Health and Nutrition Sector

Healthcare in Rwanda has historically been of inadequate quality. However, it has improved significantly in recent decades through the operation of Universal Health Coverage, and it is now considered one of the highest quality health systems in Africa. Rwanda is internationally recognized for its success in achieving universal health coverage with over 84% of Rwandans covered by the Community Based Health Insurance (CBHI), ensuring that its citizens have access to primary health care.

In order to streamline international assistance, the Rwandan government has limited the number of sectors that one DP can support up to three. Meanwhile, in response to the rapid spread of COVID-19, which is threatening the health and livelihoods of people around the world, JICA launched the “JICA’s Initiative for Global Health and Medicine” in July 2020 to strengthen its activities to protect people’s lives. Through that initiative, the JICA Rwanda Office initiated mutual discussions with the Government of Rwanda on health sector interventions, and JICA began providing assistance to improve various activities in the health sector from 2021.

From July 2021 to February 2022, JICA conducted “Data Collection Survey on Medical facilities and Equipment in Response to COVID-19 for African Countries” for 22 African nations including Rwanda to examine the possibility of formulating a Japanese Grant Aid project that includes the provision of medical facilities and equipment.

From November 2021 to May 2022, JICA conducted a” Data Collection Survey towards the Introduction of Advanced Medical Diagnostic Equipment (PET-CT).” The purpose of this survey was to understand the Rwandan Government's policy on cancer control, the state of medical service provision at major hospitals, and the status of diagnostic capabilities and future improvement plans, to examine the possibility of JICA's cooperation in improving cancer control in Rwanda.

The Ministry of Health/RBC and JICA are jointly developing a new project to support the Maternal, Child and Community Health (MCCH) activities in Rwanda. The Ministry of Health submitted an official application for a Technical Cooperation (TC) project, which was approved by the Government of Japan in March 2023.

The Government of Rwanda is committed to continuing to place nutrition at the top of the national development agenda. The ongoing National Strategy for Transformation (NST-1, 2017-2024) highlights “eradicating malnutrition” as one of the priority areas of the social transformation pillar. Accordingly, the Fourth Health Sector Strategic Plan (HSSP IV, 2018-2024) sets the prevalence of stunting as one of the indicators and aims to reduce it from 37.9% in 2015 to 19% in 2024.

However, according to the 2020 Demographic Health Survey (DHS), the prevalence of stunting remains at 33%, and the rate of decline in stunting has slowed in recent years (average rate of decline over the past five years: 1.0% per year). JICA is supporting Rwanda’s nutrition sector through the “Development Policy Loan on Nutrition Improvement through Agriculture Transformation” (2019-2021), and a “Nutrition Policy Advisor” dispatched to the National Child Development Agency (NCDA) (2021-2023).

The overall objective of this Sector Policy Loan was to promote consumption of nutritious foods through improved food supply and access. To this end, it is important to mainstream the cycle of government budget, and to support the development of priority policies, guidelines, plans and tools in both nutrition and agriculture.

To help the Government of Rwanda achieve its strategic goal of reducing stunting rate to 19% by 2024, JICA conducted an analysis to identify the determinants of stunting through the Nutrition Policy Advisor, assigned to the NCDA. Based on the request of NCDA, JICA also conducted a case control study, from 3 June to 15 November 2022, to understand the reasons for reductions and non-reductions in stunting in 10 districts. This is part of the follow-up to the regular monitoring and evaluation framework for the Sector Policy Loan Project interventions.

The key findings of this study were presented to high-level government members at the Nutrition Colloquium held in December 2022. The results of this study will be used to develop effective multi-sector approaches to improving stunting in Rwanda and will be compiled into a policy brief/note that will be used as an advocacy tool for policymakers in social cluster ministries. Furthermore, this effort will be linked to the mainstreaming of institutional budgets for nutrition improvement (nutrition budget tagging), that is currently underway at the administrative agency level.