Background
Corona Virus Disease (COVID-19), caused by the severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China in
late 2019, has spread across the globe, rapidly reaching classification
as a pandemic. As of September 24, 2020, more than 31.7 million cases
and 973,000 deaths have been identified worldwide and nearly every
country has been impacted.1
According to the World Health Organization (WHO) surveillance data, the
African region (AFRO) has 1,154,171 confirmed cases and 24,464 deaths
from COVID-19 as of September 24, 2020.1,2 Although
there is optimism that the pandemic response in Africa will be informed
by efforts from other regions of the world, there are unique
socioeconomic and health aspects in the African
context.3 Additionally, Africa faces a number of
challenges in identifying and treating COVID-19 cases, including low
relative per-capita health resources, a rapidly growing population, and
multiple endemic infectious diseases.4
Rwanda is an East African nation of more than 12 million people, with
83% of the population living in rural areas.5 Rwanda
has made significant advancements in healthcare and economic development
over the last 20 years and has emerged as a leader in healthcare in the
East African region. The country operates under a universal healthcare
model where public health insurance coverage is nearly 84%, with
another 6% of the population covered through other insurance
schemes.6 Rwanda has an estimated 1350 doctors, 9551
nurses, and 21,826 hospital beds for its 30 districts, for an average of
8919 people per doctor, 1261 people per nurse, and 552 people per
bed.7 Per district, the population per doctor ranges
from 1725 in Nyarugenge to 54,266 in Nyaruguru. The population per nurse
ranges from 412 (Nyarugenge) to 3256 (Nyaruguru), and the population per
bed from 288 (Nyarugenge) to 1025 (Nyagatare, Eastern
Province).7 In comparison, the global averages for
population per doctor, nurse, and bed are 666, 294, and 370,
respectively, and averages in Sub-Saharan Africa for population per
doctor, nurse, and bed are 5000, 1000, and 833,
respectively.8 Rwanda has eight national referral
hospitals, four provincial hospitals and 36 district
hospitals.6 Locally, there are over 45,000 community
health workers working at 499 health centers and 476 health posts,
providing the population further access to the health
system.6
While African countries have set up the Africa Task Force for
Coronavirus Preparedness and Response (AFTCOR) in concert with the
African Union Commission, the Africa Centres for Disease Control and
Prevention (Africa CDC), and the WHO,5 the Rwandan
government has also taken an engaged and innovative approach to
COVID-19. As part of its COVID response, Rwanda announced the formation
of a Joint Task Force on March 3rd, 2020 which created the Rwandan
Coronavirus National Preparedness and Response Plan with the primary
objective of “stopping the human-to-human transmission of the virus and
caring for those affected”.9