Background

Rwanda is a country that is in the heart of Africa. It is a land locked country bordered by Tanzania in the east, Uganda in the north east, Democratic Republic of Congo in the west and Burundi in the south. Rwanda as any other third world countries, has all along been characterised by unfavourable socio-economic indicators, as the proceeding paragraphs highlight.

It has the highest population density in Africa. Its population of 7.88million in 1998 is growing at a rate of about 3.6% per annum, one of the highest population growth rates in the world. Total fertility rate is estimated to about 6.5% in 1996 compared to 8.5% in 1983. The population is predominantly rural (94.2%) and female (53.5%).

Agriculture continues to be the major sector of the economy, contributing 37% of GDP in the past two years and employing 91% of the labour force. Coffee and tea remain the principal export crops, but most primarily for house hold or community consumption. Industry and manufacturing constitute 22% of GDP and employing 2% of the population. Services, transport and communication account for the remaining of GDP and employ 7% of the labour force.

Pertaining to health development, as a consequence of the war and genocide, the health services infrastracture of the country was destroyed, and the health status of the population remains a major constraint to the socio-economic development of the country. Mortality and life expectancy figures reveal the terrible state of the country's health. Rwanda is significantly worse than the Sub Saharan Africa (SSA) average. For instance, the infant mortality rate was 131 in 1996 compared to 91 for SSA, a rise from 119 in 1992. While life expectancy was 48.5 years in 1996 compared to 54 for SSA.

Estimates of the "burden of disease" suggest that malnutrition and malaria are the two biggest killers. The 1995 nutritional survey found a very high level of chronic malnutrition (41.9% of children under 6). HIV/AIDS comes next in order of importance with an incidence rate of 12.8% in the population aged 15-49. The principal constraint to the improvement of quality of health services however, is the lack of qualified human resources: there is a significant shortage of trained health workers, and the ratio of population-to-doctors and nurses are significantly higher than the averages for Sub Saharan Africa. Low levels of sanitation and hygiene must not be forgotten as another major cause of the country's poor health.

As development is explained from economic and social perspective, there is a need to address among other social aspects, a health question which seems to be the most important issue in the development of any society. Soon after genocide of 1994, the government of Rwanda set up a reconstruction and recovery programme, and as part of this programme, the National University of Rwanda (NUR) was one of the focal points for National investment. This is in line with the government's policy for the development of social capital. It is thus in this respect, that the National University of Rwanda realises a need to establish and develop a new school of public health, that will satisfy the health needs of the Rwandan population.