The republic of Rwanda is located in Central and East Africa sharing borders with Uganda, Tanzania, Burundi, and Republic democratic of Congo (Fig. 1). Rwanda is a small mountainous and landlocked country with an area of 26,338 km2; with a population of about 11,457,801 in 2012 and the population density is the highest in Sub‐Saharan Africa (414 inhabitants per square km in 2012) (NISR 2014). The population is essentially young, with 52% of all Rwandans under the age of 20 and life expectancy at birth is estimated at 52.7 years (UNDP, 2007). Rwanda is a low‐income country, most (85%) of the Rwandan population live and work in rural areas, where poverty is predominant. Figure 1 Political maps of Rwanda. Rwanda was a Belgian colony since 1923, until 1962, when it was granted full independence. In 1994, Rwanda experienced the Tutsi genocide, during which almost 1,000,000 people were killed in only 100 days, thus destroying the entire social and economic fabric of the country. At that time, Rwanda was among the poorest countries in the world (Farmer et al. 2013). Rwanda's under‐5 mortality rate that year was the highest in the world; life expectancy at birth would remain the lowest anywhere through the next few years (Binagwaho et al. 2014). Moreover, the Government of Rwanda implemented some strategies for poverty reduction and economic growth, by designing a national development plan, which led to a document called Vision 2020 (MINECOFIN 2000). The Vision 2020 goals seek to transform Rwanda from a low‐income agriculture‐based economy to a knowledge‐based, service‐oriented economy with a middle‐income country status by 2020. Rwanda is on track to meet most of the millennium development goals by 2015, one evidence is a two‐thirds drop in the child mortality (NISR 2014).