“Rwanda records most exciting recovery in public health history”

The 1994 genocide wrecked Rwanda but the small central Africa country has been transformed in the last two decades. It represents a public health model for many countries desirous of meaningful healthcare reforms.

The 1994 genocide in Rwanda dealt a big blow on every fire of the nation. It left the entire world awe struck, after realizing at least a million lives had been lost.

The former United Nations Secretary General Kofi Annan admitted that the world responded too slowly to the crisis that ravaged the sub-Saharan nation. The devastation affected the political landscape and the economy, education, health and security. There was a short-lived response by the international community after the genocide but many donations and technical support plummeted with a short time.

Today, the story of Rwanda is different. Most people in the West perhaps see genocide as synonymous to the country but the nomenclature has changed. Key American experts -including Dr. Paul Farmer, Founder of Partners in Health (PIH) and Prof. Jeffrey Sachs, a renowned economist-report a revolutionary change in the nation’s health system which led to significant improvement in health outcomes. A careful analysis of healthcare in Rwanda shows it has recorded the most exciting recovery in public health history.

Neal Emery, in a recent article published on the Atlantic, writes of the successes Rwanda has achieved: “Rwanda is the only country in sub-Saharan Africa on track to meet most of the Millennium Development Goals. Deaths from HIV, TB, and malaria have each dropped by roughly 80 percent over the last decade and the maternal mortality ratio dropped by 60 percent over the same period.”

Emery continues: “Even as the population has increased by 35 percent since 2000, the number of annual child deaths has fallen by 63 percent. In turn, these advances bolstered Rwanda's economic growth: GDP per person tripled to $580, and millions lifted themselves from poverty over the last decade”

He adds that ‘the country increased from 870 people on HIV treatment in 2002 to more than 100,000 in 2012 while retaining 92 percent of patients in care compared to 50 percent in the United States”

Besides, under-5 mortality has dropped by 70%, since 2000. The country has achieved universal coverage, with nearly 98% of the population with health insurance. Its community health insurance program caters for the vulnerable population by charging small annual premiums and affordable co-payments, subsidized by donors. It also boost of strong primary care system, with at least 45,000 community health workers.

How has it been able to achieve so much, in such a short time? According to Management Sciences for Health, strong leadership is a key factor in the health revolution that is taking place in the nation. The government created Vision 2020 to facilitate economic recovery with health as a priority. This galvanized his poverty reduction strategy. Donor agencies must conform to this vision or leave the country. Each ministry collaborates effectively with others, on cross-cutting issues with one common goal.

The government implemented a centrally coordinated system that emphasizes cost-effective evidence-based health interventions. An example is development of an effective primary healthcare system with training and deployment of 45,000 community health workers into the low-income communities to provide basic health care. This contributed immensely to improved health outcomes. 

Rwanda’s success story shatters the myth that Africa is a wound on the conscience of the world. It radiates hope to every nook and cranny of Sub-Saharan Africa. It provides a model not just for African countries with weak health systems but also for the developed nations particularly the United States which is yet to achieve universal coverage.

 

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