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RWANDA HEALTH INDICATORS: PROGRESS 2010 (DHS and EICV )

SECTOR PERFORMANCE INDICATORS HSSP I + II and III, 2000 – 2010

Trends 2000 – 2010 (baseline) and targets for MDG (2015)

INDICATORS
Source of Information / DHS 2000 / DHS 2005 / I-DHS 2007-2008 / DHS 2010
Rwanda
HMIS / Target MDGs 2015
IMPACT INDICATORS
Population (Million) / 7.7M / 8.6 M / 9.31 M / 10.4 M / ?
Life Expectancy at birth / 54.2 / 58
Neonatal mortality rate / 28 / 37 / 28 / 27 (DHS)
Infant Mortality Rate / 1000 / 107 / 86 / 62 / 50 (DHS) / 25
Under Five Mortality Rate / 1000 / 196 / 152 / 103 / 76 (DHS) / 30
Stillbirth rate (/1000 live births)
Maternal Mortality Ratio / 100.000 / 1071 / 750 / 487 (DHS) / 287
Adult mortality rate (/1000) / 3.7 (Men)
3.3 (Women)
DHS
Age standardized mortality rates
-Communicable diseases (/100000)
-Non communicable diseases
-Injuries / NA
Total Fertility Rate (TFR %) / 6.5 / 6.1 / 5.5 / 4.6 (DHS) / 4.5
Modern Contraceptive Prev Rate (CPR) / 4 / 10 / 27 / 45 (DHS) / 70
HIV Prevalence Rate in 15-49 yrs (%) / 3.0 / NA / 3.0 (DHS) / 0.5
Incidence of HIV (/100,000) / NA / NA / NA / 150 (TRACnet)
Incidence of Malaria (/1,000) (HMIS 2011) / 129 / 192 / 80 / 61 (HMIS 2011)
Incidence of TB (/100,000) (Source: WHO 2011 TB) / 286 / 162 / 123 / 106 (WHO)
Prevalence of TB (/100,000) (Source: WHO 2011 TB) / 361 / 192 / 143 / 128 (WHO)
Prevalence of raised blood pressure (%) / NA
Prevalence of raised fasting blood glucose (%) / NA
TB detection rate (%) Source: WHO 2011 TB report) / 26 / 48 / 61 / 60 (WHO) / NA
OUTCOME / OUTPUT INDICATORS
Prevalence of underweight (Wt/Age) / 30 / 18 / NA / 11 (DHS) / 6
Prevalence of Stunting (Ht/Age) / -- / 51 / NA / 44 (DHS) / 27
Prevalence of Wasting (Ht/Wt) / -- / 5 / NA / 3 (DHS) / 2.5
% Overweight (women) / 12 / NA / 16.3 (DHS)
% 0-6 month children exclusively breastfeed / 88 / 85 (DHS)
% Births attended in Health Facilities / 39 / 52 / 69 (DHS) / 75
% Delivery by caesarian section (national) / 7.1 (DHS 2010)
15% (HMIS 2012)
% U5 receiving Vit A supplements (HMIS) / 108 (HMIS)
% Children born with < 2.5 kg (low weight) / 6.1 (DHS)
% Pregnant Women receiving 1 ANC visit / 94 / 96 / 98 (DHS)
% Pregnant Women receiving 4 ANC Visits / 13 / 24 / 35 (DHS) / 50
% Children 12-23 months fully immunized / 75 / 80 / 90
% Children< 1 yr immunized for Measles / 76 / 90 / 1992: 91
2000: 76
2005: 76
2008: 90
2010: 95
(DHS) / 95
% Children < 1Y immunized with DPT3 / 97 (DHS)
% children protected against tetanus at birth / 78 (DHS)
# Districts with One Stop Centre (GBV) / 4 (HMIS) / 40
% HC with youth friendly adolescent services / 8 (HMIS) / 100
% unmet needs for contraception / 19 (DHS)
HIV Prevalence among PW attending ANC / 1.6 (Tracnet) / 1%
% Health Facilities with VCT services / 96.4 (TRACnet) / 100/100
% Health facilities with PMTCT services / 95.5 (TRACnet)
%New born post natal care 23 hours / 4.7 (DHS)
Malaria Prevalence Women / Children (%) / NA / 1,4 / 0.7 (DHS) / 0.5
Malaria Prevalence in children (%) / 2.6 / 1.4 (DHS) / 1
% HH with at least one LLITN / 18 / 60 / 82 (DHS) / 90
% U5 sleeping under LLIN / 2005: 13
2008: 56
2010: 70
(DHS)
% children under 5 years treated for malaria within 24 years after lab confirmation / 93 (HMIS)
% TB Treatment Success Rate / DOTS / 61 / 83 / 87 / 87(HMIS) / 88%
ART coverage among HIV patients (adults) (TRACnet 2011-2012) / 92(TRACnet)
ART coverage among HIV children patients (TRACnet 2011-2012 / 87 (TRACnet)
% HIV+ pregnant women receiving ART prophylaxis / 95.4 (TRACnet)
% Condom use among during the last sexual intercourse / 66.2 (DHS)
% Comprehensive knowledge HIV/AIDS (women and men aged 15-49 years) / 56 (women)
52 (men)
(DHS)
% TB/HIV patients receiving ART (Source: TB & ORD annual reports) / NA / 12 / 62 / 67 (ORD report) / 85
