Rwanda continues to impress.
The Rwandan healthcare system now covers over 90% of the population, the highest coverage rate in Africa. The informal community-based health insurance (CBHI) scheme, known as Mutuelle de Santé, focuses mainly on maternal and child health. According to the East African, the scheme is one of the most successful on the continent and it is credited for the country’s lower maternal and infant mortality rates of over 70% since 2000.
CBHI was originally voluntary and when contributions became compulsory, many saw it as paving the way to national coverage. Rwanda’s potential model for Africa is pivotal to development, as the WHO estimates that 100 million people are pushed into poverty and 150 million suffer financial catastrophe because of out-of-pocket expenditure on health services every year. Kenya is now using the CBHI model in pilot programs, while Tanzania and Uganda are openly considering it.
Benjamin Chemouni argues that Rwanda’s expansion of health insurance coverage is made possible by the concentration of power in the ruling coalition. He says the CBHI policy and its implementation are forged through both political interests and ideology. Kenya, Tanzania, and Uganda are certainly different milieus than Rwanda, so time will tell how the CBHI programs would fare in other countries.
If any country could make this model a success, however, it’s Rwanda. I have written about Africa’s innovation leaps forward and Rwanda is at the fore. Pretty impressive from a country that has done so much rebuilding in just a few decades since massive conflict. We can’t help but root for Rwandans.