• Publication of 2005
DHS: Preliminary results on HIV seroprevalence in Rwanda
• Rwanda hosts the Eastern & Indian Ocean
Regional Meeting of the Global Fund
• Ministry of Health organizes its annual Open
days for Health
• Feature : The Contractual Approach to Increase
Access to High Quality Health Care
• New Items on the MoH Website
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1. Publication
of 2005 Demographic and Health Survey:
Preliminary results on HIV seroprevalence
The Ministry of Finance and Economic Planning,
Department of Statistics, in collaboration with USAID, CNLS/MAP,
UNICEF, UNFPA and other partners together with the Ministry of
Health, the Treatment and Research Aids Center (TRAC) and the
National Laboratory completed a nationwide Demographic and Health
Survey (DHS).
For the year 2005,
the DHS also included HIV/AIDS testing in order to get clear statistics
on HIV/ AIDS prevalence in Rwanda on national and provincial levels
and major reasons why HIV/ AIDS continues to spread in different
parts of the country, so that strong measures and strategies can
be taken to fight against the HIV/ AIDS epidemic.
The survey was carried
out in all provinces of the country, both in rural and urban areas
Kigali city inclusive. 10,000 homes were selected as sample for
this survey. Half of the homes (50%) were selected for research
on HIV/ AIDS. Women between the ages of 15-49, and men between
the ages of 15-59 were interviewed.
It is worth to note
that this is the first time that HIV/AIDS survey was carried countrywide
targeting men and women whereas other HIV/AIDS survey where carried
out in either in a single health institution or targeting only
pregnant women; which obviously resulted in bias figures, such
as the 13, 5% seroprevalence so often quoted.
Results:
• Preliminary results from 5000 homes that were selected
as sample in this survey for research on HIV/ AIDS prevalence
indicate that people responded positively and turned up in big
numbers. Out of 10,385 people that agreed to give blood samples,
5,837 were women and 4,548 were men. 9 out of 10 people willingly
gave blood samples. 97% of the women and 95% of the men agreed
to give blood samples.
• In general,
the survey indicates that in Rwanda 3% of the people, are people
living with HIV/AIDS (confidence interval of 2, 6%-3, 6%). The
survey also shows that women are more infected than men, 3,6%
(confidence interval of 3,1%-4,1%) of women are infected with
the HIV/Aids virus, and 2,3% (confidence interval of 1,8%-2,8)
of men are infected with the HIV/Aids virus. Therefore, out of
100 men there are 160 infected women.
• Considering
HIV/ AIDS prevalence basing on rural and urban settings, infection
rate in urban areas is at 7,3%( confidence interval of 6,2 to
8,4), while 2,2% of the people in rural areas are people living
with HIV/ AIDS (confidence interval of 1,9 to 2,5%). Regardless
of the setting, HIV/ AIDS prevalence is high in women than men.
8,6% (confidence interval of 7,1%-10,1%) of women in urban areas
are infected with HIV/ AIDS, while 5,8%( confidence interval of
4,4%-7,2%) of men living in urban areas are infected with the
HIV/ AIDS. In rural areas, 2,6% (confidence interval of 2,1%-3,1%)
of women are infected when 1,6% (confidence interval of 1,2%-2,0%)
of men are infected.
• HIV/ AIDS
prevalence is high in Kigali city compared to other provinces:
Kigali city 5,6%, Western province 3,2%, Southern province 2,7%,
Eastern province 2,5%, and Northern province 2,2%.
Conclusion
• The survey indicates that the HIV/AIDS
pandemic is a public health related problem. According to how
the UNAIDS categorizes the AIDS epidemic on different levels,
in Rwanda the AIDS is a generalized epidemic because HIV/ AIDS
prevalence is more than 1%.
• HIV/ AIDS prevalence is high in urban areas than in rural
areas.
• HIV/Aids prevalence is high among women and girls. They
are the most affected by the HIV/ AIDS pandemic.
For
more information, please see the attached power point technical
presentation (English,
French)
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2. Rwanda hosts the
Eastern & Indian Ocean Regional Meeting of the Global Fund
From November 28- 30, 2005, Rwanda hosted
the East Africa and Indian Ocean Global Fund Regional Meeting.
The meeting aimed at ‘Building on what works’, by
highlighting specific successes and lessons learned in the fight
against HIV/AIDS, Tuberculosis and Malaria.
Speaking as a key
participant at the meeting, the UN Special Envoy for HIV/AIDS
in Africa, Ambassador Stephen Lewis described Rwanda’s efforts
in the fight against the AIDS pandemic as exemplary and strongly
advocated for more financial support to the Global Fund, especially
from the developed countries and the private sector.
