Rwanda has kept pace in the reduction of the mortality rate for children in the past two decades, a new report said yesterday.The United Nations Children Fund (UNICEF) report, titled "Committing to Child Survival: A Promise Renewed,” says child mortality rates in the country were slashed from 156 deaths per 1000 children to 54 deaths per 1000 children born annually, reflecting a two-thirds reduction.The fall implies the country is on course to achieving the Millennium Development Goal 4 – of reducing child mortality rates by two thirds by 2015. And considering what has already been done in the health sector this year, some officials are confident the country has already achieved the required 52 per cent decline in child mortality rate.The Minister of Health, Dr Agnes Binagwaho, congratulated Rwandans and health workers, in particular, for a job well done, but urged them to work even harder."Rwandans should be proud for what they have achieved, I am very grateful to the thousands of health workers who have dedicated their skills and time to make it happen, but we still have a long way to reach the level we want – the level of a middle income country,” she told The New Times.However, the minister refrained from speculating whether the country could have already hit the MDG Four target – nearly a year after the data that UNICEF used in its latest report was collected. She said accurate data on the latest progress will be available next year. "I appeal to all my colleagues, the doctors and nurses to double their efforts, but I am happy and I am proud of them.”Reacting to the report, the Director of Malaria Division at Rwanda Biomedical Centre, Corine Karema, took to Twitter yesterday, and declared "Rwanda achieves MDG 4 as Rwanda’s 2011 estimate is 54 per 1,000 live births!”"The MDG 4 target is to reduce child mortality rate by 52 per 1000 children born, the figures in the report indicate that by 2011, the rates were at 54. This implies that today, with all that has been done, we have probably achieved the target,” the Director General in charge of Communication at RBC, Arthur Asiimwe, told The New Times yesterday.According to the report, nine low-income countries, including Rwanda,Bangladesh, Cambodia, Ethiopia, Liberia, Madagascar, Malawi, Nepal and Niger have lowered their under-five mortality rate by 60 per cent or more over the last two decades.The countries used simple, tried and tested methods to improve child survival: widespread immunisation campaigns for diseases like measles and polio; insecticide-treated mosquito nets to prevent malaria; interventions ranging from folic acid supplements to clean delivery practices to improve newborn survival; and exclusive breastfeeding to address malnutrition."Part of what has led to Rwanda’s success include, the universal health care insurance scheme (Mutuelle de Sante), which has made it possible for almost all Rwandans to have access to healthcare,” said Asiimwe.Other factors responsible for the gains are the Community Health Workers (CHW), who helped with providing basic treatment for diseases like malaria, pneumonia and diarrhoea and mass vaccination against major killer diseases among children."Today, 99 percent of children have been vaccinated against the killer diseases. Also under the family planning programmes, we educated women about birth spacing and, today, the average birth space is about 2 years which saves children’s lives” said Asiimwe.A strong decline in the under-five malnutrition was also noted by the reduction from 18 percent of underweight children in 2006 to 11 percent in 2010/11.UNICEF said under-five deaths are now increasingly concentrated in sub-Saharan Africa and South Asia, which now account for 80 percent of the world’s total.MDG 4 sets out to reduce the under-five mortality rate by two-thirds. The commitment to reduce child mortality rates was taken in 1990 setting targets to be achieved by 2015.Last year, Rwanda achieved the MDG on sanitation, surpassing it by eight percent.MDG target 7c calls for reduction by half (50 per cent), the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015.Available figures indicate that by last year, about 58 percent of Rwandans had access to adequate sanitation.