Members of Parliament have requested the Ministry of Health to present before the house every year before budget approval, the planned activities so that Rwanda effectively implement the targets outlined in the Sustainable Development Goal (SDG3).

The Lower House came up with the resolution on Tuesday, February 15 after adopting the assessment report of its Committee on Social Affairs about the implementation of SDG3 that seeks to ensure healthy lives and promote well-being for all at all ages.

Some of the SDG3 targets include reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030, and end preventable deaths of newborns and under-five children.

Regarding maternal deaths, the maternal mortality ratio for Rwanda was 203 deaths per 100,000 live births in 2019-20, according to the Demographic and Health Survey 2019-20.

MP Odette Uwamariya, Chairperson of the Committee on Social Affairs said that the Ministry of Health developed the fourth health sector strategic plan (HSSP 4) running from July 2018 through June 2024, which is the guiding document outlining national strategic directions to improve health standards of Rwandans over the seven-year period.

The strategic plan was informed by global and regional development agendas Rwanda has committed to, especially the Sustainable Development Goals (SDGs)’ targets.

Concerning financing, the entire plan is projected to cost over Rwf4.2 trillion for the seven-year period, implying over Rwf600 billion annual investment.

At the end of the period, the Government seeks to increase the money it spends on healthcare per person per year to $60 (about Rwf60,000 in current exchange rates), up from $36 in 2018.

Targets under this plan include reducing maternal and child mortality, increasing the number of health facilities with required infrastructures including water and electricity, increasing the number of healthcare providers including generalists and specialists, as well as nurses and midwives.

Uwamariya said that its members lauded this health sector strategic plan as it could help achieve universal healthcare, which is also the target for SDG3.

"We want that the broader guidelines contained in this health sector strategic plan be taken into account so that the country achieves the targets it set by 2030,” she said.  

However, she said, the issue was that the needed funding was not readily available, and the Ministry of health could not provide a breakdown of the planned financing per year for this goal,” she said.

"Committee members realised that the annual budget allocation is not enough for the health sector to be able to achieve the set targets,” she said, adding that those in charge of looking for the financing should give it a priority so that the country attain the goal to provide healthcare to its residents.

The ratio of medical personnel to population

For midwife/population ratio (women aged from 15-49), Rwanda targets to have one midwife per 2,500 people by 2024 from one per 4,064 people.

Uwamariya said that it is commendable this target was achieved earlier as Rwanda had one midwife per 2,340 people by 2020.

However, for the doctor and nurse/population ratio, there is a need for efforts to achieve the set targets.

There was one doctor per 10,055 people in 2016, while the target was to have one doctor per 7,000 people. As of 2020, Uwamariya said that Rwanda had one doctor per 8,247 people.

For nurse to population ratio, one nurse was serving 1,142 people in 2015, while the target was to have one nurse per 800 in 2024.  In 2020, there was one nurse per 1,198 people.

MPs expressed concern that the number of nurses continue to be smaller compared to the population they should serve.

Some argued that the problem was due to stopping the nursing courses in secondary schools (A-level), appreciating the reintroduction of such courses.

However, MP Christine Mukabunani said that deficit of nurses in the health sector was also to blame on inefficient evaluation system, which is kind of excluding them from practicing the medical profession.

"There are some nurses who have been unemployed. Mainly, the problem is that they are subjected to doing nursing licencing exams, whereby for instance, one who studied pediatrics has to sit a generic exam which can result in their failure,” she said.

She suggested that focus should be put on ensuring the quality of education and clinical internships instead of the prohibitive examinations after getting academic certificates.