The East African reports that Rwanda has achieved universal health care with more than 90% of its citizens covered under the community-based health insurance scheme known as Mutuelle de Santé. Rwanda had always been a trail-blazer in health coverage in the Sub-Saharan region and the consistent improvements have been nothing short of remarkable considering the history of the country.
The World Health Organisation says the gains in the health sector have been driven by economic growth averaging 8.2% per year. The WHO country brief says, “Major health reforms took place, including the health insurance improvement, which aims to guarantee access for all to health care; and experience from Rwanda has shown that it is possible to achieve universal health coverage in a country with 90% of its population in the informal sector.”
Earlier this year, President Kagame presented in Geneva where he said, “In Rwanda, a combination of community-based health insurance, community health workers, and good external partnerships led to the steepest reductions in child and maternal mortality ever recorded.” The country’s constitution in Articles 41 and 45 provides for the right to health and the universal care system has been adopted as a way to fulfil this mandate. Two-thirds of the costs for health coverage are borne by the beneficiaries while a third is subsidised by the government.
Kenya recently started following Rwanda’s footsteps by launching a pilot programme which is expected to set the country for a national launch. Uganda has been sitting on a Bill to jumpstart its own process for eleven years. Tanzania’s bill is also yet to be passed but the process is gathering steam. Tanzania has at least four health insurance schemes already but only 32% of the citizens are covered. The fire from Rwanda is clearly going to spread throughout the continent. Even the United States of America could learn a lot from Rwanda’s insurance system!