Rwanda Medical Insurance
With 92 percent of Rwandans covered by the nation’s health insurance scheme, its insurance system is celebrated as one of the most successful in the world. At a premium of $2 USD a year, the Rwandan health insurance scheme provides basic health services such as maternity care, and treatment for the most common causes of death, such as diarrhea, malnutrition, malaria, infections, and pneumonia. In addition, most health centers have medicines that are on the World Health Organization’s (WHO) list of essential medicines. Some even have diagnostic laboratories for blood and urine analysis.
Of course, there are many flaws as well. Although Rwandan health facilities can provide basic medical services, the buildings often lack basic necessities such as running water and electricity. Often, medical facilities do not have sufficient personnel to run the center. In addition, more complicated treatment and diagnostic methods, such as MRI and CAT scans, are not widely available. More serious illnesses such as cancer, strokes, and heart diseases cannot be treated in the country. General surgery is available, but with the lack of physicians, the wait time can last from weeks to months. Patients, who are in a more urgent need of surgical treatment, may be transported to areas where there are teams of visiting doctors from other countries. In rare cases the government may also pay to have patients transported to nearby countries with more advanced medical facilities and surgeons to receive treatment.
Regardless of these issues, on a basic level, the Rwandan healthcare system has made great strides in the improvement of its population’s health. Life expectancy has risen from 48 to 52 in the 11 years that the health insurance system has been in place. Children and maternal mortality rates have also significantly decreased. Before major reforms took place, many women would deliver in their own homes. If there were any complications, the mother and baby were in grave danger. However, the current Rwanda health insurance system encourages mothers to not deliver at home and tries to provide at least one nurse or village health worker present at every birth.
Of course, the US$2 premiums are not enough to support the country’s insurance system. About 53 percent of funding for health expenditures comes from foreign aid. For example, Partners in Health operates two hospitals and a small network of clinics in rural parts of Rwanda. With many Rwandans living in poverty, sometimes US$2 a year still seems too much. Many Rwandans who do not get sick throughout the year often request their money back or resist to pay for something in advance when they are not sure that they will need it.
The Rwandan public health sector administration is organized into three tiers. At the capital is the central level. This level is responsibly for developing the country’s health policies, strategies, regulations, and standards. This level is also responsible for evaluating, managing, and training the staff that are in the other levels of the industry. At the intermediate level are the provincial health administrators, which are separated into three different categories: health, gender, and social affairs. Many of the country’s different districts’ public health departments are also included in this category. Finally, at the periphery level are the district administrators. Each district will have its own office, hospital, and primary health centers. These district officials are responsible for the actual implementation of care at the primary level, and creating preventive treatment schemes in addition promoting public health education and awareness. In these 39 districts in 2001, there were 252 health centers, and 113 dispensaries. There are also temporary health posts through the country that are responsible for transitional problems, such as refugees and epidemics. However, with a lack of physicians, nurses, and administrative staff, many of these hospitals and centers are often not in service. In 2001, there were 39 districts, but only 33 had a hospital.
To supplement the public health centers are government-assisted health facilities. These are typically non-profit organizations that are run by charity and religious groups. Health facilities in this category are included in the public health insurance system, follow all public legislation and standards set out by the central government. These centers often suffer from the same problems are public facilities, but are still important in the health sector as they make up 40 percent of Rwanda’s primary and secondary health centers.
Rwanda also has a private medical industry that has been steadily growing since the end of the 1994 genocide. As of 2000, there were approximately 70 private physicians, 405 pharmacies, and 329 private health clinics, over 50 percent of which operate near or in the capital.
Traditional medicine is also an important part of the health sector. Despite the low premiums, co-payments can still be costly, which is why many Rwandans choose to integrate allopathic and the cheaper traditional medicine, depending on their medical condition. Often, it is easier for Rwandans to pay for traditional medicine as well because they can pay using a barter system. The Rwandan Ministry of Health and the Institute of Scientific Research and Technology are trying to organize the traditional medicine practitioners in order to ensure a quality of standard throughout. For example, the government tried to begin a training program for traditional birth attendants (TBAs) in order to educate women on vaccinations, family planning, risk factors, and improve hygienic conditions. There were 1,800 TBAs who were trained through the program by 2001. These TBAs only receive basic equipment and training, but statistics have shown that even having the presence of a TBA with basic training can increase the chances of the survival of mother and baby if birth complications do arise from the pregnancy.
Although 92 percent of the population is covered by the Rwanda health insurance scheme, the medical services are very basic and the quality, relative to Western Europe and North America, is very low. Travelers and expatriates to Rwanda should purchase an international health insurance policy before arriving in Rwanda. Furthermore, it is highly recommended that travelers take out a policy that covers emergency evacuation and transportation costs. In the event that you are seriously injured, transportation costs can be as much as $100,000 USD.
Travelers visiting the country should get vaccinated against yellow fever, hepatitis A, hepatitis B, typhoid, rabies, tetanus-diphtheria, mumps, measles, rubella, and meningococcus. In addition, malaria is prevalent throughout Rwanda, so visitors need to carry anti-malarial medicine, sleep in bed nets, and use insect repellant. Always bring adequate supplies of personal prescription medicine and a doctor’s note for these prescriptions. It is also recommended that travelers bring diarrhea medicine, as diarrhea is a common ailment of travelers in this part of the world.
Furthermore, Rwanda has a Human Immunodeficiency Virus (HIV) infection rate of 3.1 percent. This is higher than the international average, but lower than most Sub-Saharan countries. Nevertheless, travelers should be cautious and do not engage in any activities that can risk an infection.
Pacific Prime can assist you with any international, travel or health insurance needs should you decide to travel to Rwanda. We offer professional advice at no cost to you. No matter what your budget is or what your requirements are, our professional consultants can help find a locally compliant policy that fits you or your group. Our policies can cover a wide range of services including dental, maternity, specialist consultation, transportation, inpatient services, and many more. Please contact us today for a free consultation.