Reaching Every Child: How Rwanda Closed the Immunisation Gap One Village at a Time

Target 3.b – Ensure access to safe, effective, affordable and essential vaccines for all

For many countries, achieving near-universal access to childhood vaccines remains a long-term goal. For Rwanda, it became a non-negotiable.

Back in 2015, Rwanda already had one of the highest routine childhood immunisation rates in sub-Saharan Africa. National figures sat around 98 per cent. But averages don’t tell the full story. Beneath the surface, gaps remained. Some communities, particularly in remote hills and displaced settlements, were still being left behind.

The government took this seriously. They recognised that health outcomes are only as strong as the hardest-to-reach person in the system. So they focused on filling the final gaps, not just expanding coverage, but ensuring equity.

The strategy was practical. Local clinics received additional support to deploy mobile vaccination teams. These teams worked hand-in-hand with Rwanda’s network of community health workers, most of whom were already trusted by the families they served. Together, they mapped out unvaccinated children, identified under-covered areas, and scheduled visits based on the rhythms of local life, market days, farming calendars, and school terms.

Vaccines were transported using cold-chain boxes and solar-powered fridges to keep them viable, even in off-grid villages. Staff used digital records to track who had received what, and when. There were no luxury facilities, but there was organisation, trust, and follow-through.

What made the difference was the way community health workers were treated as full partners. They weren’t just volunteers, they were trained, equipped and respected. In most cases, they came from the communities they served. They understood the language, the customs, and the fears. When a parent was unsure about a vaccine, it wasn’t an outsider who answered. It was their neighbour.

Between 2015 and 2020, Rwanda quietly achieved something extraordinary. They didn’t just maintain high vaccination coverage. They closed the equity gap. Coverage levels in rural districts matched those in urban centres. Uptake was equal across genders. There was no significant difference between rich and poor households. The final 2 per cent had been reached, not through top-down mandates, but by local coordination and patient, door-to-door care.

The impact stretched beyond disease prevention. With children less likely to fall ill, attendance at pre-school and primary school improved. Clinics, no longer overwhelmed by preventable illnesses, could focus on other needs. Parents spent less on medicine and transport. Maternal health services improved because women trusted the system more. And when COVID-19 arrived in 2020, Rwanda’s vaccination infrastructure, already built for scale, speed and community trust, gave the country a head start.

Today, Rwanda is considered a global example of how low-income countries can deliver high-quality healthcare when systems are designed from the ground up. Their immunisation strategy didn’t rely on major capital investment. It relied on public will, policy consistency, and a deep respect for the people doing the hard work in the field.

This is what SDG 3.b looks like in action. It’s not just about access to medicine, it’s about ensuring equal, reliable delivery in real-world conditions. Rwanda didn’t accept 98 per cent as “good enough.” They went after the final mile, and they didn’t stop until they got there.

Your Voice. Your Target. Your Legacy.

If your school, clinic, council or organisation wants to build health access that truly reaches everyone, follow Rwanda’s lead. Map the gaps. Invest in trusted people. Prioritise the final 2 per cent. Prove that equity is not an ideal, it’s a deliverable.

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