The number of specialist healthcare workers in Rwanda has risen significantly under a government programme to expand the workforce, with obstetrics and gynaecology recording more than a sixfold increase since 2023, Minister of Health Dr Sabin Nsanzimana has said.

Speaking on Thursday, March 19, before the parliamentary Committee on Governance and Gender Affairs, Nsanzimana addressed concerns raised in the Rwanda Governance Board (RGB) annual report for 2024/2025, particularly on health service delivery.

"The gaps highlighted in the report are largely linked to shortages of healthcare workers, but we are making steady progress through the 4x4 programme aimed at quadrupling the number of health professionals by 2028,” he said.

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The programme, approved in 2023, is beginning to yield results, although gaps persist in dental and ophthalmology services, which the government is now prioritising.

"The number of obstetrics and gynaecology specialists graduating annually has increased from 25 in 2022/2023 to 161. This is more than a sixfold rise,” he said, noting that the country previously faced a severe shortage, with public and private facilities competing for a limited pool of specialists.

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Private health facilities, particularly in Kigali, which handle about 70 per cent of daily patients, are also benefiting from the increased number of specialists.

Attention is now shifting to other critical areas. "We are focusing on increasing the number of ophthalmologists and dentists, because demand for these services remains high,” Nsanzimana said.

Training of gynaecologists has also been decentralised beyond major referral hospitals such as the University Teaching Hospital of Kigali (CHUK), King Faisal Hospital, Rwanda Military Hospital, and the University Teaching Hospital of Butare (CHUB).

"Previously, specialists were trained in only a few hospitals. We have now expanded training to at least 10 Level Two teaching hospitals across the country,” he said.

He added that each of these facilities has at least four qualified trainers, a move that has helped reduce unnecessary referrals to Kigali.

"Referrals are now largely limited to highly specialised cases such as cancer or advanced paediatric conditions,” he said.

Looking ahead, the government is preparing to absorb a growing number of graduates expected in the coming years.

"We are working with relevant institutions to ensure that by 2028, the system is ready to absorb the large number of specialists we are training. We do not want a situation where specialists are available but there are no positions for them,” Nsanzimana said.

Midwifery training has also expanded significantly, with annual intake rising from 72 to about 1,000 students.

"Midwives play a critical role in preventing maternal deaths, but their numbers were previously too low. In the past, a single midwife could assist many mothers in one night, leading to exhaustion and possible errors,” he said.

In nursing, annual student intake has increased from about 600 to 2,300.

However, the production of medical doctors remains below target. "This is a critical category because it is where we get specialists,” he said.

The number of graduating doctors has increased from about 200 to 360 annually, but the target is 1,000, a goal that will require significant investment.

Nsanzimana cited progress from institutions such as the University of Global Health Equity, while noting that more graduates are expected from other universities and from students studying abroad.

He acknowledged that shortages persist in general practitioners, partly because many have transitioned into specialist training.

"Many health facilities still face shortages of general practitioners, as those who were available have gone on to specialise,” he said.

Gaps also remain in laboratory services, radiography, anaesthesia, dental care, and emergency medicine.

"In many hospitals, non-physician anaesthetists and dentists are still few. We need to increase their numbers, just as we have done in other categories,” he said.

The minister also highlighted the revival of A2-level nursing programmes to strengthen frontline services.

"We are projecting about 3,000 associate nurses who will be deployed in health posts, health centres, and schools,” he said, noting that some schools already have infirmaries but lack qualified personnel.

Efforts are also underway to equip training institutions with simulation laboratories.

"Students should first practise on simulation equipment before working with patients. We are working to ensure institutions have the necessary tools,” Nsanzimana said.

"We need to strengthen all categories of health workers to ensure quality service delivery across the country.”