Meeting the goals

In September 2000 189 world leaders attended the Millennium Summit at the United Nations and made a commitment to address the world’s most pressing development needs by 2015.

Leaders pledged to eliminate gender inequality, environmental degradation and HIV/Aids, to improve access to education, healthcare and clean water and to develop a global partnership in the areas of aid, debt and trade.

Last week the world’s leaders gathered again at the UN to assess midway progress towards achieving these targets—known as the Millennium Development Goals.

On this occasion the Mail & Guardian, in collaboration with the UN Millennium Development Campaign, is launching the first in a series of exclusive interviews with African presidents about the progress their countries have made towards achieving the MDGs.

This week we spoke to Rwandan President Paul Kagame

How do you assess your country’s progress in achieving the Millennium Development Goals (MDGs) and is your government on track to delivering them by 2015? What is being done to overcome hurdles?
Rwanda assesses its progress towards achieving the MDGs on an annual basis using existing data management information systems, which are backed up by national surveys, such as the Households Living Conditions Surveys and the Demographic and Health Surveys (DHS), which are carried out every two to five years, providing high-quality information on targets relating to poverty, education, health and environment.

Rwanda is on track to achieve the goal on universal primary education, the goal on gender equality and the goal on HIV/Aids and malaria. Net primary enrolment is 95%, with 97% enrolment of girls. However, Rwanda still faces challenges in increasing low primary school completion rates and improving the quality of basic education. The primary completion rate increased from 45% in 2004 to 52% in 2007, but fell short of the target.

Significant results have also been achieved in the health sector. The 2005 Demographic and Health Survey shows that HIV/Aids infection rates have declined dramatically, that the number of treated cases has increased dramatically and that Rwanda is one of the few countries in Africa likely to reach universal treatment. Rwanda is on track to achieve the targeted reduction in malaria ­incidence.

The MDGs on poverty and hunger and child and maternal mortality are unlikely to be achieved without a considerably scaled-up effort. Nonetheless, progress has been made: mortality rates for children under five have decreased dramatically. Between 2000-2001 and 2005/06, poverty fell from 60,5% to 57%, but a much faster rate of reduction is needed to reach the MDG target of 30%.

Malnutrition rates in children under five have been declining from about 24% in 2000 to 18% today. Infant mortality dropped from 107 per 1 000 in 2000 to 86 in 2005 and maternal mortality decreased from 1 071 per 100 000 to 750 in the same period. Results of the 2008 mini-DHS suggest that Rwanda is now on track to achieve the MDG to reduce child mortality, with a drop in under-five mortality to 103 per 1 000. The percentage of assisted deliveries increased from 39 to 52 in 2005-2008.

In the past five years the government of Rwanda has increased financing and introduced several new policies to the health sector, including the decentralisation of health services delivery, the implementation of performance-based financing and the scaling up of community health insurance schemes. The introduction of community insurance schemes has already proved to be a great success in Rwanda. Coverage by such insurance schemes increased from 27% in 2004 to 75% in 2007.

In terms of poverty the proportion of the Rwandan population identified as poor fell from 60,4% in 2001 to 56,9% in 2006. Rural poverty reduction is also statistically significant. Based on the 2005/06 survey, 37% of Rwandans live in extreme poverty. Poverty levels remain higher in families with smaller landholdings and in female-headed households. Poverty also appears to be positively correlated with population density. These factors suggest that reducing population growth, raising agricultural productivity and incomes and diversifying sources of livelihood away from agriculture are key factors for reducing poverty. More effort is needed to ensure that women participate fully in growth. These are major components of the government’s 2008-2012 development plan.

One of your government’s biggest achievements is to increase access to education, however, Rwandan citizens have raised the question of unsatisfactory quality as a result of increased enrolment. How does your government intend to address this challenge?
Rwanda recorded important progress in education. Net primary enrolment increased from 72% in 2000 to 95% in 2005/06. Completion rates in primary school increased from 24% in 2000 to 52% in 2005/06.

The government aims to address the issue of quality by reducing pupil-teacher ratios by increasing the number of classrooms that meet minimum standards. In addition programmes aimed at increasing the number and quality of teachers are recording progress with the scaling-up of teacher training colleges. Making education material available to teachers and pupils is considered high priority, including adopting the policy of one laptop per child.

Despite new innovations in medicine, children still die because of preventable diseases. What has your government done to deal with this?
Rwanda has made great strides in reducing childhood mortality rates and is on track to achieve the goal of reducing the under-five mortality rates by two-thirds by 2015. The government is embarking on a programme to reduce the incidence of communicable diseases by improving the prevention, care and treatment of malaria, TB and other diseases. During the next five years the government aims to support further reduction of the malaria fatality rate, distributing insecticide-treated mosquito nets and encouraging their use by children and pregnant women, indoor spraying, applying bio-larvicide and by improving general sanitation. Measures will be taken to ensure early case recognition followed by the appropriate response and referral.

The call from citizens is that no woman should die in child birth. What measures has your government taken to achieve this?
One of the key objectives of the government is to strengthen reproductive health services and family planning. The policies focus on improving maternal health through scaling up emergency obstetric and neonatal care activities, sensitising the community to what the danger signs are during pregnancy and increasing access to prenatal, delivery and postnatal care. The focus is on promoting family planning, specifically on reproductive health for youth, involving men in family planning, supporting couples and individuals who decide responsibly and freely on the number and spacing of their children and ensuring free access to information, education and contraceptive services. The government is using community mobilisation to enact behavioural change.

The general call from HIV and Aids activists is to treat people for free. How has the Rwandan government addressed this demand?
The government is enhancing the implementation of programmes related to the treatment, care and support of HIV-infected and affected people, building on the progress already made by the Treatment and Research Aids Centre. The response against HIV/Aids focuses on both prevention and treatment. Most of the focus on preventative measures includes promoting changes in sexual behaviour, especially through peer education, and providing support to widows, widowers and other groups, such as orphaned and vulnerable children, who have to cope with the socio-economic impact of HIV and Aids. The government has initiated a nationwide health insurance scheme, which covers infectious and non-infectious diseases. Finally, the government has initiated programmes to enable poor people living with HIV/Aids to access antiretroviral medication free of charge.

What is your government doing to reduce dependency on international donors?
The government is strongly committed to reducing dependency on aid through the following strategies:

  • Increasing internal revenue through improved revenue administration and expansion of the tax base;

  • More effective use of aid that focuses on long-term investments with a high impact on growth, such as infrastructures; and

  • Private sector development through support for micro, small and medium enterprises and promoting the business environment and investment climate.

What is the Rwandan government doing to promote gender equality and empower women?
Rwanda is an international leader in gender-equality promotion. The Constitution stipulates that at least 30% of the decision-making positions at all levels of government be allocated to women. This is attested by a number of outcomes such as the share of females in decision-making positions (47,5% in 2006), the share of parliamentary seats filled by women (55% in 2008) and the 1:1 male-female primary school enrolment ratio. Rwanda has adopted laws promoting gender equality, such as the 1988 law allowing married women to exercise a profession, industry or commerce without the permission of their husband, the 1999 law recognising daughters’ inheritance rights as equal to those of sons and the 2005 law that accords men and women equal rights in land ownership and management.

The UN Millennium Development Campaign supports citizens’ efforts to hold their governments and the international community to account in achieving the MDGs

Next week: an interview with Tanzanian President Jakaya Mrisho Kikwete

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