Abstract: Right to Health Care – An Accompaniment Approach

Abstract

AJOL Abstract: AbstractBackgroundThe Right to Health Care (RTHC) is a Partners In Health (PIH) program that uses the accompaniment approachwith patients from any Inshuti Mu Buzima/Partners in Health (IMB/PIH)-supported district hospitals,namely Butaro, Kirehe and Rwinkwavu; and it allocates funding to ensure that quality medical care is given tothose patients when transferred to referral hospitals in Rwanda, neighboring countries and beyond.DescriptionThe Right to Health Care Program activities started, with PIH/IMB, in 2005 at Rwinkwavu hospital, then atKirehe and Butaro hospitals as well. The nurse physically accompanies the patients at the referral hospital toensure the providers have complete information and the patients receive appropriate care. We daily book patients’appointments and guide them to the clinic, pay their medical fees, and facilitate exams and medicationsprovision. We also provide them with subsistence needs, transportation, hygiene and infant care supplies,and even hire temporary attendants to assist them with other needs. The program is structured in the districtbased and central RTHC committees made of clinicians and district clinical leaders to enhance objective decision-making and prioritization in the use of the program’s budget.Lessons LearnedAccompaniment to patients relieves the complication of health care logistics by supporting their collateralexpenses. The latter can be higher than medical bills since most of referred patients are sent to Kigali wheremost of referral hospitals are located and where only 10% of population live (NISR, 2014); which wouldlead some patients or families to reject decision of transfer to Kigali while access to health care is a right ofpatients whatever it takes. Building strong relationship between referral and referring hospitals is crucial tosustain patient care and easy communication between physicians from both sides. We have been accompanyingpatients to access quality medical care at referral hospitals supporting approximately 500 inpatients yearly witha survival rate of 93.3%; and since 2012 the program supported twenty-five international patients’ transfers;and patients always show gratitude for the services that they wouldn’t have afforded on their own. Thus, ourprogram helps break the cycle of disease-poverty.ConclusionSolidarity, humility, compassion and not necessarily technical expertise are key attitudes that can help nursesand other accompagnateurs to bring hope to desperate people. The mission of nursing in society is helping individuals,families, and communities to achieve their physical, intellectual, and social potentials, even while doingso in the challenging context in which they live and work.There is a need to advocate for resources to supportpatients in Kigali referral hospitals to allow them access specialized care.This is a bigger challenge in developingcountries, such as Rwanda, but a rewarding and worthwhile endeavor