NORTHERN Province districts have up to December 31 2012 to meet the 100 percent community mutual health enrollment target or account for the failure.Aime Bosenibamwe, the Northern Province Governor, gave the stern warning at a health Sector consultative meeting between the districts and other health officials at Nyirangarama in Rulindo District recently."I understand how difficult it is but we have no option.  We cannot do otherwise. As leaders, we have to be creative and work within a system and work as a team. Its basic for the success of any health financing,” challenged the Governor.He, however, warned against forceful confiscation of any one’s property over the issue.Currently Gakenke district has the highest mutual health enrollment at 70 per cent while enrollment in the whole province stands at 66.6 per cent. The Governor advised that poor performing sectors and districts leadership should be assessed for performance gaps and where necessary their roles should be revised to see where they can do better.It was noticed however that the enrollment was higher than what was reported because of contradicting reporting methods. The directors of mutual health reported only those with mutual health cards yet some people pay to Umurenge SACCOs and keep pay slips without proceeding to register for cards.Districts were given up to 20th December, 2012 to sort out the discordance in the reporting system. The other challenge identified was that even if one family member paid in a family of more than one person, one is not allowed to get services until all family members have either been paid for fully or a half. Other health issues raised were malnutrition challenges where the worst performing district was Musanze at 0.8 while Rulindo the best performing district stood at 0.1per cent. The province malnutrition stands at 0.3 per cent.The Governor requested districts to work towards zero per cent malnutrition for all districts. He called for peer learning and promised zero tolerance for poor performers.In response to Ruhengeri hospital congestion, the governor challenged health workers to be more patriotic and do their best as the leadership tried to fix the issues.Asked on congestion situation at Ruhengeri Hospital, he said though he did not have actual patient to Dr.ratio figures, the situation was alarming because unlike other hospitals, Ruhengeri Hospital receives patients from four districts of Gakenke, Burera, Nyabihu and Musanze due to geographical factors that make it easy to access the hospital than those meant for them.  The Governor revealed that Ruhengeri Hospital is yet to be confirmed as the provincial hospital which would increase its capacity in terms of human and other resources.The Governor said he was in touch with private investors as one of the strategies to complement government efforts. He was optimistic that the problem will be fixed.   Edward Kamuhangire, the in charge of administration at the Ministry of health revealed that health standards were released and an evaluation would follow soon. Anyone who will fall short of the standards will be liable to disciplinary measures.