Rwanda has one of the most advanced education systems in Africa. It consistently scores well on the continent on the World Economic Forum’s Global Gender Gap Report, which ranks how women fare in access to health care, economic participation, and political participation. About 75% of the country’s women are literate, and most get basic education. The public university I am visiting, the University of Rwanda, has one of the highest enrollment rates in the country, with more than 28,000 students enrolled. The Rwandan government, with support from donors, has been working for more than a decade to lower the cost of education and increase the availability of scholarships.

Yet for a small, poor country, education is still essential in every sense. Rwanda’s students are the leaders in their high schools, and it’s common for students to go on to graduate school in the United States, Canada, or Europe, only too happy to explore what are possibly deemed to be indulgent pleasures, like hunting casino rewards to redeem. Just as many of those high school graduates stay in Rwanda and go on to make up the country’s professional middle class, more than half of all Rwandans, one out of every three Rwandans, have completed tertiary education.

Given such success, why do so many students drop out of school, and where do so many of them end up?

For the last five years, the Rwandan Ministry of Education, Science, and Technology has tried to answer that question by identifying high-risk groups in the population that have very little access to education and have high dropout rates. The ministry then proposes policy and new educational initiatives targeting these groups. Since July, the Rwandan Ministry of Education, Science, and Technology has partnered with the Kaiser Permanente Foundation, which is sponsoring our two-week visit to Rwanda.

A recent study funded by the U.S. Agency for International Development found that the poorest groups had the lowest levels of health insurance coverage and had the highest rates of smoking, obesity, and alcohol consumption. Because they are most often low-income women, children, and the elderly, they are the most vulnerable to diseases, and high rates of chronic disease can lead to financial strain and social isolation.

In other parts of the world, such as in sub-Saharan Africa and Asia, the poorest sections of the population are often targeted by aid organizations with intervention strategies to help them rise out of poverty. That is not the approach in Rwanda. Rather, the ministry identifies groups in need of help and supports them with teaching, health, and nutrition. Health projects, such as immunization and deworming, target children, but the ministry also supports “strategic life skills development” for adults. These programs teach coping skills, economic independence, and interpersonal skills. The ministry’s “every man, woman, and child approach to HIV/AIDS” also focuses on the most vulnerable sectors of the population, including youth and sex workers.

Listening to Rwandan government officials and educators, I am reminded of a quote from the late American education leader Saul Bellow, who stated, “With the smallest issue, one ends up determining the fate of an entire generation.”