Journal articles: 'Health insurance – Rwanda'

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Vogel, L. "Rwanda hikes premiums in health insurance overhaul." Canadian Medical Association Journal 183, no. 13 (August 8, 2011): E973—E974. http://dx.doi.org/10.1503/cmaj.109-3956.

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Woode, Maame Esi, Marwân-al-Qays Bousmah, and Raouf Boucekkine. "PARENTAL MORBIDITY, CHILD WORK, AND HEALTH INSURANCE IN RWANDA." Journal of Demographic Economics 83, no. 1 (December 5, 2016): 111–27. http://dx.doi.org/10.1017/dem.2016.28.

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AbstractMeasuring direct and indirect effects of extending health insurance coverage in developing countries is a key issue for health system development and for attaining universal health coverage. This paper investigates the role played by health insurance in the relationship between parental morbidity and child work decisions. We use a propensity score matching technique combined with hurdle models, using data from Rwanda. The results show that parental health shocks have a substantial influence on child work when households do not have health insurance. Depending on the gender of the sick parent, there is a substitution effect not only between the parent and the child on the labor market, but also between the time the child spends on different work activities. Altogether, results reveal that health insurance protects children against child work in the presence of parental health shocks.

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Twahirwa, Aimable. "Sharing the burden of sickness: mutual health insurance in Rwanda." Bulletin of the World Health Organization 86, no. 11 (November 1, 2008): 823–24. http://dx.doi.org/10.2471/blt.08.021108.

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Schneider, Pia. "Trust in micro-health insurance: an exploratory study in Rwanda." Social Science & Medicine 61, no. 7 (October 2005): 1430–38. http://dx.doi.org/10.1016/j.socscimed.2004.11.074.

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Ruhara, Charles Mulindabigwi, and Josue Mbonigaba. "The Role of Economic Factors in the Choice of Medical Providers in Rwanda." Journal of Economics and Behavioral Studies 8, no. 2(J) (May 11, 2016): 65–78. http://dx.doi.org/10.22610/jebs.v8i2(j).1255.

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The purpose of this paper is to investigate the role of economic factors in choosing alternative service providers and to recommend suitable measures that could be taken to improve the use of health services in Rwanda. The study uses a multinomial logit framework and employs the Integrated Household Living Conditions Survey (EICV2) conducted in 2005 by the National Institute of Statistics of Rwanda (NISR). To handle the problem of endogeneity, we estimate a structural model. The results indicate that health insurance is an important factor in the choice of health facilities. User fees are major financial barriers to health care access in Rwanda. The results suggest that as household income increases, patients shift from public to private health facilities where quality is assumed to be high. A number of policy recommendations emerge from these findings. First, as insurance is an important factor in choosing a health care facility, policies that reduce health care costs to patients would substantially increase the use of health services. Second, since an increase in income allows the patient to shift to private facilities, the government should consider subsidizing private health facilities to enable access to care in private sector facilities by low-income households. Finally, since distance affects access to health care in Rwanda, there is a need to improve geographical accessibility to health facilities across regions by upgrading and expanding transportation and health infrastructures.

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Woode, Maame Esi. "Parental health shocks and schooling: The impact of mutual health insurance in Rwanda." Social Science & Medicine 173 (January 2017): 35–47. http://dx.doi.org/10.1016/j.socscimed.2016.11.023.

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Schmidt, Jean-Olivier, Jean K. Mayindo, and Andreas Kalk. "Thresholds for health insurance in Rwanda: who should pay how much?" Tropical Medicine and International Health 11, no. 8 (August 2006): 1327–33. http://dx.doi.org/10.1111/j.1365-3156.2006.01661.x.

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Rubagumya, Fidel, Ainhoa Costas-Chavarri, Achille Manirakiza, Gad Murenzi, Francois Uwinkindi, Christian Ntizimira, Ivan Rukundo, et al. "State of Cancer Control in Rwanda: Past, Present, and Future Opportunities." JCO Global Oncology, no. 6 (September 2020): 1171–77. http://dx.doi.org/10.1200/go.20.00281.

