1. Aflodis KAGABA, MD Health Development Initiative(HDI) Rwanda

2. Context Unlike many of its neighbors, Rwanda has limited land, natural and mineral resources on which to base its development strategy; Rwanda is the densest populated county in the region and in sub-saharan Africa: 230/Km 2 women constitute the majority of the Rwandan population : over 57% of the 10,117,029 people in 2009 : and thus the main work force in the country

3. Assessment Investing in health can help reduce some of the major pandemics such as malaria and HIV are weighing on development, reducing the productivity of its labour force and reventing numerous households from undertaking investments. Investing in women can help maximise the impact of development strategies in the agricultural sector, where they constitute the majority of the labour force. It can also help improve the quality of education and health interventions in which women play a major role. Achieving Growth by Investing in People

4. … assessment Preventable diseases such as HIV/AIDS and malaria are enormous burdens on the economy, both in terms of direct costs to poor and vulnerable households (e.g. cost of treatment) and in terms of lost labour and labour productivity. Most importantly, high rates of infant and child mortality and low life expectancy the major reasons for the observed fertility rates. Investments in health can reduce the cost of disease, increase labor productivity and reduce population growth.

5. Challenges Children’s frequent or incurable illness is a source of spouses’ lack of initiative coordination on financial decisions and further impoverishment; while parent’s frequent or incurable illness has a direct impact on children’s education and growth HIV-AIDS has a direct impact on the productivity and livelihood of the household and the extended family setting; Epidemics control has a direct impact on transactions, free movement of goods and services, as well as tourism The Quality and predictability of aid in the health sector has a direct effect on the National Budget and government investments

6. … challenges High demographic trend is one of the major causes of the depletion of natural resources and the subsequent poverty and hunger. High fertility rate of women has a negative impact on their productivity and hence their competiveness with men on the job market; Whereas according to the Rwandan vision 2020: the high fertility rate of women is linked to (2) a pro-birth culture (3) diminishing child death rates. Prevalence of major diseases, such as malaria and HIV/AIDS, together with malnutrition reduces the productivity of the population in general;

7. Strategies Health sensitive and enabling National budgeting in line with MDGs (4: child health, 5: mother health and 6: Combat); Enacting health sensitive and enabling laws and policies (penal code, Reproductive health policies,GBV law, children policies, etc.) Putting in place effective social/health insurance schemes that are accessible to the poor; Increase accessibility of health services/centers; Support non-State health initiatives Increased Extra-budget support in health sector;

8. Conclusion For countries that considers its population as its fundamental resource and banks on it for its future development, Investments in health can have a significant economic return, but can also contribute to reducing population growth, which constitutes a threat to the environment, agriculture, and to the economy

9. Murakoze Cyane