotokore na nyuma ku rwego rw'inyandiko iheruka. Ikindi kandi, turashimira abantu bakurikira bigomwe umwanya wabo bagatanga n'ibitekerezo mu rwego rwo gukosora porotokore y'ubushakashatsi mu Ukuboza 2018: Dr. Sangeeta Mookherji, The George Washington University; Dr. Sam Phiri, Lighthouse Trust, Malawi; Dr. Shoshanna Sofaer, City University of New York; Dr. Allison P. Squires, New York University; na Dr. Kathryn Whetten, Duke University.

Turifuza no gushimira abakozi ba Gahunda ya Perezida w'Amerika igamije gutanga ubufasha bwihuse mu kurwanya SIDA (PEPFAR) na U.S. Centers for Disease Control and Prevention (CDC) mu Rwanda na CDC Atlanta, cyane cyane Ms. Emma Mtiro, kubera uruhare bagize n'inama batanze igihe ubu bushakashatsi bwakorwaga.

Bwa nyuma, benshi mu bakozi ba National Academies of Sciences, Engineering, and Medicine banatanze ubufasha muri ubu bushakashatsi. Turifuza gushimira Rebecca Morgan hamwe n'abakozi b'Ikigo cy'ubushakashatsi cya National Academies kubera ubufasha batanze mu bushakashatsi.

Turashimira kandi Ron Brown, Daniel Cesnalis, Anna Isabel Camilo Javier, Julie Wiltshire, na Skip Day (Office of Finance and Administration); Lauren Shern, Taryn Young, na Bettina Seliber (HMD Executive Office); Maryjo Oster na Dorothy Zolandz (Report Review Committee); Marc Gold (Office of General Counsel); Andrew Grafton, Greta Gorman, Nicole Joy, Jeanay Butler, na Sadaf Faraz (HMD Communications Office); ndetse na Stephanie Miceli (News and Public Information Office).

Ibirimo

IMPINE Z'AMAGAMBO

INCAMAKE

Inshingano ya Komite

Uburyo isuzuma ryakozwe

Ibyagaragaye n'imyanzuro

Ingaruka kuri virusi itera SIDA no kuri Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima

Ibyifuzo

Umwanzuro

Ibikubiye muri Raporo y'ubushakashatsi yumvikanweho yose, yavanwemo iyi Ncamake, biri ku rutonde rukurikira.

1 INTANGIRIRO: IMITERERE Y'ISUZUMA N'UBURYO BWAKORESHEJWE

Isobanurampamvu

Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima mu Rwanda

Inshingano ya Komite

Uburyo Komite yifashishije mu kuzuza inshingano yahawe

Akamaro k'isuzuma

Imiterere ya raporo

Inyandiko zifashishijwe

2 IMITEGURIRWE, UBURYO N'INZITIZI BY'ISUZUMA

Imitegurirwe

Inzitizi

Inyandiko zifashishijwe

3 ISHINGIRO, ICYEREKEZO N'IMITEGURIRWE BYA GAHUNDA YO KONGERERA UBUSHOBOZI ABAKOZI BO MU RWEGO RW'UBUZIMA

Ishingiro ryatumye gahunda ikorerwa mu Rwanda

Icyerekezo n'imitegurirwe bya Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima

