In Rwanda, looking beyond 2015 the Government’s 2020 target for the infant mortality rate is 30, which is higher than the 2015 target of 28.

According to the latest statistics available, Infant mortality stood at 50 per 1000 live births in 2010 meaning that of every 1000 babies born in Rwanda, 50 die before their first birthday. Yet given adequate care and a good environment most of them could survive. The infant mortality rate (IMR) stood at 85 prior to the Genocide against The Tutsi, increased dramatically during and in the aftermath of the tragic events of 1994 and reached a peak of 107 in 2000. Since then it has fallen dramatically, to 85 by 2005 and 62 in 2008 and 50 in 2010. To hit the MDG Target it will have to fall to 28, which would mean accelerating the rate of decline significantly.

The major cause of mortality amongst children is malaria, followed by anaemia, acute respiratory infection and diarrhoea ? all of which are preventable through comprehensive and well-coordinated interventions including the distribution of mosquito nets, improved access to water and sanitation, improved cook stoves and simple health interventions such as rehydration salts (Ministry of Health et al 2009).

Vaccination coverage is improving with an increase in the proportion of children having all vaccinations from 75 per cent in 2005 to 90 per cent in 2010.  The Target for the proportion of children immunised against measles has almost been achieved and the rate is likely to continue to go up.

Recognising that improving health requires a partnership between the Government and local communities, the Ministry of Health has put in place mechanisms that directly involve and empower local communities in health promotion. Community Health Workers (CHWs) have proven to be a way of providing g effective and efficient basic health care services at a community level in a resource ?constrained country with financial, infrastructural and geographical barriers to accessing health care.   The significant improvements in child and maternal health witnesses over the last five to 10 years are undoubtedly due, at least in part, to the service provided by CHWs.

The allocation of a specific budget  for Child Health in the Ministry of Health, will support the implementation the key prioirities to accelerate the progress to achieve this MDG4, such as the training of medical staff and CHWs, improve medical equipment as well as rolling out the Social Protection Programme (VUP).