Rwanda KEY FACTS Joined Commonwealth: November 2009 Population: 11,777,000 (2012) GDP p.c. growth: 2.2% p.a. 1990–2013 GNI p.c.: US$620 (2013) UN HDI 2014: World ranking 151 Life expectancy: 64 years (2013) Under-five mortality rate (per 1,000 live births): 52 (2013) Largest contribution to mortality: Communicable diseases; maternal, perinatal and nutritional conditions Government health expenditure: 6.1% of GDP (2013) General information The Republic of Rwanda is a landlocked country with land borders with four countries: (clockwise from the north) Uganda, United Republic of Tanzania, Burundi and Democratic Republic of Congo. Water covers 1,390 sq km of the country; the largest lakes include Bulera, Ihema, Kivu (straddling the border with the Democratic Republic of Congo), Mugesera and Muhazi, and there are many rivers. The country comprises five provinces. Climate: Though the country is close to the Equator, the climate is tempered by altitude; it is hot and humid in the valleys, and drier and cooler in the higher elevations. The rainy seasons are March–May and October–November; the hottest season is August–September. Environment: The most significant environmental issues are drought, limiting the potential for agriculture; overgrazing; soil erosion and degradation; and deforestation due to the almost universal use of wood as a fuel. Population: 11,777,000 (2013); 27 per cent of people live in urban areas. The population growth rate stood at 2.1 per cent p.a. 1990–2012. In 2013 the birth rate was 35 per 1,000 people (53 in 1970) and life expectancy was 64 years (44 in 1970). The main ethnic groups are Hutus, comprising an estimated 85 per cent of the population; Tutsis (14 per cent); and Twa (less than one per cent). Censuses carried out since the conflict of the 1990s have not included ethnicity. Economy: Rwanda is classified as a low-income economy by the World Bank. Health Child and maternal health: Infant mortality in Rwanda was 37 deaths per 1,000 live births in 2013, with an under-five mortality rate of 52 deaths per 1,000 live births in 2012. There has been an overall decline in the under-five mortality rate since 1994, with consistent reduction seen from 1998. Prior to this date there was an increase in under-five mortality from 152 deaths per 1,000 live births in 1990 to 288 deaths per 1,000 live births in 1994, coincident with the Rwandan genocide. The recent decline is encouraging, with the under-five mortality rate approaching the country’s target of 51 deaths per 1,000 live births as defined by Millennium Development Goal 4 (MDG 4). In 2010 the three most prominent causes of death for children below the age of five years were acute respiratory infections (18 per cent), intrapartum-related complications (13 per cent) and prematurity (12 per cent). Other contributory causes were diarrhoea (ten per cent), injuries (eight per cent), neonatal sepsis (seven per cent), congenital anomalies (seven per cent), malaria (four per cent), measles (one per cent) and HIV/AIDS (one per cent). In the period 2007–11 Rwanda had a mortality ratio of 320 deaths per 100,000 live births (this figure was estimated at 340 deaths per 100,000 by UN agencies/World Bank in 2010). Burden of disease: Communicable diseases along with maternal, perinatal and nutritional conditions in Rwanda accounted for an estimated 63 per cent of all mortality in 2012. The prevalence of HIV in Rwanda, as a percentage of people aged 15–49 years, stood at 2.9 per cent in 2013. Although still at general epidemic levels, HIV prevalence has halved from 5.9 per cent to 2.9 per cent in the period 1990–2013. In 2012 there were 483,470 cases of malaria in the country; rates have remained largely the same in the period 2006–12, although there has been considerable fluctuation. The number of deaths from malaria has shown a significant overall decline in 2006–12. The estimated incidence of and estimated mortality (when mortality data excludes cases comorbid with HIV) from tuberculosis (TB) has seen a significant decrease in the period 1996–2013, and an overall decrease since 1990. Non-communicable diseases (NCDs) in Rwanda accounted for an estimated 29 per cent of all mortality in 2008. The most prevalent NCDs in Rwanda are cardiovascular diseases, which accounted for 12 per cent of total deaths across all age groups in 2008. Cancer, 240 Commonwealth Health Partnerships 2015
Commonwealth Health Partnerships 2015
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