# new cases of diarrheal Diseases (HMIS) / 148,400 (HMIS) / 120,.000
# trained Env Health Officers / 160 (Annual report) / 400
Average OPD attendance / pp / yr (HMIS) / 0,33 / 0,72 / 0,95 (HMIS) / 1.1
% population with access to clean water sources / 64 / 74 (DHS)
% households using Improved, not shared latrines / 55 (DHS)
% Households using improved latrines (shared and not shared) / 71(DHS)
% ORT Diarrhea treatment / 48 (46.5 at home)
(DHS)
% use of tobacco 15-49 years (cigarettes) / 19 (DHS)
% use of tobacco among adolescents
14-19 Years / 2 (DHS)
% Tobacco use among 13-15 years / -
% Alcohol consumption
INPUT INDICATORS
% of GOR budget allocated to health / 4 (NHA 2000) / 9 (NHA 2003) / 8 (NHA 2006) / 11.5 (MTR Aug 2011) / 12
Total Health expenditures per capita (USD) / 10.4 (NHA 2000) / 16.94 (NHA 2003) / 33.93 (NHA 2006) / 38.5 ( NHA 2009-2010)
% annual GOR expenditures on health / 4.7 (NHA 2000) / 9 (NHA 2003) / 6.5 (NHA 2006) / 9.8 ( NHA 2009-2010)
Total expenditures on Health as % of GDP / 4% (NHA 2000) / 8.8 (NHA 2003) / 11 (NHA 2006) / NA
General GoR expenditures on health as % of total expenditures on health / 18 (NHA 2000) / 32 (NHA 2003) / 19 (NHA 2006) / 18 ( NHA 2009-2010)
General GoR expenditures on Health as % of total GoR expenditures / 4.7 (NHA 2000) / 8.4 (NHA 2003) / 6.5 (NHA 2006) / 13 (NHA 2009-2010)
External resources for Health as % of total expenditures on health / 52 (NHA 2000) / 42 (NHA 2003) / 53 (NHA 2006) / 63 ( NHA 2009-2010)
Social Security expenditures on health as % of general GoR expenditures on health / NA
Out-of-pocket expenditures (as % of total health expenditures) / NA / NA / NA / NA
% Population covered by Community Based Health Insurance / - / 44.1 / 85 / 91(CBHI database) / 91
% Total population covered by any health insurance scheme / - / 91 / 96 (CBHI database) / 96%
Per capita allocation to PBF (USD) / NA / 1.65 / 1.8 (Annual report)
Out-pocket expenditures/patient (DHS) / 4.37 USD (DHS)
# Community Health Workers (CHW/village) / NA / 3/village (45,000) (Annual report) / 3/village (45,000)
Doctor / Pop Ratio
Nurse / Pop
Midwives / Pop Ratio
Pharmacists (MoH report 2010-2011)
Lab Technician
Number of Environmental Health Officers
Source: MoH Single Action Plan 2012-2013, Baselines / 1 / 75.000
1 / 6.250
NA / 1 / 50.000
1 /3.900
NA / 1 / 33.000
1 / 1.700
1/100.000 / 1 / 16,001
1 / 1,291
1 / 44,584
331 (1/30,565)
1/10,626
160 / 1/ 15.000
1/ 1.100
1/50.000
MORTALITY AND CAUSE SPECIFIC MORTALITY AND MORBIDITY
U5 CHILDREN
% Stillbirth / 2 (HMIS 2011)
Causes of death among U5 children
% Birth asphyxia / NA
% neonatal tetanus / 0 (HMIS 2010, 2011)
% Sepsis / NA
% Congeniral diseases / 3 (HMIS 2011)
% Injuries / 1 (HMIS 2011)
% HIV/AIDS / 0.3 (HMIS 2011)
% Diarrhoea / 4 (HMIS 2011)
% Measles / 0 (HMIS 2010, 2011)
% Malaria / 29.4 / 36.9 / 17.5 / 13.1 (HMIS 2011)
% Prematurity / 23 (HMIS 2011)
% Pneumonia / 15 (HMIS 2011)
Age standardized adult mortality rate
% mortality due to Cancer / NA
% mortality due to cardiovascular diseases / NA
% mortality due to diabetes / NA
% mortality due to chronic respiratory diseases / NA
Mortality due to TB among HIV (neg) people/100,000 / NA
NUMBER OF REPORTED CASES
Cholera / 17 (IDSR)
Diphteria* (WHO/UNICEF JRF data, 2010) / 0
H5N1 influenza / NA (IDSR)
Japanese encephalitis* (WHO/UNICEF JRF data 2010) / Not reported
Leprosy / 36 (TB/ORD, HMIS)
Malaria U5 children / 287,031 / 499,697 / 378,154 / 141,454 (HMIS)
Malaria all ages / 1,040,921 / 1,669,614 / 772,197 / 625,174 (HMIS)
Measles* (WHO/UNICEF JRF data, 2010) / 31
Meningitis / 0 (IDSR)
MUMPS* (WHO/UNICEF JRF data, 2010 / Not reported
Neonatal tetanus* (WHO/UNICEF JRF data, 2010) / 0
Yellow fever* (WHO/UNICEF JRF data, 2010) / 0
TB (TB & ORD report) / 6,768 (TB/ORD report)
Rubella* (WHO/UNICEF JRF data, 2010) / 62
Hib meningitis* (WHO/UNICEF JRF data, 2010) / 0
Pertussis* (WHO/UNICEF JRF data, 2010) / 0

