The Ministry of Health launched the fifth Health Sector Strategic Plan (HSSP V), a comprehensive framework designed to strengthen Rwanda’s healthcare system and accelerate progress toward universal health coverage by 2030. The plan aligns with Rwanda’s Vision 2050, the National Strategy for Transformation 2, and the United Nations’ Sustainable Development Goals.
Developed through an inclusive consultative process involving the Ministry of Health, affiliated agencies, development partners, the private sector, and civil society organizations, HSSP V is built upon extensive health sector data analysis. It integrates lessons learned from the COVID-19 pandemic response and the implementation of HSSP IV while incorporating new reforms.
HSSP V is structured around five strategic pillars and two enabling factors, encompassing 24 strategic objectives, 138 interventions, and 44 priority areas. Progress will be measured using 38 key performance indicators.
. Health workforce development: A major focus of HSSP V is building a resilient and skilled health workforce. The “4×4” reform aims to quadruple the number of healthcare workers by revamping health education policies and improving career development, empowerment, and welfare.
. Health infrastructure modernization: The plan prioritizes the modernization of healthcare infrastructure by constructing and renovating facilities to be clean, safe, user-friendly, and climate-resilient. Key projects include the establishment of Kigali Health City, the construction of 10 hospitals and 23 health centers, and the renovation of 30% of existing facilities nationwide.
. Quality of healthcare through primary health care: The quality of healthcare will be strengthened by integrating health services, addressing social determinants of health, and ensuring accessibility for all. The plan emphasizes improving the six dimensions of quality—safety, effectiveness, person-centeredness, timeliness, efficiency, and equity—to enhance service delivery and patient outcomes.
. Health Security and Public Health Emergency Management: Health security and emergency preparedness will also be reinforced through real-time disease surveillance, the use of artificial intelligence for outbreak detection, and the establishment of a smart, integrated One Health system.
. Research, Innovation, Biomanufacturing, Regulation, and Digitalization: HSSP V focuses on advancing biomanufacturing and local pharmaceutical production while fostering technological breakthroughs to improve healthcare delivery. This strategic shift aims to position Rwanda as a leader in health innovation and self-sufficiency in critical medical supplies.
Additionally, two enablers—health financing and leadership and governance—will support the plan’s implementation, ensuring the sustainability of healthcare investments. Health financing will focus on mobilizing resources through innovative mechanisms to achieve universal health coverage while reducing dependency on external funding. Strategic purchasing, cost-effectiveness analysis, and sustainable health insurance schemes will be key components of this approach. Leadership and governance structures will also be strengthened to enhance coordination among stakeholders, ensuring effective implementation and accountability.
Building on HSSP IV Achievements
HSSP V builds on the substantial progress made under HSSP IV (2019–2024), which significantly strengthened Rwanda’s healthcare system, as demonstrated by key health indicators:
. Maternal mortality declined by 50%, from 210 deaths per 100,000 live births in 2014–15 to 105 deaths per 100,000 live births in 2023. This achievement places Rwanda among the top performers in Sub-Saharan Africa.
. Neonatal mortality dropped from 10.7 to 5.45 per 1,000 live births, underscoring the effectiveness of maternal and neonatal care initiatives.
. Malaria incidence declined dramatically, from 308 to 45 cases per 1,000 population, surpassing the target of 122 and marking a significant milestone in disease prevention.
. Immunization coverage for measles-rubella remained consistently high at 97.4%, ensuring widespread protection for children.
. Skilled birth attendance rose to 94.9%, nearing the target of over 95%.
. The Community-Based Health Insurance (CBHI) now covers 83.5% of the population, representing 92% of insured Rwandans.
Implementation cost
The estimated cost of implementing HSSP V is between RWF 5.9 trillion ($4.2 billion) and RWF 6.9 trillion ($4.9 billion), with a projected financing gap of 21% to 32% over the next five years. Efforts to bridge this gap will focus on increasing domestic funding and private sector investment. The implementation of HSSP V will be integrated into the national annual planning and budgeting processes under the Ministry of Finance and Economic Planning. Progress will be closely monitored through key performance indicators and real-time data analysis at the newly established Health Intelligence Center. Regular performance reviews, including Joint Sector Review Meetings, will ensure accountability and guide strategic adjustments. (End)