Kigali, Rwanda – The National Institute of Statistics of Rwanda (NISR) on December 17 released the 2025 Rwanda Demographic and Health Survey (RDHS), offering a comprehensive snapshot of population dynamics and health outcomes across the country.
As the seventh survey in the DHS series since 1992, RDHS 2025 once again underscores Rwanda’s strong culture of evidence-based policymaking and accountability.
Overall, the findings point to a health system that continues to deliver tangible gains, particularly in maternal and child health, fertility reduction and access to services.
At the same time, the data reveals emerging and persistent challenges, notably the rise in teenage pregnancy and the slow pace of stunting reduction, calling for more targeted and coordinated interventions.
Conducted nationwide between June and October 2025, the survey provides nationally representative data for urban and rural areas, provinces and selected districts.
Officials described the results as broadly encouraging, while stressing that progress must be safeguarded and accelerated where gaps remain.
Fertility decline and expanding family planning
The survey confirms a continued decline in fertility, reflecting changing family size preferences and improved access to reproductive health services.
The total fertility rate among women aged 15 to 49 has dropped to 3.7 children per woman, down from 4.1 recorded in the 2019–2020 survey. The decline is visible across all provinces, with the sharpest reductions in urban areas, though rural fertility has also steadily decreased.
This trend closely mirrors increased uptake of family planning. The survey shows that 64 percent of married women now use modern contraceptive methods, up from 58 percent five years ago, while overall demand for family planning stands at 78 percent.
NISR Director General Ivan Murenzi said the figures demonstrate steady progress but also the importance of sustained effort. “In population and social indicators, it is never enough to reach a certain level and stop,” he said.
“Our role as a statistics institution is to show where the country stands, measure progress against national goals, and help decision-makers ask what more is needed to move forward,” he added.
Teenage pregnancy and shifting adolescent risks
Despite the positive fertility trend, teenage pregnancy has emerged as one of the most concerning findings. The survey shows that pregnancies among girls aged 15 to 19 have increased to 8%, compared to 5% in the previous survey.
The increase is most pronounced among adolescents with lower levels of education, highlighting persistent vulnerabilities linked to school dropout, poverty and limited access to age-appropriate sexual and reproductive health information.
Minister of Health Dr Sabin Nsanzimana described the rise as a clear warning sign. “Most indicators are moving in the right direction, but teenage pregnancy is a clear exception,” he said.
“This is not a new problem, but the data confirms that it remains serious and is worsening. Prevention efforts must be strengthened, especially through education, protection and targeted adolescent health services.”
He added that teenage pregnancy is closely linked to higher risks of neonatal complications, maternal health problems and child stunting, reinforcing the need for multi-sectoral responses that go beyond the health system alone.
Strong gains in maternal and child health
Maternal and child health indicators continue to show significant improvement, consolidating Rwanda’s standing as a regional leader in primary healthcare.
The maternal mortality ratio has declined from 203 to 149 deaths per 100,000 live births, while infant mortality has fallen to 27 deaths per 1,000 live births. Under-five mortality now stands at 36 per 1,000.
Nearly all births in Rwanda are now assisted by skilled health providers, and 98 percent take place in health facilities. Antenatal care coverage has expanded markedly, with 78 percent of women completing at least four visits during pregnancy, a major increase particularly in rural areas.
However, neonatal mortality has declined more slowly than other child survival indicators, pointing to the need for further improvements in the quality of care during pregnancy, delivery and the immediate postnatal period.
Health authorities say newborn survival will remain a priority as the country works to further reduce preventable deaths.
Nutrition, access and quality of care
Child nutrition indicators show gradual but uneven improvement. Stunting among children under five has declined from 33 percent to 27 percent, confirming a long-term downward trend.
Yet the rate of decline, estimated at about one percent per year, remains below national targets, and stunting continues to affect several districts, particularly in rural areas. Minister Nsanzimana emphasized that stunting is a broader development challenge.
“Nutrition outcomes depend on food systems, education, sanitation and household income, not health services alone,” he said, pointing to ongoing initiatives such as accelerated stunting reduction programs, improved access to clean water and nutrition support.
Access to health services remains one of Rwanda’s strongest achievements, standing at 98 percent nationwide.
With geographic access largely secured, attention is shifting toward service quality, efficiency and patient experience. Investments in real-time data systems, including the Health Intelligence Centre, are expected to strengthen decision-making and save lives.
For many families, these improvements are already visible. Theogene Muvunyi, a resident of Nyamirambo in Nyarugenge district and a father of two, said regular medical follow-up during his wife’s pregnancies gave them confidence.
“Doctors closely monitor her health, advise us on nutrition and provide supplements,” he said. “Even though public hospitals can be busy, health workers make an effort. You feel safer knowing both the mother and baby are a priority, and if there is any complication, help is immediately available.”
According to the 2025 Demographic and Health Survey report, the gains are real and measurable, but sustaining them will require sharper focus on adolescents, newborns and children facing chronic malnutrition, ensuring that progress reaches every household.
