Just in the last ten years in Rwanda, deaths from HIV, TB, and malaria have dropped by 80 percent, annual child deaths has fallen by 63 percent, maternal mortality has dropped by 60 percent, and life expectancy has doubled. All at an average annual healthcare cost of $55 per person.
Normally, after horrific national traumas, like Rwanda’s genocide of almost a million people in 1994, countries fall into a cycle of poverty and economic stagnation. Poor health and disease cripples workers and then the national economy, leaving the country ineffective to break out of depression.
A recent article in BMJ, led by Dr. Paul Farmer, Chair of the Department of Global Health and Social Medicine at Harvard Medical School, examined data from the World Health Organization (WHO) and attempted to identify why Rwanda was able to make such dramatic progress, when so many other nations have failed before them.
They identified 5 critical factors In Rwanda’s healthcare success:
1. The government formed a centralized plan for economic development, with one of the pillars being health care; knowing that, without improving health, poverty would persist. There was heavy research and reliance on facts and data to formulate their health metrics.
2. Aid allocation was controlled and monitored; the government insisted that all aid agencies meet transparency and accountability standards consistent with the national development plan.
3. A treatment plan addressing all the associated issues around AIDS was implemented: tuberculosis, malnutrition, need for in-home care, community health workers, “psychosocial” support, primary and pre-natal care.
4. Financial incentive was given to coordinate care; a performance-based financing system was set up to pay hospitals, clinics and community health workers to follow-up on patients and improve primary care.
5. Universal health insurance for all citizens, with particular attention to providing for the most vulnerable populations. The average, annual out-of-pocket health spending was cut in half, and households experiencing health care bills that force them into poverty were significantly reduced. (Half the funding came from international donors and half from annual premiums of less than $2 per person.)
Access to healthcare for ALL citizens is a prerequisite for controlling diseases, and thus allowing for economic growth to lift people, and nations, out of poverty. The medical advances in Rwanda have pushed their economic growth, the GDP per person has tripled, and millions have been lifted from poverty over the last decade. Rwanda offers a replicable model for the delivery of high quality healthcare and effective oversight, and even with limited resources.
– Mary Purcell
Source: The Atlantic