Addressing the delegates,
His Excellency Paul Kagame, President of the Republic of Rwanda
who officially opened the meeting at Hotel Intercontinental in
Kigali pointed out that the ABC approach, Abstain, Be Faithful
and use Condoms is not anymore satisfactory and is far from being
sustainable. He urged to provide more support and attention to
E; “E for Education at the forefront, to make it EABC”.
He also called for
accountability, transparency and best practices exchanges in the
implementation and management of the Global Fund projects. “The
Global Fund should not be global in name but should focus on finding
solutions, and ensuring collaboration with the countries and people,”
noted President Kagame.
Delegates at the
meeting discussed how to enhance government commitment and leadership
in support of national priorities, increasing meaningful involvement
of civil society in Global Fund programs and putting in place
mechanisms for sharing experiences and practices.
Countries represented
consist of Eritrea, Ethiopia, Kenya, Uganda, Tanzania, Burundi,
Comoros Islands, Madagascar, Zanzibar and Rwanda, and delegates
were comprised of country representatives, civil society representatives
and development partners.
At the same meeting,
Rwanda signed the grant related to “Strengthening the Health
System” worth of 33 Millions USD and was the first country
to sign any Global Fund Round Five Grant. According to Dr Innocent
Nyaruhirira, Minister of State in charge of HIV/AIDS and other
epidemics and the signatory of the grant on behalf of the Rwandan
government, 63% of the grant will support the national health
insurance (‘mutuelles de santé’) and the remaining
part will go to equipment, training, monitoring and evaluation
of health programs.
Please click
here to read the Kigali Declaration (PDF)
Click here to view
the pictures of the official opening
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3.
Ministry of Health organizes its annual Open days for Health
From 11-12 December 2005, the Ministry
of Health in collaboration with its partners organized an exhibition
of health activities known as “Open Days for Health”
to show to the Rwandan population what is done by the different
departments of the Ministry and partners to promote Health.
The Minister of Health, Dr Jean Damascène
NTAWUKULIRYAYO who officially launched the activities emphasized
the importance of investing in health for a sustainable development.
The Minister also stressed the importance of following a treatment
as prescribed to avoid disease resistance because the treatment
of a resistance is very expensive. He mentioned that next year
2006, much emphasis will be on health insurance commonly known
as” mutuelles de santé” so that every Rwandan
should be insured for an easy access to quality care at a lower
cost.
Key guests of the event included the Ambassador
of Belgium in Rwanda, the WHO country representative, development
partners’ representatives and several directors of units
and programs within the Ministry of Health.
For the picture of the event, please visit
our gallery
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4.
Feature
The Contractual Approach to Increase Access to High Quality Health
Care
Introduced in Rwanda three years ago, the contractual approach
is based on rewarding good services with payment based on performance,
and is intended to motivate and encourage health care staff.
According to the coordinator of the contractual approach cell,
Dr Louis Rusa, since the inception of the approach, performance
among health workers has improved leading to better quality health
care, particularly in the pilot sites of Cyangugu and Butare.
“With the contractual approach, the bonus is awarded in
accordance with the services rendered and work done by health
care staff. This has in turn had remarkable results on public
health leading to quality standards,” Dr Rusa explained.
The coordinator noted, as a result of the contractual approach
that the use of family planning and other related services is
on the increase in Cyangugu giving Nyamasheke district as an example.
In Butare, many women give birth in hospitals, health care staff
visit pregnant women in the villages and sensitize them about
antenatal check ups. Health care staff in Butare knit and give
out baby clothes to rural women who give birth in hospitals as
a strategy to promote giving birth in hospitals as opposed to
giving birth in homes.
Training on the contractual approach is offered to supervisors
from district health centers. The supervisors monitor and evaluate
health care activities using evaluation forms that list indicators
for measuring the services rendered objectively, in both quantitative
and qualitative terms.
The indicators include among others, the number of pregnant women
visiting health centers, the number of women that stay in the
hospital three days after giving birth, the number of children
immunized in a month, treatment of diseases like Tuberculosis
by considering new registered cases and the number of those that
are cured, the number of people visiting the hospital for consultation
in a month, the number of mosquito nets bought in a month, and
the increase of families that adopt the use of, and practice family
planning every month.
The Ministry of Health is implementing the Contractual Approach
in partnership with Health Net, Health International, Memisa Cordaid,
the Belgian Technical Cooperation, the World Bank and GTZ.
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5.
New Items on the www.moh.gov.rw
- Employment Opportunities
- Epidemiology Weekly Newsletter
- Immunization Monthly Newsletter
- New Publications posted:
• National Health Accounts
• MoH Annual Report 2005
• Norms related to Health Districts
