Healthcare in Rwanda
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Healthcare in Rwanda was historically of poor quality, but in recent decades has seen great improvement. Rwanda operates a
universal health care Universal health care (also called universal health coverage, universal coverage, or universal care) is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized ar ...
system, and is considered to have one of the highest-quality health systems in Africa.


History

In the pre-genocide era before 1994, Rwanda's healthcare was supported by the Bamako Initiative which was sponsored by UNICEF and WHO and adopted by African ministers of health in 1987. Progress was started towards decentralising the health management system, first to the Province level and then to the district level. Unfortunately this was disrupted by the 1994 genocide, which crippled the healthcare system alongside the economy. In the post genocide period, Rwanda has had an uphill climb in the recovery of its health system as well as its economy. It has since built one of the best healthcare systems in the region. In 2008, the government spent 9.7% of national expenditure on healthcare, compared with 3.2% in 1996.


Health insurance system

Health insurance became mandatory for all individuals in 2008; in 2010 over 90% of the population was covered. In 2012, only about 4% were uninsured. President Kagame made healthcare one of the priorities for the Vision 2020 development programme, boosting spending on health care to 6.5% of the country's
gross domestic product Gross domestic product (GDP) is a monetary measure of the market value of all the final goods and services produced and sold (not resold) in a specific time period by countries. Due to its complex and subjective nature this measure is oft ...
in 2013, compared with 1.9% in 1996. The government has devolved the financing and management of healthcare to local communities, through a system of health insurance providers called ''mutuelles de santé''. The ''mutuelles'' were piloted in 1999, and were made available nationwide by the mid-2000s, with the assistance of international development partners. The mutuelles are owned and managed at the level of Rwanda's thirty districts. There are separate national health insurance schemes for public servants and soldiers. Premiums under the scheme were initially
US$ The United States dollar (symbol: $; code: USD; also abbreviated US$ or U.S. Dollar, to distinguish it from other dollar-denominated currencies; referred to as the dollar, U.S. dollar, American dollar, or colloquially buck) is the official ...
2 per annum; since 2011 the rate has varied on a sliding scale according to wealth, with the poorest citizens entitled to free health insurance and wealthiest paying premiums of US$8 per adult. , more than 90% of the population was covered by the scheme. The government has also set up training institutes including the Kigali Health Institute (KHI), which was established in 1997 and is now part of the
University of Rwanda University of Rwanda is a public collegiate, multi campus university based in Kigali, Rwanda. Formed in 2013 through the merger of previously independent education institutions, the University of Rwanda is the largest education institution in R ...
. In 2005, President Kagame also launched a program known as ''The Presidents' Malaria Initiative''. This initiative aimed to help get the most necessary materials for prevention of
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
to the most rural areas of Rwanda, such as mosquito nets and medication. Rwanda follows a
universal health care Universal health care (also called universal health coverage, universal coverage, or universal care) is a health care system in which all residents of a particular country or region are assured access to health care. It is generally organized ar ...
model, which provides health insurance through the ''mutuelles de santé''. The system is a community-based health insurance scheme, in which residents of a particular area pay premiums into a local health fund, and can draw from it when in need of medical care. Premiums are paid according to a sliding scale, with the poorest members of society entitled to use the service for free, while the wealthiest pay the highest premiums and are charged copays for treatment. In 2012, about 45% of the system was funded by premium payments, with the rest coming from government funding and international donors.


Quality

Rwanda's healthcare system operates 499 health centers, 680 health posts which are mainly involved with the outpatient programmes such as immunizations and family planning services, a number of dispensaries, and 42 district hospitals.http://hrhconsortium.moh.gov.rw/rwanda - at - a - glance The country's villages are served by a network of thousands of community health workers. There are four national referral hospitals, which are Kigali University Teaching Hospital, Butare University Teaching Hospital,
King Faisal Hospital Kigali King Faisal Hospital is an hospital in the Kacyiru area of the Rwandan capital Kigali. It was established between 1987 and 1991 with the help of the Saudi Fund for Development (SFD). Being the largest referral hospital in Rwanda, King Faisal Hos ...
and the Rwanda Military Hospital. The most advanced of them is King Faisal Hospital, which is operated on a for-profit model by the government but participates in the national health insurance system, and therefore accepts patients referred to it by other hospitals and clinics. It is the most advanced hospital in Rwanda, equipped with a CT and
MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves ...
machine, two dialysis machines, and a wide range of surgical capabilities. Rwanda's clinics are equipped with basic medical equipment and a cupboard of essential medications. The district hospitals offer basic surgical services, and all have a minimum of 15 doctors. Those in need of more advanced and specialized care are referred to one of the four national referral hospitals. There are five cancer treatment centers in the country, the Rwanda Cancer Centre at Butaro Hospital and facilities at the four national referral hospitals.


