At the time of this review, the Government of Rwanda was involved in decentralization of administrative functions that also impacted the health sector. Decentralization was seen as an opportunity for expanding laboratory capacity, improving data management and maximizing the use of surveillance information at all levels of the health care system in line with the IDSR strategy. In the Department of Epidemiology and Public Hygiene (DEHP), decentralization focused on improving coordination of disease surveillance with the alert and response system at the district level. Among the changes fostered by decentralization, a Geographic Information System (GIS) was set up, and bacteriology laboratories were established at five district hospital laboratories.