I. HEALTH

In the past two decades, Rwanda's health sector has made unprecedented progress in investing and ensuring Universal Health Coverage and health for all Rwandans.

Over 90% of the population is covered by community-based and private insurance schemes. 

Maternal and Neonatal Mortality 

Rwanda has achieved Millennium Development Goals (MDG) 4 and 5, to reduce child mortality and improve maternal health. In relation to MDG 5, maternal mortality rates have dropped steadily from 476 per 100,000 live births in 2010 to 210 per 100,000 live births in 2015. As of 2016-2017, 98% of women now deliver in health facilities. As per data from DHS 2015, neonatal mortality rates have dropped to 20 per 1,000 live births. In addition, under five mortality rates have dropped to 50 per 1,000 live births, and infant mortality rates have dropped to 32 per 1,000 live births.

VACCINATION

More than 98% of Rwandan children are vaccinated against 12 antigens protecting them against tuberculosis, poliomyelitis, diptheria, neonatal tetanus, pertussis, hepatitis B, hemophilus, influenzae type B, streptococcus, pneumonia, rotavirus, and rubella.

Rwanda is also the first country in Africa to introduce the human papilloma vaccine (HPV) with 97% coverage to protect young adolescent girls from cervical cancer.

In addition, pregnant women get vaccinated against tetanus during the antenatal visits.

MALARIA

Rwanda has made significant strides in controlling the Malaria epidemic through the implementation of various control interventions including mass distribution campaigns of long-lasting insecticide treated nets (LLINs), indoor residual spraying (IRS) in high-risk districts, adoption of mandatory laboratory confirmation, Artemisinin-based Combination Therapy, national scale up of community based management, and strong social behavior change communication interventions. Between November 2016-March 2017, there has been a 50% decline in severe malaria cases.

HIV/AIDS

As of 2018-2019, HIV prevalence among adults, aged 15-49 years, is currently 2% and those aged 15-64 years, was 3%, a number that has remained steady for more than a decade. Prevalence rates were also higher among women at 3.7% in relation to men at 2.2%.

According to the 2018-2019 Rwanda Population-based HIV Impact Assessment (RPHIA) survey, Rwanda has madesignificant progress in relation to The Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets. Key findings indicated that Rwanda has respectively attained 84-98-90, particularly among women, and is on track to meet and surpass each target by 2020.

• 83.8% of adults living with HIV were aware of their status, due to self-reporting or the detection of antiretrovirals (ARVs) in blood samples
• Of adults who knew their status, 97.5% were on ART, due to self-reporting or the detection of ARVs in blood samples
• Of adults who had detectable ARVs or reported current use of ARVs, 90.1% had viral load suppression

To eliminate HIV mother-to-child transmission, a package of services have been implemented including community support, HIV counseling and testing, linkage to care and treatment, initiation of ART and adherence support to medication, infant feeding, and counseling on family planning methods.  

HEALTHCARE WORKFORCE

A National Human Resources for Health (HRH) program was created to allow training medical specialties in Rwanda and is contributing to the increase of qualified health professionals equipped to deliver specialized health care services. As of September 2019, there were 1,464 physicians working in both private and public health facilities, including 504 specialists, 751 general practitioners, and 209 residents.

Additionally, in the last 10 years the workforce has significantly increased across all health professions to reflect:

• Doctors per population ratio has increased from 1 doctor/16,001 people in 2010 to 1/8,197 in 2018.
• Nurses per population ratio has increased from 1 nurse/1,291 people in 2010 to 1/1,094 in 2017.
• Midwives per population ratio has increased from 1 midwife /66,749 people in 2010 to 1/4,064 in 2017.

Community Health Workers

There are about 58,000 Community Health Workers country wide, 66% of whom are women. Each Community Health Worker is elected by his/her community and are the first point of contact for communities to link with the health sector. Community Health Workers are trained by the Ministry of Health throughout the country to deliver quality services, monitor health at the village level, and refer patients to the nearest health centre, specialized health facility, or referral hospital based on the severity of cases. Community Health Workers can screen and treat for moderate cases of malaria, diarrhea, pneumonia, provide family planning methods, and perform growth monitoring and screening for malnutrition. Most recently, they have begun to provide pregnancy tests to improve early utilization of antenatal care and reduce maternal and neonatal mortality and stunting.

ACCESS 

In the last 10 years, the country has built a health care delivery system on primary health care with individuals and communities at the center of our actions. The number of primary health care services including hospitals, health centres, specialized clinics, and dispensaries has increased from 490 facilities in 2008 to 1,497 in 2017.