Imitegurirwe

Imicungire y'imari

Uburyo n'ibibazo by'imicungire ya porogaramu

Ikurikiranabikorwa n'Isuzuma

Itegurwa ry'ibikorwa biramba

Imyanzuro

Inyandiko zifashishijwe

4 UBUFATANYE BW'ABARIMU

Ibyagezweho n'ubufatanye buhuriweho

Ibibazo mu bufatanye buhuriweho

Imyanzuro

Inyandiko zifashishijwe

5 UBUSHOBOZI BW'INZEGO Z'UBUREZI BW'ABAKOZI BO MU RWEGO RW'UBUZIMA

Ireme ry'uburezi

Guha akazi no kugumana abarimu babishoboye bo mu rwego rw'ubuzima

Integanyanyigisho z'amasomo y'abiga iby'ubuzima

Itangwa ry'ibyangombwa n'inyigisho zo ku rwego rw'inzobere

Amahugurwa y'abashakashatsi n'abakozi

Imyanzuro

Inyandiko zifashishijwe

6 KONGERA UMUBARE W'ABAKOZI BO MU RWEGO RW'UBUZIMA

Urwego rw'ubuzima ku isoko ry'umurimo mu Rwanda

Guha akazi no kugumana abakozi bo mu rwego rw'ubuzima

Kuvugurura no kugura ibikoresho

Imyanzuro

Inyandiko zifashishijwe

7 INYUNGU KU BAKOZI BO MU RWEGO RW'UBUZIMA N'IREME RYA SERIVISI Z'UBUVUZI

Inyungu rusange za Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima

Icyorezo cya SIDA mu Rwanda

Uburambe n'ishimangirwa

Imyanzuro

Inyandiko zifashishijwe

8 IBYIFUZO

Imyanzuro y'isuzuma ireba inzego zinyuranye

Ingaruka kuri virusi itera SIDA na Gahunda yo kongerera ubushobozi abakozi bo mu rwego rw'ubuzima

Ibyifuzo

Inyandiko zifashishijwe

IMIGEREKA

A IMYIRONDORO Y'ABAGIZE KOMITE, IMPUGUKE N'ABAKOZI

B INGINGO Z'IBIGANIRO RUSANGE

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Akazu, ibishushanyo n'imbonerahamwe

AKAZU

1-1 Ikigamijwe mu bushakashatsi

IBISHUSHANYO

S-1 Iby'ingenzi byagaragaye: ibyagezweho n'ibibazo

1-1 Urwego rwa Gahunda yongerera ubushobozi abakozi bo mu rwego rw'ubuzima

1-2 Inzira nyunguranabitekerezo y'isuzuma

2-1 Uko isuzuma ryakozwe

3-1 Uko ubukungu bw'u Rwanda bwari buhagaze hagati ya 2000 na 2018 mu madorari y'Amerika

3-2 Amafaranga yakoreshejwe mu rwego rw'ubuzima mu Rwanda hagati ya 2000 na 2016 (hakurikijwe ubushobozi bw'umuturage)

3-3 Impuzandengo y'amafaranga agenda ku rwego rw'ubuzima mu Rwanda hakurikijwe aho akomoka

3-4 Amafaranga yari ateganyijwe gukoreshwa na PEPFAR mu Rwanda hakurikijwe akarere gahunda ikoreramo n'ijanisha ryagenewe kongera ubushobozi bw'abakozi bo mu rwego rw'ubuzima

3-5 Amafaranga MINISANTE yakoresheje hagati ya FY 2010/2011 – FY 2014/2015 (mu madorari y'Amerika)

3-6 Ingengabihe ya Gahunda ya HRH

6-1 Abaganga, abaforomo n'abaforomokazi n'ababyaza ku baturage 10 000

6-2 Igiteranyo cy'abaganga b'impuguke barangije Kaminuza batewe inkunga na Gahunda ya HRH ku mwaka

6-3 Igiteranyo cy'abaforomo n'abaforomokazi b'impuguke barangije Kaminuza batewe inkunga na Gahunda ya HRH hakurikijwe ibyo bize

6-4 Imiterere y'akazi ababonye impamyabumenyi ku nkunga ya Gahunda ya HRH batanze amakuru bagiye bakora nyuma yo kurangiza amasomo

6-5 Imiterere y'akazi abaforomo n'abaforomokazi bahuguwe ku nkunga ya Gahunda ya HRH batanze amakuru bagiye bakora nyuma yo kurangiza amasomo

6-6 Imbonerahamye y'ibigo bihabwa ibikoresho by'imfashanyigisho mu masomo y'ubuvuzi bitangwa ku nkunga ya PEPFAR binyujijwe muri gahunda HRH hakurikijwe Akarere

