health system in rwanda,another succes

A nation’s wealth and vibrancy can, in part, be measured by the health of its people and the investments it makes in developing its human capital. Investment in health is, therefore, the capital investment per excellence.

                                          mutuelle de sante,one of succes in rwanda health system

To attain the government’s Vision 2020 and the United Nations Millennium Development Goals (MDGs) that were agreed by countries around the globe and the leading development institutions, Rwanda, through the Ministry of Health has established policies and strategies aimed at making provision of quality care a national priority.

Notable among the policies and strategies are Universal Health Insurance, Performance Based Financing (PBF), decentralisation of healthcare services, Community-based healthcare provision, and investments in e-health.

Infectious diseases, including HIV/AIDS, malaria, TB, and childhood diseases, have received priority attention. Attention to hygiene and sanitation, as well as the fight against malnutrition, has received Presidential leadership, with impressive results.

Investments in maternal and child health have put Rwanda on track to achieve the MDGs on Maternal and Childhood Mortality.

Universal Health Insurance and easy access to healthcare has reduced catastrophic out of pocket expenditure for healthcare, especially for the poorest quantile of our population. Average life expectancy at birth is now at 52 up from 25 in 2000.

The number of sick people who visit health facilities has also noticeably increased as a result of the health insurance or Mutuelles de Santé. 

Easy access to health facilities, reduced cost of healthcare services coupled with health systems innovation have enabled Rwanda to register tremendous and remarkable milestones in reducing infant mortality from 86/1000 to 62/1000, under five mortality from 152 to 103/1000, Malaria morbidity and mortality have reduced by over 60 percent and the HIV/AIDS prevalence is less than 3 percent, down from 11 percent in the year 2000. Maternal mortality has decreased from 1, 071/100,000 live births; to an estimated 383/100,000 live births in 2008.

Policies and strategies are only as good as the people who design and implement them. The government has, therefore, invested in human resource for health.  From an estimated 30 doctors in the aftermath of the genocide in 1994, Rwanda now has one doctor for every 18,000 people (585 doctors), and one nurse for every 1,700.  This improvement, although dramatic, is insufficient. Heavy investments in medical education, including continuing professional development for health professionals will continue to be a priority. Higher training, including at university degree level, is being offered for nurses and midwives for the first time in Rwanda’s history. Professional councils and associations have been established, and a Charter of Patients’ Rights and Responsibilities is now in use.

Today, some 150 doctors are pursuing clinical and sub-clinical specialisation in the country and abroad. This is a sea change compared to the period before 1994 when at any one time, less than 10 students would be enrolled in medical school in any given year. Since 1995, Rwanda has produced more doctors than were produced in the thirty years following her independence. It is also training them better, and providing clear career paths for them. This is true across the entire health workforce spectrum.

It is evident that development of human resources and skills alone cannot guarantee improved health care services. Thus, the Ministry of Health has put extra efforts to develop healthcare infrastructure and bridge the geographical access gap by construction of new health facilities, rehabilitation and equipment of the health facilities, as well as the improvement of the laboratory system and the development of Telemedicine.

CORNEILLE KILLY
nckilly2011@gmail.com