Education and Health
The Rwandan government provides free education in state-run schools for nine years: six years in primary and three years following a common secondary programme. President Kagame announced during his 2010 re-election campaign that he plans to extend this free education to cover the final three secondary years. Many poorer children still fail to attend school due to the necessity of purchasing uniforms and books and commitments at home. There are many private schools across the country, some church-run, which follow the same syllabus but charge fees. A very small number offer international qualifications. From 1994 until 2009, secondary education was offered in either French or English; due to the country's increasing ties with the East African Community and the Commonwealth, only the English syllabi are now offered. The country has a number of institutions of tertiary education, with the National University of Rwanda (UNR), Kigali Institute of Science and Technology (KIST), and Kigali Institute of Education (KIE) being the most prominent. In 2009, the gross enrolment ratio for tertiary education in Rwanda was 5%. The country's literacy rate, defined as those aged 15 or over who can read and write, was 71% in 2009, up from 38% in 1978 and 58% in 1991.
The quality of healthcare is generally low, but improving. It once was that one in five children died before their fifth birthday, often from malaria., however, infant mortality has dropped to half of what it was in the period 2005-2010. There is a shortage of qualified medical professionals in the country, and some medicines are in short supply or unavailable. 87% have access to healthcare but there are only two doctors and two paramedics per 100,000 people. The government is seeking to improve the situation as part of the Vision 2020 development programme. In 2008, the government spent 9.7% of national expenditure on healthcare, compared with 3.2% in 1996. It also set up training institutes including the Kigali Health Institute (KHI). Health insurance became mandatory for all individuals in 2008; in 2010 over 90% of the population was covered. Prevalence of some diseases is declining, including the elimination of maternal and neonatal tetanus and a sharp reduction in malaria morbidity, mortality rate, and specific lethality, but Rwanda's health profile remains dominated by communicable diseases. HIV/AIDS seroprevalence in the country is classified by the World Health Organization as a generalized epidemic; an estimated 7.3% of urban dwellers and 2.2% of rural dwellers, aged between 15 and 49, are HIV positive.
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—Thomas Jefferson (1743–1826)