| Abstract: | Implementing change is far harder than making policy pronouncements that call for change. Rwanda, in the 20 years since the 1994 genocide, has made substantial progress in turning around its economy and in meeting key Millennium Development Goals (MDGs). Real GDP in Rwanda grew at a rate of over 8% per year in the past years, the percentage of the people living in poverty has dropped by 14%, and UNDP reports that Rwanda is on track to meeting many but not all MDGs by 2015. Rwanda's progress in economic and social spheres stands out in Africa, where many countries, despite commitments to the MDGs, lag behind on performance. The difference in Rwanda is the leadership's attention to implementation, and the incorporation of endogenous practices, particularly into planning and accountability. This article is based on observations of practice at national and community levels and of policy design and implementation. It is a by-product of a study of the impact of different approaches to community health delivery systems in Rwanda, completed as part of the author's doctoral dissertation, and also of the author's experience working within the government in Rwanda. |
