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Paying for health in two Rwandan provinces: financial flows and flaws
Author(s) -
Kalk Andreas,
Mayindo Jean Kagubare,
Musango Laurent,
Foulon Gerard
Publication year - 2005
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2005.01464.x
Subject(s) - business , equity (law) , health care , population , incentive , health policy , scope (computer science) , finance , actuarial science , economic growth , medicine , environmental health , economics , political science , programming language , computer science , law , microeconomics
Summary The study intended to analyse the financial flows in two provinces within the Rwandan health system through the review of all available documentation and through interviews with key informants, to assess the scope for improved resource allocation. In Rwanda, there exists a large deficit of available financial resources in the health sector in general, and more specifically at health centre level. To improve this situation, it is considered to cover a large proportion of the entire population by mutual health insurance schemes. The schemes are able to pool certain risks, and they definitely improve financial access to health services. Nonetheless, they are inaccessible to the ‘very poor’, and – due to their limited financial base – they are unable to cover a complementary health care package. It is unlikely that they will mobilize substantial additional resources for health. External long‐term commitments are required to cover this gap. A reassurance and readjustment system between the various insurance schemes should be established in order to increase financial protection provided. It might link up with insurance schemes in the formal employment sector. The combination of such a support for health insurance with performance‐related incentives for health staff has the potential to increase both equity and quality of health services simultaneously and substantially.