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Malaria Infection Linked to Rampant Poverty


The New Times (Kigali)


February 2, 2006

Posted to the web February 2, 2006


Joseph Kamugisha



Many of the leading causes of mortality and morbidity of children in Rwanda, like in other countries in the Great Lakes Region, are closely related to poverty which suggests that as well as targeting these major causes directly, policy must be focused in ensuring more Rwandans afford to access the health care system.


With the support of multilateral and bilateral donors, the Government of Rwanda has taken a series of measures aimed at decreasing infant and maternal mortality rates through; Improving sanitation and hygiene as well as availing safe drinking water, providing adequate financing for health care and spreading knowledge of child care at family level.


To date, Malaria is the major cause of mortality and morbidity in children followed by acute respiratory infections, diarrhoea and injuries. To respond to such intolerable challenges, the Ministry of reacted by raising child immunization coverage to an acceptable level of 70%.


It should not be forgotten that after the violent events of 1994, the vaccination campaign was restarted with coverage of close to 70% of all young children in the country by 1997. By 1999, it had dropped to less than 50% due to reduced supervision and monitoring efforts.


Of recent, the government of Rwanda has signaled its intentions to pursue policies, to reduce mortality. The main approach to reach these targets includes: Reducing malnutrition and micro nutrients deficiencies in children, increasing financial access to health insurance schemes, improving primary health care.


"Community-based services through new management methods and the deployment of qualified health workers and strengthening preventive care and health promotion," says Dr Florent Senyana, the director of epidemiology in the Ministry of Health


Until now Malaria is one of the leading causes of outpatient attendance, and it leads to 40% of all health centre visits and it is the principal cause of morbidity in every province in Rwanda. It should be noted strongly that during 1999-2002, the percentage of children under five years with insecticide-treated mosquito nets was only 5%. The provinces of Byumba, Butare, Umutara and Gitarama are particularly infected by Malaria mostly.


With 40 % of deaths in children under five years of age due to malaria, it is the most deadly disease for the age group. In 1995, the estimated direct cost per episode of malaria was $2.09 and the indirect cost over $5. After ten years, the cost has reduced gradually during the year 2005 and this shows concerted efforts by the Ministry of health to overcome malaria linked infections.


With Rwanda's population of roughly 8 million inhabitants, most of them suffering an estimated two or three episodes per year, malaria-related costs represent a tremendous financial burden. These high financial costs do not even fully capture the productivity and opportunity costs of the disease. A person suffering from malaria will miss, on average, eight days of work or school to recover. It is well known that malaria presents the most severe health risks to pregnant women and children under five.


Since 1998, severe epidemics of malaria have been observed nationwide every two years. Malaria has widely spread to rural-urban migration. The National Malaria Control Programme in cooperation with WHO has also found that 41% of malaria cases are resistant to Chloroquine.


Malaria is now evident in high attitude areas and other areas, where the disease was not a public health issue before.

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Taken on December 20, 2005