Rwanda reduces under-5 mortality by 79 percent over 20 years

Rwanda ranked the biggest mover of change for improving children’s lives in the region and the second-biggest in the world.

Twenty-five years after the Genocide against the Tutsi, Rwanda has made a great improvement in children lives. Rwanda’s score rose 241 points, from 503 to 744 since 2000 in Save the Children’s “End of Childhood” index which ranks countries according to how well they create a protective environment for children.

Launched today, Save the Children’s 2019 Global Childhood Report evaluates 176 countries across the globe on their ability to protect children ‘childhood enders’ – life-changing events like child marriage, early pregnancy, exclusion from education, sickness, malnutrition and violent deaths.

The report includes the annual End of Childhood Index, which finds that circumstances for children have significantly improved in over 70% of the 24 countries in the East and Southern Africa since 2000.

Rwanda highlights include:

• Rwanda, the biggest improver in the region and the second-biggest in the world, with the country reducing under-5 mortality by 79 percent over 20 years. Many more children are in school and many fewer children are married before age 18, with the out-of-school rate and child marriage rate both down by 60 percent. Rwanda also cut child labor, adolescent births and child homicides in half since 2000.
• Rwanda is among the four countries in East and Southern Africa – (Rwanda, Ethiopia, Angola and Zambia) – increased their index scores by 200 points, representing substantial improvements for children over the past 20 years.

While substantial progress has been made, the under-5 mortality rate remains high overall in the region, with 59 deaths per 1,000 live births. The highest rate in the world is in Somalia, with one child in eight dying before their 5th birthday. South Sudan also remained in the global top ten for under-5 mortality.

Globally, the report found at least 280 million children have a better chance to grow up healthy, educated and safe than at any time in the past two decades.  In the year 2000, an estimated 970 million children were robbed of their childhoods due to ‘childhood enders’. That number today has been reduced to 690 million – meaning that at least 280 million children are better off today than they would have been two decades ago. Together, China and India account for more than half of the global decline in stunting alone.

Of the eight ‘childhood enders’ examined in the report, displacement due to conflict is the only one on the rise globally, with 30.5 million more forcibly displaced people now than there were in 2000, an 80 percent increase.

Philippe Adapoe, Save the Children Rwanda Country Director, said:

“Rwanda has made this great progress due to strong Government leadership that forces accountability and encourage local level authorities to ensure great progress in all sectors including health, education and child protection.

“The Government of Rwanda in partnership with Rwandan people, civil societies and development partners has been working to improve health systems, investing in education, strengthening legal frameworks, and empowering children to make life choices that set them on a path to realize their full potential”.

“The progress is outstanding. But there are still many stunted children and other missing out on education. We need to keep the momentum to ensure every Rwandan child accesses quality education, health and is protected.”

-Twenty-five years after the Genocide against the Tutsi, Rwanda has improved on most of the ‘childhood enders’. The number of children dying before the age of 5 has decreased by 79 percent.  Many more children are in school and many fewer children are married before the age of 18. Rwanda has also cut child labor, adolescent births and child homicides in half since 2000.

– Rwanda is one of the countries making good gains in education. Household survey data suggest Rwanda’s out-of-school rate has dropped by 61 percent (from an estimated 59 percent of children out of school in 2000 to 23 percent today). Limited data suggest progress in Rwanda has favored the poorest at every level of education, although equity gaps remain and too many children at all income levels are failing to receive a basic education.

– Rwanda has cut its under-5 mortality rate by a remarkable 79 percent since 2000. Major health sector reforms and investments in Rwanda have built up the health workforce, increased immunization coverage and increased exclusive breastfeeding, among other advances. Improved socioeconomic conditions have also been important for Rwanda’s success.

-In 2000, 16 million girls aged 15 to 19 gave birth. Today, that number has been cut to about 13 million. But progress has been uneven. Regional leaders in Africa are South Sudan (47 percent reduction in teen birth rates since 2000), Rwanda (45 percent reduction) and Ethiopia (41 percent reduction). In Rwanda, current use of modern contraceptives among married teens aged 15 to 19 rose from 1 percent in 2000 to 33 percent in 2015. Among sexually active unmarried women, use of modern contraceptive methods was much lower – with a rate of 11.6 percent in 2015.

–  In the year 2000, an estimated 970 million children had been robbed of their childhoods due to “childhood enders” – life-changing events like child marriage, early pregnancy, exclusion from education, sickness, malnutrition and violent death. That number today has been reduced to 690 million. One-fifth of these children have died. The rest – 545 million – are alive and missing out on childhood. This is 24 percent or 1 in 4 of the 2.3 billion children under the age of 18 worldwide. To reach this number, a series of reasonable assumptions were made based on evidence of overlap between groups of children who have experienced one or more childhood ender events. It includes:  152 million stunted children under age 5, an estimated 30 million children age 5 who are stunted, 262 million children aged 6-17 who are out of school and a subset of child laborers (86 million) and forcibly displaced children (16 million) who are not likely to be stunted or out of school. The reference year for this analysis is 2017. For details, see Methodology and Research Notes in Save the Children’s Global Childhood Report.

– In East and Southern Africa, the vast majority of countries significantly improved their scores between 2000 and 2019. Over seventy percent of countries in the region (17 of 24) increased their scores by over 100 points. And four countries (Rwanda, Ethiopia, Angola and Zambia) had 200-point increases. More details on the regional countries and their scores available below. Further detail is available in the Global Childhood Report.