The Reach Project is an initiative by the Munk School of Global Affairs and the MasterCard Center focused on researching the delivery of social services in the hardest to reach populations in the global south.

Rwanda:  Arrival in the Land of a Thousand Hills

Rwanda: Arrival in the Land of a Thousand Hills

James Bao

Rwandan coffee is not just utilitarian but a true pleasure to indulge in and experience. Locally grown and roasted, Rwandan coffee beans are highly prized due to the ideal growing conditions around Kigali: a landscape of a high-rolling hills and a well defined rainy and dry season. Thankfully for us, the team arrived to catch the tail-end of the 3-month dry season with the goal of showcasing Rwanda’s child immunization success story.

The land of a thousand hills holds a challenging history, and the success of the country’s health programs demonstrates the resilience and motivation of Rwandans. During the 1994 genocide, close to a million Rwandan lives were tragically lost, destroying much of the country’s health infrastructure and system. Immunization rates plummeted within months of the genocide, reaching a low of 23% for the DTP vaccination. Today, despite being a post-conflict, post-genocide country, Rwanda boasts one of the highest immunization rates in the world, with 98% coverage for 7 essential child vaccinations in 2015. Their immunization program stands out as an exceptional example of reaching the hard to reach.

Through a year of research, our team has worked to uncover factors that we believe have contributed to the success of Rwanda’s child immunization program. These are some highlights:

  1. Engaged community health workers who sensitize communities throughout the country on the importance of vaccinations

  2. Imihigo, a form of goal setting and accountability that facilitates successful  development and health outcomes across all levels of government

  3. Rapid SMS and mUbuzima technology that allows community health workers to conduct routine health surveillance for newborns and identify missed vaccination cases

  4. Integration of global health initiatives which creates carry-over benefits in the form of health systems development to benefit the entire health sector

  5. Government commitment to strong health outcomes for all Rwandans which has resulted in coordination of donor funds, reduced duplication and activities aligned with Rwanda’s Health Sector Strategic Plan.

This week we will be speaking with the implementers of the immunization program on all levels, from community health workers on the front lines to the high level policy-makers at the Ministry of Health. We are excited to meet the people that have been involved in this program, and understand how they have made this success a reality.

Community Health Workers: the frontlines of Rwandan health care

Community Health Workers: the frontlines of Rwandan health care

Jordan:  Reflection on Innovation in the Humanitarian Sector

Jordan: Reflection on Innovation in the Humanitarian Sector