7-1 Imibare y'abanduye virusi itera SIDA mu Banyarwanda bafite hagati y'imyaka 15 na 49

7-2 Abahawe imiti igabanya ubukana bwa virusi itera SIDA, hagati ya 2010 na 2017

7-3 Imibare mishya y'abanduye virusi itera SIDA, hagati ya 1990 na 2018

7-4 Ababyeyi bari bakeneye gufashwa kwirinda kwanduza abana n'abagore batwite bafataga imiti igabanya ubukana bwa virusi itera SIDA, hagati ya 2011 na 2016

7-5 Isesengurampamvu rishingira ku makuru yatanzwe

IMBONERAHAMWE

1-1 Imibare y'abanduye virusi itera SIDA n'abahabwa imiti igabanya ubukana mu Turere tw'Afurika y'Iburasirazuba n'iy'Amajyapfo, 2012

2-1 Imibare y'abanduye virusi itera SIDA n'abahabwa imiti igabanya ubukana mu bitaro by'Uturere

2-2 Urugero rw'ababajijwe mu buryo bw'ikiganiro mu bushakashatsi

2-3 Ibibazo by'ubushakashatsi mu buryo bw'ikiganiro hakurikijwe ibyiciro by'ababajijwe

3-1 Inkomoko z'inkunga ya Gahunda PEPFAR yagize uruhare muri Gahunda ya HRH

3-2 Ingengo y'imari ya Gahunda HRH ku mwaka (mu madorari y'Amerika)

3-3 Amafaranga CDC yatanze mu rwego rwa Gahunda ya HRH ku mwaka (mu madorari y'Amerika)

3-4 Ingengo y'imari n'amafaranga yagaragajwe ko yakoreshejwe na Minisiteri y'Ubuzima mbere no mu gihe cya Gahunda ya HRH (mu madorari y'Amerika aburungushuye mu mamiriyoni)

3-5 Amafaranga yagiye ku bakozi ba MINISANTE hakurikijwe ibyiciro ku mwaka (mu madorari y'Amerika)

3-6 Imiterere y'ishyirwa mu bikorwa ry'intego za Gahunda ya HRH

3-7 Amafaranga yagiye kuri Gahunda ya HRH avuye mu yashowe na PEPFAR (mu madorari y'Amerika)

5-1 Isesengura rigereranya rya Gahunda za MHA na MSN

5-2 Amasomo asabwa muri CPD hakurikijwe umwuga

6-1 Umubare w'abakozi bo mu buzima mu Rwanda hakurikijwe urwego

6-2 Umubare w'abize iby'ubuvuzi muri Kaminuza y'u Rwanda barangije hakurikijwe ibyo bize

6-3 Umubare w'abaganga bahabwa impushya zo gukora

6-4 Imbonerahamwe y'abaganga b'impuguke n'abaganga basanzwe hakurikijwe urwego rw'ikigo cy'ubuzima

6-5 Ibikoresho byatanzwe mu Karere ku nkunga ya PEPFAR binyujijwe muri Gahunda ya HRH, hagati ya 2013 na 2017

6-6 Ibikoresho byatanzwe mu Kigo ku nkunga ya PEPFAR binyujijwe muri Gahunda ya HRH, hagati ya 2013 na 2017

6-7 Ubwoko bw'ibikoresho byatanzwe ku nkunga ya PEPFAR binyujijwe muri Gahunda ya HRH, hagati ya 2013 na 2017

7-1 Intambwe imaze guterwa mu gushyira mu bikorwa intego z'ubuvuzi 90-90-90 mu Rwanda

7-2 Ikigereranyo cy'imibare y'ababyeyi bahawe serivisi zo kurinda umubyeyi kwanduza umwana virusi itera SIDA mu Rwanda zitanzwe n'Ishami ry'Umuryango w'Abibumbye ryita ku kurwanya icyorezo cya SIDA na PEPFAR, hagati ya 2011 na 2016

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Impine z'amagambo

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