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Rwanda is a densely populated low-income country in East Africa. Previously considered a failed state after the genocide against the Tutsi in 1994, Rwanda has seen remarkable growth over the past 2 decades. Health care in Rwanda is predominantly delivered through public hospitals and is emerging in the private sector. More than 80% of patients are covered by community-based health insurance (Mutuelle de Santé). The cancer unit at the Rwanda Biomedical Center (a branch of the Ministry of Health) is responsible for setting and implementing cancer care policy. Rwanda has made progress with human papillomavirus (HPV) and hepatitis B vaccination. Recently, the cancer unit at the Rwanda Biomedical Center launched the country’s 5-year National Cancer Control Plan. Over the past decade, patients with cancer have been able to receive chemotherapy at Butaro Cancer Center, and recently, the Rwanda Cancer Center was launched with 2 linear accelerator radiotherapy machines, which greatly reduced the number of referrals for treatment abroad. Palliative care services are increasing in Rwanda. A cancer registry has now been strengthened, and more clinicians are becoming active in cancer research. Despite these advances, there is still substantial work to be done and there are many outstanding challenges, including the need to build capacity in cancer awareness among the general population (and shift toward earlier diagnosis), cancer care workforce (more in-country training programs are needed), and research.

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Strobl, Renate. "Does Health Insurance Reduce Child Labour and Education Gaps? Evidence from Rwanda." Journal of Development Studies 53, no. 9 (November 16, 2016): 1376–95. http://dx.doi.org/10.1080/00220388.2016.1224854.

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Barasa, Edwine, Jacob Kazungu, Peter Nguhiu, and Nirmala Ravishankar. "Examining the level and inequality in health insurance coverage in 36 sub-Saharan African countries." BMJ Global Health 6, no. 4 (April 2021): e004712. http://dx.doi.org/10.1136/bmjgh-2020-004712.

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IntroductionLow/middle-income countries (LMICs) in sub-Saharan Africa (SSA) are increasingly turning to public contributory health insurance as a mechanism for removing financial barriers to access and extending financial risk protection to the population. Against this backdrop, we assessed the level and inequality of population coverage of existing health insurance schemes in 36 SSA countries.MethodsUsing secondary data from the most recent Demographic and Health Surveys, we computed mean population coverage for any type of health insurance, and for specific forms of health insurance schemes, by country. We developed concentration curves, computed concentration indices, and rich–poor differences and ratios to examine inequality in health insurance coverage. We decomposed the concentration index using a generalised linear model to examine the contribution of household and individual-level factors to the inequality in health insurance coverage.ResultsOnly four countries had coverage levels with any type of health insurance of above 20% (Rwanda—78.7% (95% CI 77.5% to 79.9%), Ghana—58.2% (95% CI 56.2% to 60.1%), Gabon—40.8% (95% CI 38.2% to 43.5%), and Burundi 22.0% (95% CI 20.7% to 23.2%)). Overall, health insurance coverage was low (7.9% (95% CI 7.8% to 7.9%)) and pro-rich; concentration index=0.4 (95% CI 0.3 to 0.4, p<0.001). Exposure to media made the greatest contribution to the pro-rich distribution of health insurance coverage (50.3%), followed by socioeconomic status (44.3%) and the level of education (41.6%).ConclusionCoverage of health insurance in SSA is low and pro-rich. The four countries that had health insurance coverage levels greater than 20% were all characterised by substantial funding from tax revenues. The other study countries featured predominantly voluntary mechanisms. In a context of high informality of labour markets, SSA and other LMICs should rethink the role of voluntary contributory health insurance and instead embrace tax funding as a sustainable and feasible mechanism for mobilising resources for the health sector.

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Ejughemre, Ufuoma John. "Scaling-up health insurance through community- based health insurance schemes in rural sub- Saharan African communities." Journal of Hospital Administration 3, no. 1 (September 12, 2013): 14. http://dx.doi.org/10.5430/jha.v3n1p14.

