Rwanda on right path of achieving MDG mark in health care provision

In 2000, 189 United Nations member states (now 193) made a promise to free citizens from deprivations like extreme poverty, hunger, lack of health care, gender inequality, among others by the end of this year (2015). This pledge turned into the eight Millennium Development Goals (MDG’s). Zeroing down on the resolutions made in line with the health sector, three major areas were to be tackled; reducing under-five child mortality rates by two-thirds, between 1990 and 2015, cutting maternal deaths by three quarters, and combating HIV/AIDS and malaria. Maternal mortality In this line, Rwanda has done a deserving job, though more is needed, for instance mid last year, the country met the MDG 5 target of reducing the number of women who die during pregnancy, or shortly after giving birth, by three-quarters, beating the deadline. Dr Fidel Ngabo, the Coordinator of Maternal and Child Health in the Ministry of Health attributes this to rolling out of more hospitals and maternity services over the years. Allowing more women to have safe births, for instance nearly 7 in 10 deliveries occurred at a health facility compared to 5 in 2007-2008. “Community Health Workers have been given mobile telephones to call for quick medical intervention and ambulances whenever an expectant mother seems to have complications,” he said. About two years ago, the Ministry of Health also launched a training program for traditional birth attendants that teaches them basic nursing and midwifery skills, and this perhaps explains the considerable reduction in maternal and child deaths. Child mortality This (achieving of the MDG 5 target of reducing the number of women who die during pregnancy) also came 3 years barely after the country hit the MDG 4 target on child mortality, by reducing deaths from 156 deaths per 1000 children in the last 20 years to 54 reflecting a two-thirds decline. Improvements in vaccination coverage over this period also contributed significantly with the number of children vaccinated increasing from 75% in 2006 to 90.1% as of July last year. HIV/AIDS fight Government has also done a good job as regards containing the HIV prevalence rate, for instance it remained constant between 2006 and December last year, standing at 3%. According to Dr Sabin Nsanzimana, the head of HIV division at the Rwanda Biomedical Centre (RBC), a lot has been invested in prevention measures. “For instance between July 2013 and June 2014, 11,273,800 male condoms and 45,020 female condoms were distributed through the public sector, while 12,112,976 male condoms were distributed through social marketing efforts,” he said. It (government) also intends to raise condom use by 13 per cent, thereby reducing the estimated new infections in children from 1,000 to less than 200 and increasing the fraction of male adult circumcision from 13 per cent to 66 per cent by 2018. Malaria and TB The government’s fight against Malaria has also been incredible and this has seen Malaria deaths go down over the years, for instance In 2005, 477,000 people died of malaria. This number reduced to 11,450 in 2012. There has been a decline in malaria and Tuberculosis cases. The death rate associated with TB decreased from 6% to 4% between 2006 and 2011. Ownership of at least one long lasting insecticide treated bed net had risen from 15% in 2006 to around 83 per cent in September 2014 “The number of children under five years getting appropriate treatment within 24 hours of catching Malaria grew from 845 in 2009 to 96 per cent in 2013,” says Dr Corine Karema, the head of malaria and other parasitic diseases at RBC. Safe drinking water Since last year, 74.5 per cent of the population had access to a safe drinking water source from 64% in 2006.The target is to provide safe drinking water to 100 per cent of its population by the year 2017. Universal health coverage A year before the UN set goals in 2000, a community based health insurance scheme (Mutuelle de Santé) had kicked off and as of the fiscal year 2013/14, an estimated 73 per cent of Rwandans had subscribed. This explains why the life expectancy of Rwandans has improved in two decades to 64.5 years for both sexes, according to the final report of Fourth Population and Housing Census conducted in 2012 by the National Institute of Statistics of Rwanda (NISR). In a related development in May 2013, Rwanda was ranked number one among 48 African countries that had registered significant progress in achieving Millennium Development Goals (MDGs). According to a continental data report released by ONE, a campaign and advocacy organisation of more than 3 million people taking action to end extreme poverty and preventable diseases, Rwanda was ranked top with 6.0 MDGs progress score. Challenges However a lot more has to be done in line with fighting HIV, as about 226,225 people in the country are infected with the virus and statistics show that a person gets infected every 3 minutes meaning that about 10,000 people are infected with the virus every year, while 5,000 people die of HIV/AIDS related diseases per year. Stunted growth for children under the age of 5 is also relatively high, standing at 44% way above the World Health Organisation’s maximum target of 20%, meaning the government has to do more in line with fighting malnutrition. Post 2015 MDG’s As of September last year, Rwanda and Tunisia were the two African countries (out of 10 globally) chosen to pilot thematic areas in the post-Millennium Development Goals because of their remarkable performance under the UN development agenda. Among the areas where Rwanda will serve as a model will be on strengthening capacities and building effective institutions for implementation and localisation of internationally agreed and development plans beyond 2015.