Rwanda’s community-based health insurance scheme, best known as Mutuelles de Santé, has greatly contributed to the achievement of universal healthcare in the country. Mutuelles de Santé was established in 2003 extending medical insurance cover to low-income earners and people working in the informal sector. The scheme covers more than 80 per cent of Rwanda’s estimated 12 million people, with official figures indicating that coverage reached 84.4 per cent, or some 9 million subscribers, as of January 22, 2021. The result has been immense, with the scheme impacting the country in a way we hadn’t seen before. Timely healthcare is key to ensuring a healthy workforce, which is indispensable for socio-economic development. But, as you’d expect, the scheme continues to face funding problems. To help address the challenge and to bring about efficiency and pragmatism in the way the Fund is managed, the government transferred the mandate of implementation of ‘Mutuelles’ policy to Rwanda Social Security Board (RSSB). A few years later, funding is still a challenge but there are signs of improvement. Financial contributions toward the scheme amounted to Rwf35.6 billion in the 2019/2020 fiscal year, leaving a gap of over Rwf20 billion. Subsequently, two Prime Minister’s Orders (2019 and 2020) introduced subsidies for the community-based health insurance scheme and determined financial support amounting to an estimated Rwf27 billion for the scheme annually. Additional funding (subsidy) was to come from various sources, including registration fees for pharmaceutical products, levies on telecommunication companies’ annual turnover, charges on fuel sales, parking fees, a 0.5 per cent deduction off employee’s net salary both in private and public sectors, as well as charges on the tourism revenue sharing scheme. As a result, RSSB says it was able to collect up to Rwff11.5 billion in additional funding for ‘Mutuelles’ in the first half of the current fiscal year (2020/21), meaning from July through December 31, 2020. This is good news considering where we are coming from. Some institutions have yet to remit their contributions arguably owing to Covid-19. Now, the pandemic has affected everyone in one way or another but this is the time to come closer together and lend a hand to those less fortunate. One way to do that is to help ensure that this important scheme continues to serve millions of citizens in the best way possible. With the government already paying premiums for millions of vulnerable beneficiaries, it is important that every other stakeholder plays their part in ensuring that Mutuelles de Santé continues to save lives. If we pay our respective contributions and honour our commitments we will not only sustain the Fund, but we will make it possible for beneficiaries to be provided with a broader range of life-saving health services. Funding our universal healthcare is investing in the future of the country.