Note: Where available, HMIS and TRACnet figures have been used for the outcome / output indicators.

* WHO/UNICEF JRF data for 2010

IDSR: Integrated Disease Surveillance and Response

HMIS: Health Management Information System

NHA: National Health Accounts (NHA 2009-2010 are preliminary results)

HEALTH EQUITY INDICATORS (DHS 2010)

Indicator / Rural / Urban / Non educ / 2ndary / Lowest quintile / Highest quintile
% modern contraceptive prevalence / 44.9 / 47 / 37.3 / 52.3 / 38.5 / 49.6
% Antenatal care / 98 / 98.3 / 96.6 / 98.7 / 98.6 / 98.9
% Assisted deliveries in HFs / 67.1 / 82 / 56.7 / 87.3 / 61 / 85.7
Immunization: % DTP3 (3 doses) / 89.7 / 93.3 / 87 / 96.8 / 86.6 / 95.5
% U5 stunted (height for age) / 46.5 / 27.3 / 52 / 22.9 / 54 / 25.8
U5 mortality ratio/1000 live births / 105 / 81 / 125 / 63 / 119 / 75

Socio-economic statistics (Source: Rwanda statistical yearbook 2011, EICV, DHS 2010)

Indicator / Status
Adolescent fertility rate (15-19 years) / 41/1000
Literacy rate / Men: 82%
Women: 77%
Net primary school enrolment / Boys: 94.2%
Girls: 96.5%
Population poverty (< 1 $/day) / 46%
Mobile phones owning / 45.2%
Crude birth rate/1000 / NA
Crude death rate/1000 / NA
% population living in urban areas
Annual population growth rate / 2.8% (estimation from 2002 census)
Gross income per capita / 540 $

Health Information System and Data availability: number of population based surveys 2000-2011

Indicator / Number of population surveys
Child anthropometry / 2
Child mortality / 3
Maternal mortality / 3
HIV prevalence / 2
Adult health / 4
Causes of death registry / 11 (annual