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Context: The knotty and monumental problem of health inequality and the high burden of diseases in sub-Saharan Africa bothers on the poor state of health of many of its citizens particularly in rural communities. These issues are further exacerbated by the harrowing conditions of health care delivery and the poor financing of health services in many of these communities. Against these backdrops, health policy makers in the region are not just concerned with improving peoples’ health but with protecting them against the financial costs of illness. What is important is the need to support more robust strategies for healthcare financing in these communities in sub-Saharan Africa. Objective: This review assesses the evidence of the extent to which community-based health insurance (CBHI) is a more viable option for health care financing amongst other health insurance schemes in rural communities in sub-Saharan Africa. Patterns of health insurance in sub-Saharan Africa: Theoretically, the basis for health insurance is that it allows for risk pooling and therefore ensures that resources follow sick individuals to seek health care when needed. As it were, there are different models such as social, private and CBHI schemes which could come to bear in different settings in the region. However, not all insurance schemes will come to bear in rural settings in the region. Community based health insurance: CBHI is now recognized as a community-initiative that is community friendly and has a wide reach in the informal sector especially if well designed. Experience from Rwanda, parts of Nigeria and other settings in the region indicate high acceptability but the challenge is that these schemes are still very new in the region. Recommendations and conclusion: Governments and international development partners in the region should collect- ively develop CBHI as it will help in strengthening health systems and efforts geared towards achieving the millennium development goals. This is because it is inextricably linked to the health care needs of the poor.

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Chemouni, Benjamin. "The political path to universal health coverage: Power, ideas and community-based health insurance in Rwanda." World Development 106 (June 2018): 87–98. http://dx.doi.org/10.1016/j.worlddev.2018.01.023.

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Habimana Kabano, Ignace, Annelet Broekhuis, and Pieter Hooimeijer. "Fertility Decline in Rwanda: Is Gender Preference in the Way?" International Journal of Population Research 2013 (June 6, 2013): 1–9. http://dx.doi.org/10.1155/2013/787149.

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In 2007 Rwanda launched a campaign to promote 3 children families and a program of community based health services to improve reproductive health. This paper argues that mixed gender offspring is still an important insurance for old age in Rwanda and that to arrive at the desired gender composition women might have to progress beyond parity 3. The analyses are twofold. The first is the parity progression desire given the gender of living children. The second is gender specific replacement intention following the loss of the last or only son or daughter. Using the Demographic and Health Surveys of 2000, 2005, and 2010, we show that child mortality does not lead to extra parity progression beyond three, while having single gender offspring does and even more so when this is the result of the loss of the last son or daughter.

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Saksena, Priyanka, Adélio Fernandes Antunes, Ke Xu, Laurent Musango, and Guy Carrin. "Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection." Health Policy 99, no. 3 (March 2011): 203–9. http://dx.doi.org/10.1016/j.healthpol.2010.09.009.

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Makaka, Andrew, Sarah Breen, and Agnes Binagwaho. "Universal health coverage in Rwanda: a report of innovations to increase enrolment in community-based health insurance." Lancet 380 (October 2012): S7. http://dx.doi.org/10.1016/s0140-6736(13)60293-7.

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Liu, Kai, Benjamin Cook, and Chunling Lu. "Health inequality and community-based health insurance: a case study of rural Rwanda with repeated cross-sectional data." International Journal of Public Health 64, no. 1 (June 8, 2018): 7–14. http://dx.doi.org/10.1007/s00038-018-1115-5.

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Mukangendo, Mecthilde, Manasse Nzayirambaho, Regis Hitimana, and Assumpta Yamuragiye. "Factors Contributing to Low Adherence to Community-Based Health Insurance in Rural Nyanza District, Southern Rwanda." Journal of Environmental and Public Health 2018 (December 18, 2018): 1–9. http://dx.doi.org/10.1155/2018/2624591.

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Background. Community-based health insurance (CBHI) schemes are an emerging mechanism for providing financial protection against health-related poverty. In Rwanda, CBHI is being implemented across the country, and it is based on four socioeconomic categories of the “Ubudehe system”: the premiums of the first category are fully subsidized by government, the second and third category members pay 3000 frw, and the fourth category members pay 7000 frw as premium. However, low adherence of community to the scheme since 2011 has not been sufficiently studied. Objective. This study aimed at determining the factors contributing to low adherence to the CBHI in rural Nyanza district, southern Rwanda. Methodology. A cross-sectional study was conducted in nine health centers in rural Nyanza district from May 2017 to June 2017. A sample size of 495 outpatients enrolled in CBHI or not enrolled in the CBHI scheme was calculated based on 5% margin of error and a 95% confidence interval. Logistic regression was used to identify the determinants of low adherence to CBHI. Results. The study revealed that there was a significant association between long waiting time to be seen by a medical care provider and between health care service provision and low adherence to the CBHI scheme (P value < 0.019) (CI: 0.09107 to 0.80323). The estimates showed that premium not affordable (P value < 0.050) (CI: 0.94119 to 9.8788) and inconvenient model of premium payment (P value < 0.001) (CI: 0.16814 to 0.59828) are significantly associated with low adherence to the CBHI scheme. There was evidence that the socioeconomic status as measured by the category of Ubudehe (P value < 0.005) (CI: 1.4685 to 8.93406) increases low adherence to the CBHI scheme. Conclusion. This study concludes that belonging to the second category of the Ubudehe system, long waiting time to be seen by a medical care provider and between services, premium not affordable, and inconvenient model of premium payment were significant predictors of low adherence to CBHI scheme.

