The Government Accountability Day: My experience

Last Tuesday, January 31, I was proud to be part of the second Monthly Government Accountability Day, held under the theme - “Quality services: A Pillar of Development.” Led by the Prime Minister, senior government officials, including Ministers, Heads of public Institutions, and Mayors responded to questions raised by journalists, participants and the general public who participate using social media, phones or text messages.The proceedings are broadcast live on public radio and TV as well asthe internet.The many questions focused on justice, access to land, quality services in administration, health insurance for foreigners living in Rwanda, malnutrition, infrastructure, salaries of civil servants especially in education sector, access to education, security and absence of political opposition in Rwanda.This last subject was answered by participants themselves and the Prime Minister stating that opposition is there but they joined the vision of welfare and development and we are working all together for a common vision.Despite the fact that, sections of the western world prefers that we concentrate on fighting each other rather than unite and join efforts towards development.One person asked a question; why ministers just leave the office only for meetings in good hotels. The response was all of them, especiallythe Prime Minister, do field visits. The Prime Minister took the example of my regular countrywide visits of health centers and hospitals in remote areas as well as in cities. As a matter of fact, I have already visited 17 out of the 45 hospitals upcountry and during each visit I make sure that I tour the attached health center and that time is set aside for in-depth exchange with health professionals as well as local leaders. In doing so, we identify challenges, discuss them and find solutions.During this accountability session, I was also asked what we did to increase the quality of health services we deliver. I pointed out that there is a charter of patients explaining the rights and responsibilities of caregivers and patients, respectively.In a bid to improve customer care, we have also instructed all health workers responsible for wards to display their photo and telephone contacts at the entrance of their wards so that patients can contact them directly in case of any inquiries.In addition to the above, each health facility has a suggestion box that we use to monitor satisfaction as well as a hotline 114 for receiving advice or channeled complaints.The second question was why our neighbours from Congo cannot benefitfrom “Mutuelle de santé”.I explained that the subsidization given by the Government is very important and extracted from taxes payers’ money and the mobilization of specific funds done by the Government through the Ministry of Health.Citing an example of the 25 percent of my poorest compatriots, the indigents, who pay nothing at all as they don’t pay either for the premium nor the co-pay for any medical services they receive but have the right to the same health care as the Rwandan paying the highest premium for their “mutuelle”. I made it clear, that the cost of health care has gone up in the last three years. In 2009, statistics show that the cost of health uptake was around Rwf3500 per capita; today it should be more.We currently have 68.8 percent of Rwandans paying Rwf3000 per capita, per year as contribution to “mutuelle” while another small percentage pays Rwf7000 annually. This is still not enough because, for various reasons, the cost still exceeds the contributions.One reason is that there is a link between the cost and the more health services provided over time and increase in care uptake due to “mutuelle” that breaks financial barriers however, the cost of drugs, consumables and salaries of health workers has increased. Nothing is free.Essentially, the difference between the premium and the real yearly cost of health uptake for each individual is paid by government and as a matter of fact, the percentage of Rwandans that pay Rwf7000 have a better economic status. This normally comes with better education and higher demand for health care uptake, implying that their deficit is also covered by the government.All these initiatives are geared towards ensuring that all Rwandans have equal access to quality health care because they deserve it.I am proud of my Government because I am part of the process that draws ways that make our vision to improve welfare, a reality.Accountability days take place on a monthly basis.The Author is Rwanda’s Minister of Health