Poor mobilisation hampers medical insurance scheme

Lack of strong awareness mechanisms and strategies among some grassroots leaders has been blamed for slow subscription to the community health insurance, better known as Mutuelle de Santé, in the Southern Province.

Thursday, October 24, 2013
Women await healthcare at a facility while holding their health insurance cards. The New Times/ File.

Lack of strong awareness mechanisms and strategies among some grassroots leaders has been blamed for slow subscription to the community health insurance, better known as Mutuelle de Santé, in the Southern Province.Vedaste Kabera, the director of specific programmes in the province, said on Wednesday that some grassroots leaders have demonstrated limited capacity in mobilising their population to embrance the health insurance scheme.This justifies why some sectors and districts still have few subscribers to the scheme, about four months into the 2013/2014 fiscal year, Kabera said.He was addressing officials at a meeting to discuss ways of spearheading performance contracts in the province.The meeting discussed several topics, including the health insurance scheme, the construction of classrooms meant for the Nine and Twelve years basic Education Programme, membership to savings and credit cooperative as well as ways of increasing agriculture production in the province.Kabera said although the situation continues to improve, it is not clear how some areas are lagging far behind while others have successfully engaged their residents toward the scheme.While some sectors have reached 100 per cent subscription, while others are lagging with less than 20 per cent, according to recent provincial figures.Ngoma Sector in Huye District is ranked the first in the province with full subscription to the scheme, while Kabagali Sector in Ruhango and Busanze Sector in Nyaruguru were ranked the last with only 19.4 per cent of people subscribed.According to a recent assessment, only 18 sectors out of the total 101 making up the Southern Province have more than 50 per cent of their total population subscribed to the scheme. Sixty-seven others have between 30 and 49 per cent of residents’ subscription, while remittance of Mutuelle fees among residents of the remaining sectors (16) stands at less than 30 per cent.At district level, Kamonyi District has so far the highest subscription level in the province with slightly over 83 per cent of its residents having so far remitted their Mutuelle fees. The district stands at the 5th position in the country. Huye follows with 78.8 per cent, while Ruhango has the least percentage at nearly 60 per cent (27th at the national level).The entire province stands at an average of 70 per cent of subscription to health insurance.Door-to-door mobilisationHuye mayor Eugene Kayiranga Muzuka said leaders need to keep up awareness efforts and devise new strategies to mobilise the populace to pay their remittances. Muzuka singled out the door-to-door mobilisation as a strategy that is proving to be successful. He also cited informal savings groups, (Ibimina), as contributing to boost the numbers of people subscribing to the health insurance scheme.Through such groups, which are generally made of up to 30 members, residents meet regularly to give their contributions and the money is pooled and deposited to an account opened at a Sacco. The contributions are used to offer loans to members and pay their subscriptions to the community health insurance scheme."The groups have proven to be a successful strategy and ideal mobilisation forum,” Muzuka said.Involving development partners to support the poor and church leaders in the efforts are also part of strategies that Muzuka said are helping his district in the effort.Louis Nyaminani, the executive secretary of Busanze Sector, said they are devising new strategies."We have started moving from door-to-door to mobilise residents and look at the challenges facing them in their quest to subscribe,” Nyaminani said.Only 19.4 per cent of the sector’s residents are so far subscribed to the scheme, figures show.Jeanne Izabiriza, the Southern Province executive secretary, urged leaders to make every effort to increase the number of subscribers. However, she cautioned against the use of coercive measures such as grabbing people’s property, warning that such means are "strictly illegal.”