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Community Based Health Insurance (CBHI) was
implemented in Rwanda to improve health care
utilization for the poor population.
Using data from health centers and CBHI
schemes in pilot and control health districts, this
study assesses the impact of the
CBHI scheme on utilization of health services and on
financial sustainability. CBHI significantly improved
utilization of health
services
by increasing visits of members by four-fold, while
the non members utilization remained unchanged over
the same period. Results from multivariate regression
models indicate that increase in CBHI enrollment was
statistically associated with a reduction in visits.
The majority of CBHI schemes were not able to cover
their operating costs from the revenues collected
from members.Government and donors should play an
active role in supporting CBHI,
especially at their early stage of development. Good
risk management and community participationremain
key elements for the success of CBHI in Rwanda. The
author provides practical recommendations to health
policy makers on how to improve the performance of
CBHI and its scale up at the national level.
implemented in Rwanda to improve health care
utilization for the poor population.
Using data from health centers and CBHI
schemes in pilot and control health districts, this
study assesses the impact of the
CBHI scheme on utilization of health services and on
financial sustainability. CBHI significantly improved
utilization of health
services
by increasing visits of members by four-fold, while
the non members utilization remained unchanged over
the same period. Results from multivariate regression
models indicate that increase in CBHI enrollment was
statistically associated with a reduction in visits.
The majority of CBHI schemes were not able to cover
their operating costs from the revenues collected
from members.Government and donors should play an
active role in supporting CBHI,
especially at their early stage of development. Good
risk management and community participationremain
key elements for the success of CBHI in Rwanda. The
author provides practical recommendations to health
policy makers on how to improve the performance of
CBHI and its scale up at the national level.