Monday, November 4, 2013

Health insurances

An old man showing Mutuelles for his family
For 19 years, Rwanda is actively drafting and implementing a series of essential and pro poor reforms within its various sectors of development. 
The Rwandan leadership under President Paul Kagame is committed to transform Rwanda into a middle income nation by the year 2020 also commonly known as the Vision 2020. Recently, the World bank's envoy to Rwanda Mr Denny Kalyalya praised Rwanda to be an example of all the countries in terms of using granted support. In his word, he said
"The things you are doing in Rwanda are not only seen here but also outside, your achievements make us proud, you have made progress and it this makes sense to support this progress."

This midget country of a thousand hills in the East Africa, is notable among others to be operating the most effective community based health insurance. The formulation of this community based health insurance is meant to facilitate easy access to health care nationwide. Rwandans particularly those from informal and rural economies are praising this scheme. Through risk pooling mechanism of this program, every Rwandan can get access to health care. However, not every Rwandan can afford the annual subscription to this scheme. Through our non profit, we are facilitating a community of poor in the outskirts of Kigali- Rwanda to benefit from this wonderful policy.
Subscription to the Rwanda's community based health insurance (also called mutuelle de sante) is voluntary and its premiums are priced and payable according to individuals' wealth status. Some media outlets in Rwanda reports of the poor being forced to pay their health insurances, but Rwanda's prime minister has ever since promised to address the issue. The scheme is highly subsidised by the central government itself and through her development partners.
Every year, improvements are being made on this program to respond to discovered glitches. Clearly, It is not a problem free, but what can be referred to as a good work in progress. The ministry of health in Rwanda shows how health indicators are being improved and there is a general rating that the scheme has helped all citizens get access to care irrespective of how much they earn. That said, there are still some pockets of communities who are still unable to buy their yearly premiums like the Cyaruzinge (formerly Bwiza) community which we work with. Each year and every day, families of this community are confronted with many competing ends to keep their families alive, getting food, water, clothing and sanitation is not at its best either. Saving for healthcare has not taken ground for this community live on hand to mouth basis. This assertion does not signify that this community does not plan for their future, but due to many competing ends to meet their day-to-day life they remain penniless. All that said, I personally consider them to be the most sophisticated economists. We are encouraged by the desire and local initiatives established by this community to develop themselves, we will continue working with them to achieve their goals. Till now we have been busy helping this community to purchase their health insurances and helping their children with school supplies needed on a yearly basis.
Some of the Bwiza community members showing their health insurance cards
Broadly speaking, we are aware that helping this community with health insurances, does not entirely remove their barriers to accessing health care. Difficulties remain for if a member of a family falls sick, he/she still have to pay an out of pocket equal to 10% of the care they receive at the local clinic, a demand which is most of the times remains latent. However, the solidarity and camaraderie among this community is playing a key role in supporting each other in case one falls ill and does not have immediate money to cover the costs of services. We are busy working with the community on a feasible plan to finding the lasting solution to this particular case so that the community members can be able to purchase their insurance on their own and become able to pay for services when they fall sick. I am optimistic that we will see some real change in this community. 



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