Nationally, health in Rwanda has been improving since 2000, with considerable improvement since 2005.Despite improvements, rural areas continue to lag behind urban sectors with regard to key health outcomes.Partners In Health (PIH) has been supporting the Rwanda Ministry of Health (MOH) in two rural districts in Rwanda since 2005. Since 2009, the MOH and PIH have spearheaded a health systems strengthening (HSS) intervention in these districts as part of the Rwanda Population Health Implementation and Training (PHIT) Partnership.