Staffing

There is a network of 58,286 Community Health Workers who provide primary care in the 14,837 villages and make referrals. Rwanda has a shortage of medical professionals, with only 0.84 physicians, nurses, and midwives per 1,000 residents in 2013. The
United Nations Development Programme The United Nations Development Programme (UNDP)french: Programme des Nations unies pour le développement, PNUD is a United Nations agency tasked with helping countries eliminate poverty and achieve sustainable economic growth and human dev ...
(UNDP) is monitoring the country's health progress towards
Millennium Development Goals The Millennium Development Goals (MDGs) were eight international development goals for the year 2015 that had been established following the Millennium Summit of the United Nations in 2000, following the adoption of the United Nations Millenn ...
4–6, which relate to healthcare. A mid-2015 UNDP report noted that the country was not on target to meet goal 4 on infant mortality, despite it having "fallen dramatically"; the country is "making good progress" towards goal 5, which is to reduce by three quarters the maternal mortality ratio, while goal 6 is not yet met as HIV prevalence has not started falling. Rwanda is participating in a seven-year program begun in 2013 that sees hundreds of medical educators and clinicians from 25 American medical institutions, including
Harvard Medical School Harvard Medical School (HMS) is the graduate medical school of Harvard University and is located in the Longwood Medical Area of Boston, Massachusetts. Founded in 1782, HMS is one of the oldest medical schools in the United States and is consi ...
,
Yale Medical School The Yale School of Medicine is the graduate medical school at Yale University, a private research university in New Haven, Connecticut. It was founded in 1810 as the Medical Institution of Yale College and formally opened in 1813. The primary te ...
, and Duke Medical School, training Rwandan medical personnel and establish training and residency programs, which, after seven years, will be run by the Rwandan government with its own budget, teachers, and clinicians.


See also

*
Health in Rwanda The quality of health in Rwanda has historically been very low, both before and immediately after the 1994 genocide. In 1998, more than one in five children died before their fifth birthday, often from malaria. But in recent years Rwanda has seen i ...
*
List of hospitals in Rwanda This is a list of all hospitals in Rwanda. Kigali City * University Teaching Hospital of Kigali (CHUK) * Hopital la Croix du Sud (HCS) * Kacyiru Police Hospital * Muhima Hospital * Kibagabaga Hospital * Kanombe Military Hospital (also Rwanda Mi ...
*
HIV/AIDS in Rwanda Rwanda faces a generalized epidemic, with an HIV prevalence rate of 3.1 percent among adults ages 15 to 49. The prevalence rate has remained relatively stable, with an overall decline since the late 1990s, partly due to improved HIV surveillance m ...
*
COVID-19 pandemic in Rwanda The COVID-19 pandemic in Rwanda was a part of the ongoing COVID-19 pandemic, worldwide pandemic of coronavirus disease 2019 () caused by severe acute respiratory syndrome coronavirus 2 (). The virus was confirmed to have reached Rwanda in M ...
*
University Teaching Hospital of Kigali (CHUK) The University Teaching Hospital of Kigali (CHUK) is a 519 beds teaching hospital located in Kigali City, Rwanda. Founded in 1918 by Belgian colonialists, CHUK is the first and the biggest healthcare institution in Rwanda. CHUK has played a role in ...
* King Faysal Hospital Kigali


Notes


References

* * * * * * * * * * * * * {{DEFAULTSORT:Rwanda, Healthcare In * Health care by country