The detailed structure of the Rwandan administrative structure is at the same time the basis for the structure of the health care system. At the top are four provinces and the independently administered capital Kigali. These five superordinate areas are divided into 30 districts, 416 sectors, 2,148 cells and 14,980 parishes, also called Umudugudu (plural: Imidugudu), down to the lowest administrative units. Adjusted to this, in 2015 (some new facilities are in the construction phase) there were 5 references nationwide for basic health care for the population- and 42 district hospitals and around 525 health centers are available. A network of around 60,000 health and social workers also provides support. As a result, every district has at least one regional hospital with a catchment area of around 300,000 residents. Today there are one or two health centers in almost every sector that have to care for around 20,000 people.
The lack of qualified personnel is the most important handicap; only one doctor and 12 nursing staff are available on average for around 15,000 people. According to oxfordastronomy, further basic problems of the Rwandan health system are the insufficient supply of the population with clean drinking water and the diseases caused by malnutrition and malnutrition. Infectious and parasitic diseases are significant and cause the majority of deaths.
Government efforts in recent years have improved conditions across the country. Remarkable successes have been observed in particular with regard to the reduction of high infant, child and maternal mortality rates. From the UNDP’s point of view, Rwanda has achieved the Millennium Development Goals in this area. There have also been successes in the fight against malaria. Malaria is still widespread, but now ranks behind influenza, measles, respiratory diseases, skin infections, and stomach and intestinal diseases in terms of frequency and cause of deaths.
The HIV prevalence in the general population is given as an average of 3% (or 2.6% of the proportion of the population aged between 15 and 49 years); it is higher in the urban population than in rural areas.
Before traveling to Rwanda, we strongly recommend that you get qualified medical advice in good time. The German Society for Tropical Medicine and Global Health eV (DTG) is one of the best ways to search for a doctor. Further information is provided by the travel medical information service and the medical information from the Federal Foreign Office. Vaccinations and Profilaxes, which sometimes require a longer duration of action, are usually recommended. Basic medical care in Rwanda is guaranteed by a network of state health centers, district and reference hospitals that is not dense but extensive. In the cities there is also a growing offer of private clinics. Frequently occurring diseases can be treated on site. However, the possibility of good specialist medical care in particular is limited. In the case of more complicated diseases, which require highly qualified personnel or high-quality technical facilities for the treatment, the next treatment option is in Nairobi, Kenya, an hour and a half flight away, or Johannesburg (South Africa), a four-hour flight away. The most common diseases are diarrheal diseases caused by amoebas, worms or bacteria or viruses, respiratory diseases and hepatitis. Even if malaria cases have decreased significantly protection against mosquito bites is still strongly recommended. Mosquito nets, etc. are helpful for this. Prevention with medication should take place after advice from experienced tropical medicine. AIDS, sexually transmitted diseases and tuberculosis should also be considered. Evidence of a yellow fever vaccination, which was mandatory for a long time at the airport when entering Rwanda, has meanwhile been revoked for travelers from Europe, among others, but it still exists when entering from a yellow fever area.