Rwanda of 1884 assigned the territory to Germany as part of German East Africa, marking the beginning of the colonial era. The explorer Gustav Adolf von Götzen was the first European to significantly explore the country in 1894; he crossed from the south-east to Lake Kivu and met the king. The Germans did not significantly alter the social structure of the country, but exerted influence by supporting the king and the existing hierarchy and delegating power to local chiefs. Belgian forces took control of Rwanda and Burundi in 1916, during World War I, beginning a period of more direct colonial rule.
Healthcare in Rwanda make referrals. Rwanda has a shortage of medical professionals, with only 0.84 physicians, nurses, and midwives per 1,000 residents in 2013. The United Nations Development Programme (UNDP) is monitoring the country's health progress towards Millennium Development Goals 4–6, which relate to healthcare. A mid-2015 UNDP report noted that the country was not on target to meet goal 4 on infant mortality, despite it having "fallen dramatically"; the country is "making good progress" towards goal 5, which is to reduce by three quarters the maternal mortality ratio, while goal 6 is not yet met as HIV prevalence has not started falling.