Essay: Rwanda health system reform

Rwanda reaffirms its commitment to providing access to a sustainable and equitable health system. Rwanda is deeply concerned with the challenges that developing countries face in eradicating hunger, communicable and non-communicable diseases, and lack of access to health services in rural populations.  Thus, Rwanda is on track to achieving its Millennium Development Goals (MDGs), which sets high international standards for development. Rwanda also recognizes HIV/AIDS as a significant epidemic that affects every country. Therefore, Rwanda commends the many member states and organizations that have the means to help alleviate this situation and have stepped up their efforts to eliminate this disease in whatever way they can. Rwanda will continue to voice support and take action whenever possible to suppress this disease and help Sub-Saharan African countries plagued with this issue through the assistance of various multilateral organizations and conferences such as the World Health Organization, World Summit for Children, the United Nations Conference on Environment and Development, the World Conference on Human Rights, and the International Conference on Population and Development. and the African Development Bank. Rwanda wishes to continue a partnership with the Joint UN Committee in advocating for global action against HIV/AIDS including expanding access to treatment and testing. To show further dedication to eradicate HIV/AIDS, Rwanda has achieved universal access to antiretroviral treatment (ART) for adults. Rwanda continues to support the Programme of Action of the International Conference on Population and Development stating that all nations should create ‘development strategies, planning, decision-making and resource allocation at all levels and in all regions, with the goal of meeting the needs, and improving the quality of life, of present and future generations’ in A/CONF.171/13. Rwanda is in compliance with this statement and furthermore has enacted policies to provide access to adequate health care. Also, we have improved health education and health care. Rwanda, like other developing states, is challenged by the fact that it is difficult for medical resources to access remote populations. Only 17% of medical personnel work in rural areas, while 81.1% percent of Rwanda’s residents live in these underserved rural areas. In the face of this situation, Rwanda strives towards the achievement of universal access to prevention, treatment, care and support services and recognizes that it is necessary to have special funding to help enable these programs to succeed, and would help the developing nations to implement the Programme of Action. To improve nutrition among the poor, the government set up the Girinka or ‘One Cow per family’ Program in 2006. The innovative policy gives poor families a cow so that the milk can improve their children’s nutrition. So far, over 90,000 families have received a cow. Agricultural policies such as this have led Rwanda to protein and calorie production that reaches international standards. Rwanda’s ‘Vision 2020’ strategy created in 2000, Rwanda hopes to transform itself into a middle-income nation in two decades, decreasing levels of extreme poverty from 60% of the population to 25% and raising life expectancy to 65 years. In order to ensure that all citizens have adequate access to health care, Rwanda provides universal health insurance and that allows significant attention to provide vulnerable populations primary medical access. The community-based health insurance program, Mutuelles de sant?? (RAMA), significantly cut the rate of households experiencing health care bills that force them into poverty by reducing out of pocket spending in half. Rwanda demonstrates its drive to make progress against HIV/AIDS, TB, and malaria by requiring transparency of all its aid partners. With data from both self-reported and donor reported aid, Rwanda’s Aid Policy has assisted the government in determining which aid and health policies benefit Rwanda’s unique health system the most. Thus, such policies have helped Rwanda become one of the few countries in sub-Saharan Africa to be on track to meet most of the MDG’s by 2015. Rwanda recommends that both IGO and NGO aid beneficiaries work closely with the operating health systems of developing nations by implementing a transparent and mutual accountability strategy, such as DPAF (Donor Performance Assessment Framework), to reinforce a commitment to health and to confirm the effectiveness of worldwide aid. With humanitarian aid supplementing the RAMA community based insurance, healthcare in Rwanda is nearly universal. Rwanda suggests that developing member states promote community participation in health decision-making while also educating healthcare providers and communities on the importance of the right to health in service provision. Rwanda also notes with appreciation the many stakeholders which include the private sector, civil society and international development partners in developing and sustaining equitable healthcare to developing countries with remote populations.