Photo: Smiling boy East Africa

Malaria burden

Rwanda has the 15th highest burden of malaria in the world (2% of all global malaria cases in 2019), but only the 29th highest death rate from malaria (1% of global malaria deaths in 2019). [1]

From 2005 to 2011, with scale up of successful interventions in Rwanda, malaria incidence declined by 86%, and inpatient malaria deaths declined by 74%. Similarly, malaria prevalence decreased from 2.6% in 2008 to 1.4% in 2010 among children under five years of age. From 2012 to 2016, however, malaria incidence increased every year in Rwanda. For example, the Malaria Indicator Survey (MIS) in 2017 indicated (by microscopy) a prevalence of 7.2% among children under five years of age as compared with 2.2% in the Demographic Health Survey (DHS) in 2014-2015. [2]

As a result of strong malaria case management, from 2017 to 2019, there was a 60% reduction in both severe malaria cases and malaria related deaths. Rwanda also made significant progress in reducing malaria incidence from 409/1000 population in 2016/17 to 290/1000 population in 2019. [2]

Together with the National Malaria Control Programme, support from partners has helped to decrease all-cause child death rates by 67 percent and reduce total malaria-related deaths by 53 percent countrywide from 2016 to 2018. [3]

Health-seeking behaviour

Among children seeking care for fever, 14 percent were seen in the private sector; and among women who reported treatment for malaria care, 88 percent listed a health center/post, 42 percent a community health worker, 13 percent a hospital, and 7 percent a private health facility (MIS 2017).

Prevention of malaria

In late 2016 and early 2017, the Government of Rwanda distributed over 5 million ITNs through a mass distribution campaign, increasing the proportion of the population with access to ITNs from 64% in 2014–2015 to 72% in 2017. [3]

Rwanda does not conduct seasonal malaria chemoprevention. Intermittent preventive treatment for pregnant women was discontinued in 2008 because of documented resistance to sulfadoxine-pyrimethamine (SP). [2] As of June 2019, 46 percent of pregnant women initiated ANC during the first trimester while 36 percent attended at least 4 ANC visits. [2]

National treatment guidelines
Uncomplicated  malaria Treatment
First-line treatment artemether-lumefantrine (AL)
 Severe malaria Treatment
Strong IV Artesunate
Alternative IV Quinine


Recommendation Prevention

(intermittent preventive treatment)

Recommendation Treatment
Uncomplicated oral quinine plus clindamycin (first trimester)
Uncomplicated AL (second and third trimesters)
Strong IV quinine (first trimester)