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Chankova, Slavea, Laurel Hatt, and Sabine Musange. "A community-based approach to promote household water treatment in Rwanda." Journal of Water and Health 10, no. 1 (January 24, 2012): 116–29. http://dx.doi.org/10.2166/wh.2012.071.

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Treatment of drinking water at the household level is one of the most effective preventive interventions against diarrhea, a leading cause of illness and death among children in developing countries. A pilot project in two districts in Rwanda aimed to increase use of Sûr'Eau, a chlorine solution for drinking water treatment, through a partnership between community-based health insurance schemes and community health workers who promoted and distributed the product. Evaluation of the pilot, drawing on a difference-in-differences design and data from pre- and post-pilot household surveys of 4,780 households, showed that after 18 months of pilot implementation, knowledge and use of the product increased significantly in two pilot districts, but remained unchanged in a control district. The pilot was associated with a 40–42 percentage point increase in ever use, and 8–9 percentage points increase in use of Sûr'Eau at time of the survey (self-reported measures). Our data suggest that exposure to inter-personal communication on Sûr'Eau and hearing about the product at community meetings and health centers were associated with an increase in use.

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Woldemichael, Andinet, Daniel Gurara, and Abebe Shimeles. "The Impact of Community Based Health Insurance Schemes on Out-of-Pocket Healthcare Spending: Evidence from Rwanda." IMF Working Papers 19, no. 38 (2019): 1. http://dx.doi.org/10.5089/9781484398074.001.

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Nkurunziza, Joseph, Annelet Broekhuis, and Pieter Hooimeijer. "Do Poverty Reduction Programmes Foster Education Expenditure? New Evidence from Rwanda." Journal of Asian and African Studies 52, no. 4 (August 4, 2015): 425–43. http://dx.doi.org/10.1177/0021909615595988.

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The Rwandan Government has implemented various education policies that contribute to higher enrolment in education, but has become aware that these policies might be less effective for children from poor families. This study investigates the contribution of poverty reduction programmes on education expenditure of households. Using a multi-level regression analysis, combining district data on labour markets with detailed expenditure data on 7,230 households, it teases out the effects of several social protection programmes. The results show that access to health insurance and to waged work are positively related, while direct financial or in kind support are negatively related to paying into the children’s schooling. Non-agricultural employment opportunities in particular seem to stimulate education investments. Reducing the vulnerability of households might provide more equal access to these opportunities.

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Schneider, Pia, and Kara Hanson. "Horizontal equity in utilisation of care and fairness of health financing: a comparison of micro-health insurance and user fees in Rwanda." Health Economics 15, no. 1 (2005): 19–31. http://dx.doi.org/10.1002/hec.1014.

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Ruhara, Mulindabigwi Charles. "Effect of Health Insurance on Demand for Outpatient Medical Care in Rwanda: An Application of the Control Function Approach." Rwanda Journal 3, no. 1 (October 6, 2016): 77. http://dx.doi.org/10.4314/rj.v3i1.6b.

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Zeng, Wu, Angelique K. Rwiyereka, Peter R. Amico, Carlos Ávila-Figueroa, and Donald S. Shepard. "Efficiency of HIV/AIDS Health Centers and Effect of Community-Based Health Insurance and Performance-Based Financing on HIV/AIDS Service Delivery in Rwanda." American Journal of Tropical Medicine and Hygiene 90, no. 4 (April 2, 2014): 740–46. http://dx.doi.org/10.4269/ajtmh.12-0697.

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Ndabarora, Eléazar, Védaste Ngirinshuti, Jean Claude Twahirwa, Dariya Mukamusoni, Fulgence Munyandamutsa, and Joseph Rurabiyaka. "Prevalence of diabetes mellitus and factors associated with screening uptake in Kanjongo, Nyamasheke District, Rwanda." KIBOGORA POLYTECHNIC SCIENTIFIC JOURNAL 1, no. 1 (April 11, 2018): 6–10. http://dx.doi.org/10.33618/kpscj.2018.01.002.

