Why Kagame’s Rwanda is one of the African countries with best vaccine coverage

Author: Samson Kasujja

• 2023-07-22 04:51:00

According to a joint statement released by the World Health Organisation and UNICEF, on July 18, Rwanda – with a general coverage of 98 percent – is one of the African countries with the best coverage for the third dose of diphtheria, pertussis and tetanus (DPT3) vaccine which is used globally to assess vaccination rates.

Rwanda has, for several years, sustained a high coverage for the most common infectious vaccine-preventable diseases and therefore, among others, reduced child mortality. For people who know Rwanda, nothing comes as a surprise.

In March 2021, for example, Rwanda's President Paul Kagame became the first leader in East Africa to receive the Covid-19 vaccine. Earlier, in February, Rwanda became the first country in the region to begin vaccinating against the disease, targeting high-risk groups such as healthcare workers and the elderly.

Kagame believes that no amount of material or financial resources can transform a nation without a clear political and policy purpose, and a deliberate strategy and commitment to continuously improve the conditions of its most important asset – people.

Good health, according to Kagame, is the currency of progress.

In Rwanda, key was an approach that put people at the centre. Factors including high-level political will, multilevel accountability, effective use of funding, partnership with development partners, integrated health information, as well as community-level data collection and community engagement, contributed – so much – to the country’s vaccination success. It’s health system especially benefits from strong relationships with development partners and cross-over effects from global health initiatives.

The unique cultural practice which involves leaders signing performance contracts (Imihigo) to achieve certain targets, enhances accountability and ownership.

At the highest level of governmental, the vaccination program is driven by strong political will to prioritize Rwandans’ health.

At the local level, an engaged cadre of community health workers (Abajyanama b’ubuzima) regularly sensitizes communities on the importance of vaccinations. The emphasis on community-based health care allowed for the decentralisation of services and the development of a health workforce that is more receptive to public needs. The strategy helped to increase access to care in rural areas and reduce disparities in health outcomes.

An integrated health management information system guides vaccination procurement and distribution to support vaccine delivery at the local level. Investment in health information systems and technology has allowed for better data collection and analysis. It increased the efficiency and effectiveness of Rwanda’s health-care system.

Implementation is sufficiently decentralized to the district and village level to tailor appropriate approaches for the local population.

Certainly, despite the remarkable progress the country has made in its health-care system following the devastating loss of life and infrastructure in the 1994 genocide against the Tutsi, a lot more remains to be done to rebuild the country’s health-care system and provide its citizens with access to quality care.

Detractors of the post-genocide Rwandan government, who are mostly genocide ideologues in exile and their allies, often pick on areas where the country’s health-care system is still on a mend to attack the government. What the detractors will not mention is the fact that prior to the Genocide, the country’s health-care system was extremely weak, with the relatively small numbers of hospitals and clinical networks too expensive for the average citizen and totally removed from folks in rural areas.

Thanks to Kagame’s visionary leadership, the reinvention of the country offers hope. With limited resources, Rwanda's progress in improving its health-care system is a valuable lesson for other countries.

It shows that, with the correct investments and a strong commitment to health, a robust health-care system that responds to the needs of the population can be rebuilt and provide access to high-quality care even in the aftermath of a devastating genocide that decimated the country’s health-care system and workforce.