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We describe the results of a web-based survey among district health managers in Rwanda who gave their personal opinions on the factors that drive performance in the health sector, in particular those that determine maternal health service coverage and outcomes.

The questionnaire covered the six health systems building blocks that make up the WHO framework for health systems analysis, and two additional clusters of factors that are not directly covered by the framework: community health and determinants beyond the health sector.

It is the comprehensiveness and combination of interventions that drive performance in Rwanda, rather than a single health systems strengthening intervention or a set of interventions that target a specific disease.

There is need for policy makers and scholars to acknowledge the complexity of health systems, and the fact that they are dynamic and influenced by society’s fabric, including the overall culture of performance management in the public sector.

So before tightening your noose around the neck of a man or woman of the pen, it's absolutely paramount to first know what constitutes a drink.

So unless you are not human, dating a journalist will most likely end in you being the subject of one of their stories.It is the reason male journalists who are dating, or have ever dated a woman, will feel inclined to write about really personal stuff, while female scribes in a relationship, or that have dated in the past, may vent about foul breath and other bodily odors that stink like an old tortoise's fart.Journalists also love their drink, and by drink I do not mean things like soda and ikinyomoro and ikivuguto and agashya and water and coffee and tea because who says that those are journalists' drinks?A polling assistant holds a ballot paper marked "Yes" and "No" at a polling station in Rwanda's capital Kigali, on December 18, 2015.Rwandans voted in a referendum on amending Rwanda’s Constitution to allow President Paul Kagame to seek a third term in 2017.