Rwanda: High Population Density a Challenge for Kigali Health System

High Population Density a Challenge for Kigali Health System

Dr. Blaise Uhagaze, director of health and environment in the city of Kigali, indicates that high population density in the city of Kigali causes a burden to health system.

This was said in Kigali this Tuesday during a workshop organized by the Belgian Technical Cooperation (BTC).

Over the past decades, de number of inhabitants in the capital has skyrocketed. Where there were only 6,000 in 1962, in the next 40 years it grew a hundred-fold to reach 765,325 by 2002. The growth rate has further increased in the past decades, to 923,176 inhabitants in 2006 and an estimated 1,220,000 today. According to projections, 2 million people will live in Kigali by 2020.

Uhagaze indicated that as a result the public health system in the capital is overwhelmed. For example, Kigali has the highest prevalence HIV-AIDS prevalence in the country with 7%, against 3% nationwide.

The capital also accounts for more than a third of the tuberculosis cases in the country, and also had a bigger share of other respiratory and non-communicable diseases like asthma and diabetes. In addition, it rates high for drugs abuse, violence and accidents, with which the health system also has to deal.

Against that, the public health sector is woefully lacking in human resources and infrastructure with only 18 health centers and 3 hospitals. This results in too many patients ending up at CHUK, a referral hospital, where it is estimated that 26% of the cases could have been treated at a lower level.

Staff is also insufficient, with just 1 nurse (A2) and 0.4 doctors per 10,000 inhabitants. Needless to say, there is an even greater gap when it comes to specialists, who are mainly to be found in private hospitals and clinics, yet in general those do not accept the public health insurance (mutuelle de santé).

One positive point is that there is reasonable growth in the private health sector at 30%, although currently it mainly caters for out-patients.

Dr. Uhagaze indicated that there is a program to better equip health centers and train nurses to improve treatment of especially non-communicable diseases.

Efforts are also being made to increase infrastructure. For example, with the assistance of BTC four health centers were equipped as a way of increasing quality of care offered at the first level to reduce unnecessary transfers to referral hospitals that receive patients from all around the country.

The health sector seeks to focus on four components namely institutional support, the mental health program, the medical maintenance center as well as the urban health program.

Officials remarked that there is a need for a public-private partnership to promote health services at the lowest community level. In order to effectively provide quality health care, one official in the ministry indicated that an accreditation body to monitor health activities is required.

Source: All Africa

Rwanda: Blood Donor Day – Doctors Tipped On Safe Transfusion


Doctors have been advised to always consult the Centre for Blood Transfusion (NCBT) or blood experts before administering blood transfusion to patients in critical condition.

The head of division National Centre for Blood Transfusion (NCBT), Dr Swaibu Gatare, made the call ahead of Saturday’s World Blood Donor Day.

The appeal followed reports of loss of lives in different hospitals across the country arising from poor prescription of the relevant blood type for parents during emergencies.

“The problem is that doctors in hospitals do not consult blood experts during emergencies. For example if someone is O negative and is in critical condition, we can recommend them to be given O positive blood. However, for the cases of mothers we give them an additional drug to avoid the side effects it may have. But often you find doctors are not aware of such treatment,” Gatare said during a news briefing in Kigali on Wednesday.

“We have received several complaints regarding inappropriate use of blood, an example is a case of a mother who died at one of the hospitals in the country because the hospital prescribed a wrong blood group for her. If the doctors had consulted us early enough she could still be alive,” Gatare added.

Gatare said that to enhance communication between doctors and the transfusion centre, they had embarked on a hospital based training project where they train doctors in blood transfusion.

The move is aimed at minimising cases of inappropriate blood use as well as bridge the communication gap between hospitals and the transfusion centre.

Gatare’s call is in line with this year’s theme for the World Blood Donor Day which is “Safe blood for saving mothers”.

According to the World Health Organisation (WHO) every day, about 800 women die from pregnancy or child birth-related complications in developing countries.

Severe bleeding during delivery and after child birth was cited as a major cause of mortality, morbidity and long term disability.

Last year, Rwanda collected over 43,074 units of blood from volunteers which Gatare said helped save lives of patients.

He explained that most of the blood collection in the country goes to the obstetrics and gynecology departments.

The national celebrations will be held in Kansi sector, Gisagara District in the Southern Province and will seek to raise awareness on the need for safe blood transfusion as well as recognise the voluntary donors for their life saving gift of blood.

To offer effective and efficient service delivery, NCBT has got over 450 collection sites and five regional blood centres in Kigali, Rwamagana, Butare, Ruhengeri and Karongi districts.

For one to be eligible to donate blood, they have to be between 18 -65 years of age and must at least have 50 kilos and above with no health complications.

Source: all africa