Health and development
The government of Rwanda has adopted a primary health care approach for its health system. The approach is based on the principles of Alma Ata. In 1996, the Health Strategic Plan was revised, then replaced by a Vision 2020 plan. The plan focuses on the following approaches:
- primary health care;
- community participation health;
- development of human resources;
- strengthening of the health information system; and
- intersectoral approach to health.
The system has three tiers, with central responsibility for policy and overall planning and evaluation.
A shortage of human resources in the health sector is one of the biggest challenges facing the government. In order to fill the gaps, the government has invested significant resources in pre-service training institutes. In the meantime, concentrating on the middle level cadre, the government established the Kigali Health Institute, which is charged principally with training nurses and technicians for the health sector.
The government allocation of resources to health has increased in recent years. As a share of the national budget, health has increased to 12%, up from 4.2% in 1996. 60% of government resources are decentralized into the districts. The government has started a social insurance scheme to make services available to the communities. This scheme mostly serves the poor, and has been very successful. It will serve as a model for other insurance programmes. Donor inputs account for well over 70% of health sector funding. The government believes that this is not sustainable and is seeking long-term, sustainable solutions.
Health sector successes
There have been some significant improvements in the health sector. The government campaign for HIV/AIDS has yielded a downward trend in the prevalence of the disease. The current prevalence is 3%.
The government is very concerned about population growth. At the highest levels, the government is advocating for limiting family size. This is felt to depend on many factors, including family traditions, cultural ties, and shared responsibilities between men and women.