In 2005, the Government of Rwanda (GOR) decided to upgrade its nursing education by phasing out the lower-level, A2 (similar to U.S. nurse’s aide) training programs and closing all its nursing schools except for five, at which a higher-level, three-year, A1 Registered Nursing and Midwife Program will be installed. A new, 18-month university degree nursing program has also been designed to prepare nurse educators to teach at the five A1 nursing schools. None of this could have been done without the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

Using PEPFAR funds, the U.S. Government has taken a unified approach to building the capacity of nurses to provide quality HIV/AIDS services in Rwanda. IntraHealth/The Capacity Project, a USAID partner, collaborated with the Ministry of Health and key stakeholders to draft a national Nursing Strategic Plan, outfit the five nursing schools, and develop the HIV/AIDS curriculum, which will be integrated into the three-year Registered Nursing Program. The treatment portion of the curriculum, which also covers prevention, care and support, was developed by Columbia University, a Centers for Disease Control (CDC) PEPFAR partner.

An additional exciting element in this joint effort has been Family Health International’s pilot project to train nurses to prescribe antiretroviral therapy under physician supervision. In response to the GOR’s ambitious goals to increase the number of clinical sites offering ART, FHI is training nurses to evaluate HIV-infected patients, prescribe first-line drugs, and identify more difficult cases to be referred to the doctor. Now at three health centers, the pilot intervention is being evaluated by Rwandan health authorities for its potential for relieving doctors’ caseloads and moving more patients into treatment more quickly.