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The prevalence of diabetes mellitus in Sub-Saharan Africa was 13.7% in 2016 (Werfalli, Engel, Musekiwa, Kengne, & Levitt, 2016), which is higher than 8.7%, the global diabetes prevalence in 2015 (WHO, 2016). Fewer studies explored the factors associated with diabetes early detection for its prevention and control (WHO, 2016). Study objectives were: (1) to determine the prevalence of diabetes mellitus among the population attending the monthly community work in a selected sector, and (2) to identify the factors associated with diabetes screening and early detection. All 383 respondents who were attending the community monthly work were invited to be screened for diabetes and to be surveyed using an interview-guide questionnaire. Out of 383 respondents, 60.3% were female and 39.7% were male. The prevalence of diabetes was 8.6%, and only 27.9% have been tested before. The majority (95.3%) perceived regular testing beneficial, 62.4% perceived themselves susceptible to get diabetes, and 94.8% perceived diabetes as a serious disease. The sources of information were radio and television (89.6%), health care staff (79.4%), mass campaigns (73.1%), Community Health Workers (CHWs) (67.1%), and the neighbors (57.7%). Reported barriers to screening were lack of information (87.5%), delay of health insurance (79.1%), lack of readiness of the health care staff (75.7%), perceived quality of health care (52.2%) and the perceived cost (46.5%). The factors associated with the screening were the age (p=0.01), occupation (p<0.000), the perceived susceptibility (p˂ 0.000), the perceived threat (p=0.005), community sensitization by CHWs (p=0.003), mass campaign (p=0.001), and neighbors (p=0.009). Diabetes prevalence was lower than the Sub-Saharan prevalence estimates. Community sensitization through CHWs, mass campaigns and neighbors, information provision, disease perception, age, occupation, and quality of health care were the predictors of diabetes screening. Decentralized community sensitization and screening programs are highly recommended.

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Ndabarora, Eléazar, Clemence Nishimwe, Clarte Ndikumasabo, Jean Claude Twahirwa, Jean de la Croix Muvandimwe, Elysée Hitayezu, and Ezechiel Bizimana. "Prevalence of hypertension and factors associated with screening uptake in Kanjongo, Nyamasheke District, Rwanda." KIBOGORA POLYTECHNIC SCIENTIFIC JOURNAL 1, no. 1 (April 11, 2018): 15–19. http://dx.doi.org/10.33618/kpscj.2018.01.004.

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Hypertension in Africa was estimated to 30.8% in 2010 with dramatic increase in some regions ranging between 36.2%-77.3% (Adeloye & Basquill, 2014). In Rwanda, the prevalence of hypertension was estimated to 15.3%, but the factors associated with screening uptake were not explored (Nahimana et al., 2017). The study objectives were: (1) to determine the prevalence of hypertension among the population attending the monthly community work” Umuganda” in a selected sector, and (2) to identify the factors associated with screening uptake. Data were collected using an interview questionnaire, the blood pressure was at the same time measured, and analytic cross-sectional design was adopted. The respondents were 383, of them 60.3% were female and 39.7% were male, aged between 18-34 years old (30.5%), 35-49 years old (39.4%), and 50 years and above (30.0%). The prevalence of hypertension was 17.5%, and 46.5% have never been tested before. The majority (96.3%) planned to get tested regularly, 95.6% perceived hypertension as a serious disease, and 64.8% perceived themselves susceptible to get hypertension. Sources of information were media (89.6%), health staff (79.4%), campaigns (73.1%), Community Health Workers (CHWs) (67.1%), and neighbors (57.7%). Reported barriers to screening were lack of information (87.5%), delay of health insurance (79.1%), lack of readiness of the health care staff (75.7%), perceived quality of health care delivery (52.2%), and the perceived cost (46.5%). Factors influencing the screening were gender (Chi-square 7.82, p=0.004), age (Chi-square 8.35, p=0.015), and occupation (Chi-square 19.53, p˂0.000). The perceived susceptibility influenced the perceived severity (Chi-square 33.51, p˂0.000), community sensitization (Chi-square 5.52, p=0.019), and perceived benefits (Chi-square 9.08, p=0.003). Hypertension prevalence was higher than the national estimates. Perceived susceptibility, community sensitization, age, gender and occupation were the key factors influencing the screening uptake. Community-based interventions to increase awareness and screening of hypertension are highly recommended.

