A latest review of the community based health insurance scheme (Mutuelle de Santé) has shown that 83.2 per cent of users access the medical service within less than two hours from health facilities.The findings, contained in a countrywide survey conducted by FIOM Rwanda, a local NGO, paint a picture of a programme that returns value for money as 72.7 per cent users appreciated the scheme, compared to 27.3 who said they were dissatisfied. The report, released last week, indicates that 95 per cent of respondents said they had received treatment from the nearest health institutions using their insurance cards.Janvier Rukwatage, the FIOM Rwanda representative, said, according to the survey, people who criticise Mutuelle de Santé are mostly those who don’t use it but most of its users appreciate its usefulness.Vincent Sinduhunga, one of the consultants who was involved in the survey, said 27.3 per cent of Mutuelle de Santé users were dissatisfied with the categories they were placed in, while others claimed discrimination against Mutuelle de Santé users at the health facilities."Of the respondents, 20.1 confirmed the existence of discrimination, while others said that they are discriminated because they are HIV positive,” he said.There are three categories of medical insurance cover. These include people considered to be very poor who pay an annual premium of Rwf2, 000 that is settled by government on their behalf.  The rest are expected to pay for themselves with premiums standing at Rwf3000 and Rwf7, 000, respectively based on their category.Sinduhunga added that other challenges that were pointed out were the bad attitude of nurses towards Mutuelle de Santé card holders, medicine shortage and stock outs that were said to be common.The report recommended that management committees of the community based health insurance at cell and sector levels should assure that the categorisation of members affiliated to Mutuelle de Santé is done in transparency.The consultant also called upon NGO’s   and all other local initiatives of the districts in charge of contributions of the vulnerable people to make payments on time and inform the beneficiaries.Andrew Makaka, the Director of Mutuelle and Performance - Based Financing in the Ministry of Health said government shall continue advocating for funds to take health care closer to the population, adding that Rwanda’s coverage rate of mutuelle is  93 per cent. He added that they shall continue to sensitise and educate the public on health insurance. The government targets to spend Rwf 31 billion for this fiscal year health insurance fees, according to the Ministry of Finance and Economic Planning. The biggest amount representing 70 per cent will be raised from the contribution of the beneficiaries, while 30 per cent comes from the government and donors.The government subsidises medical cover for beneficiaries in category one and two which account for 25 per cent of all beneficiaries who cannot afford to pay their own premium. It has already paid for them over Rwf7.2 billion for this year.