Article originally appeared in All Africa
By Marie-Brigitte Kabalira
One of the United Nations Millennium Development Goals is to reduce child mortality by ensuring that the number of children who die under the age of five is reduced by two-third, come 2015. So, how much progress has Rwanda made?
According to a report by the Ministry of Health, in 2000 the infant mortality rate was of 107 deaths per 1,000 live births, while the under-five mortality rate was of 196 per 1,000 live births - an indication that most deaths occurred during the first year of life.
"In Rwanda the main causes of child deaths have proven to be diarrhea, malaria and pneumonia," says Dr Anniseth Nzabonimpa, coordinator of the family planning, HIV, maternal and child integration unit in the Health Ministry.
Therefore, the ministry has been putting in place strategies to prevent them.
Efforts have focused on immunization of children. "In recent years, new vaccines like the pneumococcal vaccine were introduced. New ones will continue to be introduced as they become available," said Nzabonimpa.
According to the 2010 demographic and health survey, 90% of the children aged 12-23 months were vaccinated - a significant increase from 75% and 80% of 2005 and 2008 respectively.
Other strategies are provision of clean water and good sanitary conditions. "We give to the families 'Sur'eau', a product used to purify the water they drink and urge them to increase measures of hygiene in their homes," said Dr Ferdinand Bikorimana, of the maternal and child health department in the health ministry. "The community health workers are instrumental in the campaign as they are constantly on the ground. So we provided them with whatever is needed to help the community attain the above."
To fight against malaria, a leading cause of death among children, mosquito nets have been distributed to the community.
Neonatology services, which specifically take care of all newborn babies with problems, have also been introduced and there is a plan to have them in every hospital. "In general, the care that a newborn baby receives determines if he dies or lives," explained Nzabonimpa.
New methods like the kangaroo mother care, used to keep new born babies warm, have been introduced and encouraged. "A mother's health, especially when pregnant, is key to the health of the new born, which is why antenatal care is important," explained Bikorimana. Parents are taught how to take care of their baby's health, nutrition and hygiene. As it is easier to teach younger people, this is also taught to the youth. "It's better to know how to handle a situation before it rises," Bikorimana added.
The percentage of babies delivered by health professionals has increased from 52% in the 2007-08 to 69% in 2010. The proportion of babies delivered at a health facility increased substantially during the same period, from 45% in 2007-08 to 69% in 2010.
To make health care for children easier for parents, the Ministry of Health is implementing an integration of different services. "If a mother comes to get immunization for the child, we want to also have a general checkup for the child and give him/her the treatment needed," explained Nzabonimpa. If possible, the mother will also be treated. "Some of them have to travel a long distance to get to the hospital, so it will be easing their burden."
With all these strategies and programs, the country has managed to reduce child mortality rates recording an infant mortality rate of 50 per 1.000 live births and under-five mortality rate of 76 per 1,000 live births in 2010.
Considering all the improvements made against both malaria and pneumococcal disease, and the efforts to take better care of new born babies and under five children, Rwanda is on track to meet the 2015 target of reducing the mortality rates to 28 for infants and 50 for under-five children.