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Sibomana, Providence, and Aline Ingabire. "Contribution of women entrepreneurs’ initiatives to community welfare in Kanjongo, Nyamasheke District, Rwanda." KIBOGORA POLYTECHNIC SCIENTIFIC JOURNAL 1, no. 1 (April 11, 2018): 37–46. http://dx.doi.org/10.33618/kpscj.2018.01.007.

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Entrepreneurship has been a male-dominated phenomenon from the very early age, but time has changed the situation and brought women as today's most memorable and inspirational entrepreneurs. In almost all the developed countries in the world women are putting their steps at par with the men to increase the productivity of their society. This study has been done purposely to show the contribution of women in country development starting from them towards surroundings in Kanjongo sector of Nyamasheke district, Western province of Rwanda. The socioeconomic contribution of women in community development has been assessed using interview; the economic benefits analysis has been conducted to compare the women entrepreneurs’ status before and after being engaged in entrepreneurial activity. The results indicated that 37.21% of women contributed to the payment of health insurance for themselves and families while they were only 15.12% before. The capacity of paying school fees for their children has increased from 12.79% to 24.42%. The capacity of saving above 50,000 Frw has grown up from 27.91% to 62.8%. Their tax payment capability was raised from 19.77% to 100% as well as the capacity of having domestic animal which has risen from 27.91% to 100%. The construction of houses, job creation and food security also were known as fields where women used their earnings. Women entrepreneurs revealed challenges of lacking experience and skills at a level of 47.67%. These findings show that women entrepreneurs should be more sensitized on the importance of taking entrepreneurships initiatives and the government should organize short and long trainings to women to enhance their entrepreneurships skills and sustain their businesses.

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Nwankwo, Chinenye Mercy, and Yasmin Umubyeyi Omar. "Factors associated with delays in seeking tuberculosis treatment among patients at Muhima district hospital, Rwanda." International Journal Of Community Medicine And Public Health 7, no. 8 (July 24, 2020): 3183. http://dx.doi.org/10.18203/2394-6040.ijcmph20203398.

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Background: Few studies exist in Rwanda to establish the reasons behind delays in seeking treatment in the health institutions which further affected timely diagnosis and case detection. The study investigated factors associated with delays in seeking treatment among tuberculosis (TB) patients at Muhima District Hospital, Rwanda.Methods: The study adopted descriptive cross- sectional study of 49 smear-positive TB patients derived using proportion estimation of case registry (November 2016 to January 2017) newly- diagnosed patients, first and second months treatment. Systematic sampling technique used to select 60 TB patients from target population. Data collected by researcher and trained research assistant, using a close- ended questionnaire through a translation in local dialect.Results: About 49% (24) of the smear- positive TB patients experienced delayed in seeking treatment for more than 180 days (6 months). Also 53% (26) were within the 36-45 age-cohort, while majority 75.5% (37) of the respondents was male. About 57% (28) of the respondents have poor knowledge of TB transmission. Similarly, about 51% (25) were the results on the perception of taking anti- TB medication, while median time interval from onset of symptoms and initiation of treatments was 45 days, average 71 days between 15 -180 days.Conclusions: Statistically significant relationship exist between initial source of treatment using home remedies (p=0.0) and private insurance cover (p=0.0) in relation to delay, which further contributed to delay among majority. Recommendations of the study are strengthening medical services utilization, improving case detection, medical infrastructures and collaboration with non- formal healthcare practices.

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Bein, Murad. "The association between medical spending and health status: A study of selected African countries." Malawi Medical Journal 32, no. 1 (March 31, 2020): 37–44. http://dx.doi.org/10.4314/mmj.v32i1.8.

