Delivery of Health Care/economics; Financing, Personal; Health Care Reform; Health Policy; Health Services Accessibility; Humans; National Health Programs/economics; Pilot Projects; Politics; Rwanda
Abstract :
[en] Rwanda has made the setting up of a prepayment scheme a priority in its health sector reform in order to make health services more financially accessible to the population. A pilot study was carried out in three districts. The yearly family subscription charge was fixed at 7.9 US dollars, which covers care delivered at Health Centre level as well as some services at the hospital. The beneficiaries and providers mention difficulties in order to mobilise the subscription charges all at a time, the insufficiency of the offer of services at the hospital and the absence of involvement of the political authorities in the process. The Ministry of Health did initiate the experiment but the choice of the privileged pilot districts prevents results from being extrapolated to the country taken as a whole with a view to a possible extension at a later stage. Given the relatively short time in which it has taken place, the population could neither understand the contingency and solidarity issues implied nor have the opportunity to feel personally involved in the system. As a conclusion, the study advocates the continuation of the experiment with a reinforcement of the coordination which should take the weak points identified into account.
Disciplines :
General & internal medicine
Author, co-author :
Musango, Laurent
Martiny, Patrick
Porignon, Denis ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique : aspects spécifiques
Dujardin, Bruno
Language :
French
Title :
Le systeme de prepaiement au Rwanda (I): analyse d'une experience pilote.
Alternative titles :
[en] The prepayment scheme in Rwanda (I): analysis of a pilot experiment
Publication date :
2004
Journal title :
Santé: Cahiers d'Études et de Recherches Francophones
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