The second-generation health post initiative was launched to address the health needs of rural communities to ensure the reduction of average time taken by a Rwandan citizen to reach a health facility. The average time, in minutes, to reach the nearest health facility reduced from 95.1 minutes in 2010 to 49.9 minutes in 2017. By 2024, the target is to reach 1,534 health posts to ensure that no one will have to travel greater than 25 minutes to access health primary health services. 

INNOVATIONS  

Drones: In partnership with Zipline, the use of medical drones have been implemented to supply life-saving medical products, such as blood and vaccines, to remote hospitals throughout the country. These drones provide instant access to blood products to nearly 8 million citizens of Rwanda.

Digital systems: Several information system interventions have been implemented to improve the provision of health service.  The systems that have been put in place include: Electronic Medical Records (EMR), Electronic Logistics Management Information Systems (E-LMIS), Mobile community based information systems (RapidSMS), Health Management Information System (HMIS), Medical Equipment Management System (MEMS), Smart IFMIS, Integrated Financial Management Information System (IFMIS) and Pharmaceutical Regulatory Information Management System (PRIMS).

II. SOCIAL PROTECTION

The poverty rate in Rwanda reduced from 57% to 38.2 % and extreme poverty from 36% to 16% from 2005/2006 to 2016/2017, according to different IECV reports.  This is partly thanks to effective Social protection programs have played a key in ensuring a dignified standard of living for all Rwandan citizens, with improved access to employment and livelihood opportunities. 

The social protection sector - which builds on best global practices while also relying on home-grown solutions and tradition of mutual assistance and support (Ubudehe) - has evolved into a comprehensive, preventative, life-cycle oriented social protection system.

As per Rwanda’s seven-year social protection sector strategic plan (2018-2024), social protection in Rwanda is built on four pillars which are:

• Social security (Direct income support, voluntary saving schemes regulated by government, mandatory social insurance, health insurance for subsidies groups),
• Linkages to complementary services (Employment/skills support, sensitisation and financial literacy, Needs assessment and referrals, Targeted asset transfers, VUP caseworkers)
• Social care services (protection of women, children, PwDs and older people, Needs assessment and referrals, psycho-social support, Institutional care and placement of children and youth, advocacy and rights promotion) 
• Disaster relief (shelter construction/rehabilitation, support for emergency health costs, cash and in-kind short-term assistance provided by local government)

III. EDUCATION

Rwanda's education sector has remarkably evolved over the last two decades. Until 1994, Rwanda counted barely 1,000 primary schools and a handful secondary schools. Access to education was limited and orchestrated by ethnic seglegation and regionalism and the transition from primary to secondary education was not driven by actual academic performance. Till then the country counted only 2000 university graduates in a population of 7.4 million. 

To date, Rwanda is among the countries that are on course to achieve universal access to primary education, with a net enrolment rate of 98 per cent (UNICEF, 2019). 

As of 2018, Rwanda counted 2,909 in Primary schools, 1,728 Secondary schools, 360 TVET schools, and 40 tertiary institutions. The total number of learners registered in the Rwandan education system was 3,626,362, including 6,491 in pre-nursery, 3,210 in Nursery Schools, 2,503,705 in primary schools, and 652,944 students in secondary schools. 38,338 are enrolled in public tertiary institutions, compared to 50,822 students private tertiary education. The country also counts 4,991 adult literacy centres, with 132,365 learners.  Read the Statistical Year Book here. 

World-class universities in Rwanda

To drive its ambitions of becoming a knowledge-based economy, the Goverment of Rwanda initiated the Kigali Innovation City project, through which the country was able to attract world-class universities, technology companies, and biotech firms interested in expanding their activities on the continent. These include among others, The African Institute of Mathematical Sciences (AIMS), The Carnegie-Mellon University Africa, University of Global Health Equity, the African Leadership University (ALU), University of Kigali, Adventist University of Central and East Africa (AUCA), Akilah Institute for Women, Kigali (AIWK).

Transformative changes in basic education 

Competence Based Curriculum (CBC)

In 2015 Rwanda launched the Competence Based Curriculum (CBC) that rolled out in 2016 to match global trends in line with the 2013 Harmonised Curriculum Framework developed under the guiding East African Community key principles. The new curriculum specifically accounts for shortfalls identified in Knowledge Based Curriculum (KBC) that would constitute obstacles to the country’s overarching vision of becoming a knowledge-based economy. These included but not limited to little or no emphasis on competences and social skills and limitations in application of what is learnerd in school in real life. The overall goal is to train up a competent workforce that reflects not only skills of employability but also humane, social skills fit for a socially cohesive Rwanda as artuculated in national guiding documents (Vision 2020, EDPRS2 ,ESSP 2013-2018, 7YGP). 

