Rwanda — one of the poorest countries in Africa with a per capita income estimated at $250 — has been in the forefront among African countries in developing and implementing alternative health financing strategies that attempt to improve equity and quality of health care for its citizens. In particular, Rwanda has played a lead role in designing and implementing district-based health insurance schemes known as mutuelles to raise revenues for health services for rural populations in a way that the population can afford. By 2006, data from Rwanda’s national information system indicated that nearly 70 percent of Rwanda’s population had enrolled in mutuelles and independent evaluations have found evidence of increased access and use of health care among beneficiaries, as well as lower levels of out of pocket spending.
The Global Health Financing Initiative hosted a discussion of the lessons learned in Rwanda to date with Caroline Kayonga, permanent secretary of the Ministry of Health of Republic of Rwanda. She shared experiences in scaling up community-based health insurance and reflect on challenges faced to reach universal coverage.
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