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BackgroundThe report from the World Health Organization (WHO) reveals that health spending worldwide remains highly unequal as more than 80% of the world’s population live in low and middle-income countries but only account for about 20% of global health expenditure. Another report by the WHO on the state of health financing in Africa published in 2013 intimates that countries that are part of their member states are still on the average level in meeting set goals in financing key health projects. ObjectiveThe study set out to investigate the association between public and private spending and health status for eight selected African countries, namely Burundi, Eritrea, Ethiopia, Kenya, Rwanda, Sudan, Tanzania and Uganda. Health status indicators include the incidence of tuberculosis, mortality rates, maternal deaths and prevalence of HIV. MethodsDescriptive statistics and pairwise correlation are used to assess the relationship between healthcare spending and health status. Random and fixed effect models are further employed to provide insights into the association between descriptive statistics and pairwise correlation. We used annual data from the year 2000 to 2014 obtained from world development indicators.ResultsThe relationship between healthcare spending (public and private) and health status is statistically significant. Public healthcare expenditure has a higher association than private expenditure in reducing the mortality rate, tuberculosis and HIV for the average country in our sample. For example, an increase in public healthcare spending is negatively associated and statistically significant at 5% or better in reducing female mortality, male mortality, tuberculosis and HIV. Private healthcare spending is more impactful in the area of maternal deaths, where it is associated negatively and statistically significant at 1%. An increase in private healthcare spending is linked to a reduction in maternal deaths. We also compared the association between an increase in healthcare spending on males versus females and observed that public health expenditure impacts the health status of both sexes equally, however, private health expenditure provides a greater positive benefit to males. It is worth remembering that two goals of the United Nations agenda on sustainable development are gender equality and ensuring healthcare for all. ConclusionThe findings of this research call for the selected African countries to pay more attention to public healthcare expenditure in order to improve health status, especially since private healthcare which provides access to healthcare facilities for some poor people leads to costs that are a burden. So, future research should focus on analyzing components of private healthcare spending such as direct household out-of-pocket spending, private insurance and direct service payments by private corporations as dependent variables to understand what form of private investment should be encouraged.

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Schneider, P., and K. Hanson. "The impact of micro health insurance on Rwandan health centre costs." Health Policy and Planning 22, no. 1 (December 8, 2006): 40–48. http://dx.doi.org/10.1093/heapol/czl030.

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Musango, Laurent, Jean Damascene Butera, Hertilan Inyarubuga, and Bruno Dujardin. "Rwanda's Health System and Sickness Insurance Schemes." International Social Security Review 59, no. 1 (January 2006): 93–103. http://dx.doi.org/10.1111/j.1468-246x.2005.00235.x.

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Finnoff, Kade. "Gender Disparity in Access to the Rwandan Mutual Health Insurance Scheme." Feminist Economics 22, no. 3 (November 7, 2015): 26–50. http://dx.doi.org/10.1080/13545701.2015.1088658.

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Nyandekwe, Médard, Manassé Nzayirambaho, and Jean Baptiste Kakoma. "Universal health insurance in Rwanda: major challenges and solutions for financial sustainability case study of Rwanda community-based health insurance part I." Pan African Medical Journal 37 (2020). http://dx.doi.org/10.11604/pamj.2020.37.55.20376.

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Kalk, Andreas, Natalie Groos, Jean-Claude Karasi, and Elisabeth Girrbach. "Health systems strengthening through insurance subsidies: the GFATM experience in Rwanda." Tropical Medicine & International Health, November 2009. http://dx.doi.org/10.1111/j.1365-3156.2009.02424.x.

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Chirwa, Gowokani Chijere, Marc Suhrcke, and Rodrigo Moreno-Serra. "Socioeconomic inequality in premiums for a community-based health insurance scheme in Rwanda." Health Policy and Planning, December 2, 2020. http://dx.doi.org/10.1093/heapol/czaa135.

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Abstract Community-based health insurance (CBHI) has gained popularity in many low- and middle-income countries, partly as a policy response to calls for low-cost, pro-poor health financing solutions. In Africa, Rwanda has successfully implemented two types of CBHI systems since 2005, one of which with a flat rate premium (2005–10) and the other with a stratified premium (2011–present). Existing CBHI evaluations have, however, tended to ignore the potential distributional aspects of the household contributions made towards CBHI. In this paper, we investigate the pattern of socioeconomic inequality in CBHI household premium contributions in Rwanda within the implementation periods. We also assess gender differences in CBHI contributions. Using the 2010/11 and 2013/14 rounds of national survey data, we quantify the magnitude of inequality in CBHI payments, decompose the concentration index of inequality, calculate Kakwani indices and implement unconditional quantile regression decomposition to assess gender differences in CBHI expenditure. We find that the CBHI with stratified premiums is less regressive than CBHI with a flat rate premium system. Decomposition analysis indicates that income and CBHI stratification explain a large share of the inequality in CBHI payments. With respect to gender, female-headed households make lower contributions towards CBHI expenditure, compared with male-headed households. In terms of policy implications, the results suggest that there may be a need for increasing the premium bracket for the wealthier households, as well as for the provision of more subsidies to vulnerable households.