Increase in the numbers of qualified teachers                          

Over the last 10 years, the number of teachers in general education has more than doubled with a remarkable increase of 109% while the teacher-pupil ratio improved from 1:63 to 1:56 in primary; this has facilitated improved class management and close follow on students’ performance. In the same period the number of qualified teachers has increased from 91% to 98.6% in Primary and from 57.4% to 76.5% in secondary.  A special teacher statute was adopted in 2017 and revised in 2019, this statute specifies the aspects of teacher recruitment, promotion and development.

ICT in education

Integration of ICT in classroom increased up to 64% by 2018. The Government tremendously invested in different initiatives to integrate ICT in basic education.

One Laptop Per Child (OLPC) program

The program was introduced in Rwandan primary schools in 2008. The program aimed at enhancing the education through the introduction of technology in primary schools. It also allows pupils to early access to computer skills and computer science understanding while expanding their knowledge on subjects’ matters like science, mathematics, languages and social science through online research or content hosted on servers. Currently, the program has reached 75.5% of Rwandan schools (Education statistics 2018).

Smart classroom program

From 2016, the Government introduced 2 smart classrooms per school to enhance teaching and learning hence improving the quality education in secondary schools. Smart classrooms allow both teachers and learners to access to a diverse educational materials or resources hence improving research skills. Besides smart classroom program, there are computers reserved to teachers.  Through this initiative, teachers and learners are more exposed to ICT gadgets to facilitate the development of 21st Century skills: creativity, problem solving, critical thinking, collaboration and communication skills. This program has reached 55% Public and Government Aided schools and it is used for learning all subjects. Access to computers in secondary schools is at 84.26%, access to internet connectivity is at 52.9% and the number of schools using ICT in teaching and learning is at 64.7% including all public and private schools. This program has so far, increased computer per students’ ratio at 8:1( Education statistics 2018 ). 

Rwanda Coding Academy

Established to prepare youth into future software developer, cyber security systems, and embedded system programming to develop artificial intelligence systems such as robotics. The school is at its second intake attracting both girls and boys equally to home grown software development.

IV. FAMILY

As stipulated by the Rwanda Constitution of 2003 revised in 2015, in its article 18, the family is the natural foundation of the Rwandan society and it is protected by the State.  

Gender equality and Women empowerment

For the past 25 years after the 1994 Genocide against Tutsi, as result of a strong commitment and the political will of the Government, Rwanda has registered significant achievements in promoting gender equality and empowerment of women ranging from; an enabling policy, legal and institutional framework, enhanced socio-economic and political participation, setting a global pace for equality between men and women. 

Financial exclusion among women reduced from 32.2% in 2012 to 13.6% in 2016 while Women and youth’s financial inclusion through the village Credit and Saving Scheme (Umurenge SACCO) has also been prioritized by the Government. 

Women’s access to land contributed to increased control over productive resources and access to loans as they use it as collateral in banks, which consequently impacted to their financial capacity.  26% of women own land and 54% of women co-own land with their spouses. This is contrary to the situation before, where women had no rights on land and assets and women and girls were denied inheritance rights.

Youth 

Rwanda’s Youth are a major asset of the Country and key drivers for sustainable development, if empowered and well-motivated. In Rwanda youth was defined as the population aged 14 to 35 years before 2015. Since then, the new national youth policy defines youth as the population whose age is between 16 and 30 years. Overall, youth population (16-30 years) makes up 26.6% of the total population of Rwanda, according to the 5^th Integrated Household Living Conditions Survey (EICV5). The largest age group in youth was 16-20 years, which comprises 10.2% of the total population. The Country has implemented a series of programs derived from the National Youth Policy since 2006. Most of these programs mainly focused on Youth participation, mobilization and social welfare due to the challenges of the time.

Children

In line with the universal principle that  children should grow up safe and protected in families, the Government has developed an ambitious programme of care reform and family strengthening called Tubarerere Mu Muryango (TMM), translated to Let’s Raise Children in Families.The programme is rooted in Rwandan cultural values, which place a strong emphasis on family care. Through this programme, over 3,000 children were reunited with families and communities since 2012.