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