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Chemouni, Benjamin. "The Political Path to Universal Health Coverage: Elite Commitment to Community-Based Health Insurance in Rwanda." SSRN Electronic Journal, 2016. http://dx.doi.org/10.2139/ssrn.2893122.

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Wang, Wenjuan, Gheda Temsah, and Lindsay Mallick. "The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda." Health Policy and Planning, October 6, 2016, czw135. http://dx.doi.org/10.1093/heapol/czw135.

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Rubogora, Felix. "Analyzing Challenges Associated with the Implementation of Community Based Health Insurance (CBHI) in Rwanda." Arts and Social Sciences Journal 08, no. 03 (2017). http://dx.doi.org/10.4172/2151-6200.1000275.

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Muremyi, Roger, Haughton Dominique, Francois Niragire, Kabano Ignace, and Sandrine Abayisenga. "Analysis of the effect of health insurance on health care utilization in Rwanda: a secondary data analysis of Rwandan integration living condition survey 2016-2017 (EICV 5)." PAMJ - One Health 4 (2021). http://dx.doi.org/10.11604/pamj-oh.2021.4.10.25256.

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Iruhiriye, Elyse, Deanna Olney, Jessica Heckert, Gayathri Ramani, Edward Frongillo, and Emmanuel Niyongira. "Stories of Change: How Rwanda Created an Enabling Environment for Reducing Malnutrition (P22-011-19)." Current Developments in Nutrition 3, Supplement_1 (June 1, 2019). http://dx.doi.org/10.1093/cdn/nzz042.p22-011-19.

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Abstract Objectives Eliminating malnutrition is on many countries’ political agendas but knowledge of how enabling environments are created and used is needed. We assessed the drivers of change in stunting reduction among children <5 y of age in Rwanda and contributors to differential reduction over 10–25 y. Methods We conducted in-depth interviews on changes in nutrition with nutrition stakeholders at national (n = 32), district (n = 38), and community (n = 20) levels, and community focus group discussions (n = 40) in 10 purposefully selected districts in Rwanda's 5 provinces. In each province, we selected 1 district with decreased stunting and 1 where no change or an increase occurred (2010–2015). We also used regression decomposition analysis to investigate drivers of change in stunting with Demographic and Health Surveys (2005, 2010, and 2015) data. Results Respondents believed peace and security along with improved leadership and decentralization helped to create an enabling environment for change. Rwanda experienced increased political and institutional commitment to nutrition indicated by adoption of a multisectoral policy and reinforced with horizontal coordination platforms and plans at national and sub-national levels, but greater financial commitment is needed according to respondents. Vertical coordination across administrative levels improved through communication, staff working on nutrition at these levels, and relationships between nutrition actors. From respondent reports, health and agricultural programs and increased availability and use of health services helped improve nutrition; differences between study districts included climate change challenges, food insecurity, weak horizontal and vertical coherence, and weak implementation of coordination plans. Supporting this, giving birth in a health facility, attending ≥4 antenatal care visits, antenatal care quality, fertility, parental education, household wealth, and health insurance coverage drove stunting reduction from the regression decomposition analysis. Conclusions Leadership, commitment and horizontal and vertical coherence are important for creating enabling environments and providing programs and services that can lead to reduced malnutrition. Funding Sources Ministry of Foreign Affairs of Kingdom of Netherlands through SNV Netherlands Development Organization.

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African Journal, The Pan. "Retraction: Analysis of the effect of health insurance on health care utilization in Rwanda: a secondary data analysis of Rwanda integrated living condition survey 2016-2017 (EICV 5) (PAMJ - One Health. 2021;4:10. Doi: 10.11604/pamj-oh.2021.4.10.25256)." PAMJ - One Health 5 (2021). http://dx.doi.org/10.11604/pamj-oh.2021.5.8.29814.

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Journal articles on the topic 'Health insurance – Rwanda'

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