Thirty years after the 1994 Genocide against the Tutsi in Rwanda, the country operates a highly regarded universal healthcare system. Despite all the challenges, healthcare is a right guaranteed for all, not a privilege reserved for the rich. The country has, among others, a community-based health insurance programme (CBHI), and more than 1,500 health posts that provide basic health services undeserved rural communities.

Looking back, 30 years ago, Rwanda was a devastated nation. More than one million lives were lost in the genocide against Tutsi. Even slightly before the genocide, the economy was ailing;  with inflation at a record 64 per cent, and a poverty rate at 78 per cent.

As of 2019, Community-Based Health Insurance, also known as Mutuelle de Sante covered 96 per cent  of the population, and the country achieved a life expectancy of 69 in 2019 from just 26 years in 1993.

According to the WHO, Universal Health Coverage (UHC) means that “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.”

This success is credited to its visionary leadership, good governance, and accountability – which led to low corruption levels, citizen participation, and decentralization; as well as the adoption of an inclusive development model marked by gender equality, pro-poor policies, and promotion of unity and solidarity.

Rwanda was ranked the beacon of Universal Health Coverage in Africa by 2019. Rwanda’s health sector agenda in general and in particular the health reforms towards UHC have been highly valued, notably the CBHI policy and subsequent reforms which served as the key instruments for accelerating progress towards achieving UHC in Rwanda.

The country has ensured that citizens have access to primary health care. The country operates a well-functioning, decentralized healthcare public service system comprising 1,700 health posts, 500 health centers, 42 district hospitals, and five national referral hospitals.

Since 2000, the prevalence of child malnutrition in Rwanda has decreased from 48.5 percent to an estimated 29.8 percent. This improvement is notable, especially considering that at one point, the figures reached as high as 49.1 percent.

When it comes to stunting rates in Rwanda, there has been a remarkable decline over the years, plummeting from 56.8 percent in 1992 to 33.1 percent as of 2020 according to UNICEF, WHO, and the World Bank joint global database on stunting released on May 31.

To further address this issue, Rwanda launched a comprehensive two-year plan on June 12, with the goal of reducing stunting and achieving the National Strategy for Transformation (NST1) target of reducing stunting to 19 percent by the end of 2024.

Rwanda targets to completely eradicate malaria by 2030, and the trend over the last seven years gives hope that it is possible. About five million cases were recorded in 2016, but just over 600,000 were registered last year.

The numbers speak volumes; a reduction of severe malaria cases by 90 per cent , a decline in malaria-related deaths by 91 per cent , and an increase in Community Health Workers (CHWs) managing malaria cases from 18 per cent to 60 per cent. The statistics are not just figures in a report; they represent lives saved, families protected, and communities strengthened.

Rwanda has undergone a remarkable journey in tackling its high maternal mortality rate over the past decade. From an alarming 1071 maternal deaths per 100,000 live births in 2010, the country has accelerated its rate of reduction in the MMR, reaching 210 deaths per 100,000 live births in 2015. In recent years, the decline has been slower, with the MMR standing at 203 per 100,000 live births in 2020 – a decline of only 7 data points over 5 years.

The country is currently operating at a ratio of 1 skilled health professional per 1000 population – below the WHO recommended minimum of 4 per 1000 – the Government of Rwanda introduced a comprehensive plan designed to strengthen the nation's health system. Known as the "4x4 Strategy", the initiative aims to quadruple the health-care workforce over four years, while implementing significant enhancements to health-care infrastructure and processes.

The country’s leadership is doing its best to go beyond universal primary care and develop world-class specialty healthcare services; encourage investment by specialized healthcare services providers through targeted investment promotion; and positioning Rwanda as a specialized regional medical tourism hub.