April 2013
Post on GAVI Web
These are exciting
times for the people of Rwanda. Less than two decades after the1994 genocide,we
are making substantial progress. Recent studies suggest that more than one million Rwandans
were lifted out of abject poverty and our people are better protected from some of the most devastating
diseases that not only threaten our health but also our continued productivity
and economic growth. As we continue to focus our efforts on the improvement of
our health and look forward to continuing progress on many of the
health-related Millennium Development Goals (MDGs), it is important to take
stock of how far we have come and the reasons for our achievements.
In Rwanda
public health policies have been inspired by our vision 2020 and commitment to the
MDGs. Not only have they helped guide our public health plans and activities,
they have also served as important progress indicators. Consistent with MDGs 4,
5 & 6, we have made improvements of the health of our mothers and children
a national priority. To date, Rwanda has more than halved child mortality and
we look set to achieve the MDG targets for cutting both infant mortality,
under-five mortality and maternal mortality by 2015. Rwanda is ranked among
five countries recognized for having reduced maternal mortality by more than
half; alongside Malawi, Ethiopia, Nepal and Yemen. This is partially because we
have been prioritizing family planning and women’s health.
From the
very beginning, we recognized that efforts to better our health could not try
to fully replicate those of more developed nations. Constrained by limited financial
and human resources, we needed to find a model that worked for our people and
that was based on our shared history, culture and health realities. As part of
our Vision 2020 process, we reached out to the Rwandan people to reflect on how
to accelerate our development with innovative strategies and being as ambitious
as the developed countries for we want the best for our people. We then developed a process and strategic
plan that we once again took to the people to ensure that it was workable at
the local level. We needed to do it the
Rwandan way and I believe our home grown solutions have helped us to focus on substantial
targets.
Much of our
work has been guided by a focus on engagement with all levels of our society,
because we believe that 80% of the burden of disease needs to be solved at the
community level. We have decreased the financial and geographic barriers in the
access of health. A better service delivery system combined with basic
education and awareness campaigns have resulted in a broad utilization of
health services. In each village our three elected Community Health workers
have helped to ensure the accountability and transparency needed to implement
effective health interventions at the local level. This has given us a large
advantage in the implementation of broad immunization efforts that must
encompass the vast majority of the population to be successful.
Our
government’s commitment to adequate prevention efforts and in particular our
focus on the scaling of immunization program have been a significant driver of
our results. The government of Rwanda has worked closely with the GAVI Alliance
and its partners, WHO and UNICEF, to immunize children against many
common diseases. As a result of this support, by 2008, we have reached 95% of
babies born in Rwanda with essential vaccines to protect them against five key
childhood diseases. This level of coverage is seldom reached on the continent
of Africa or anywhere else in the world and is a testament to the political
will of our leaders at all level, combined with the support of our people and
our international partners. We have been at the forefront in terms of
vaccinating our girls against HPV. Rwandan children now have access to the 11
vaccines recommended by WHO for routine immunization. Just recently, in March,
we launched the Measles and Rubella immunization campaign. Over four days in
which healthcare workers worked around
the clock, across the country, to vaccinate almost five million children between the ages of 9 months and 14
years.
The partnership
with GAVI Alliance also extended to strengthening the health system so that
once we secured these vaccines we could effectively deliver them to our
children. Our delivery system now has the capacity and ability to protect the
cold chain supply so that we will be able to leverage this work to continue to
deliver vaccines.
Despite all
this, we still have a long way to go. Among children and women, chronic
childhood malnutrition remains high, as well as severe anemia; contraception remains underused by many
Rwandans and while infant and child mortality have decreased dramatically,
neonatal mortality remains a challenge. Rwanda also faces a
substantial burden of non-communicable diseases. We have developed actions plans at village, sector, district and referral point
of care to tackle these and other unmet challenges.
Our health efforts – similar to many of our development efforts- have
been implemented in partnership between the government, the people and our
international partners. We have adopted the processes of using scientific
evidences, equity, and participation for more efficient results with our few
resources.
The government of Rwanda is committed to building on its proven achievements
and to expanding immunization so that we can reach the universal goal
of reducing child mortality by two thirds by 2015. The 1994 genocide has devastated
Rwanda and made it very difficult to achieve the MDGs. It was a said
impossible challenge to achieve the MDGs, however, the determination of the
people of Rwanda, the good leadership at all levels focussing on the health of
Rwandans and the policies that have been adopted have open the way to achieve
the MDGs and laid the foundations for a healthier future.
