At the United Nations General Assembly in 2015 adoption Universal Health Coverage as one of the Sustainable Development Goals. The purpose of universal health coverage is to ensure that all people and communities, regardless of their circumstances, have access to the health services they need, when and where they need them, and without the risk of financial ruin. Many countries have committed to this concept, resulting in many health reforms.who recognize Rwanda is one of the countries that has reached the goal of universal health coverage.of Cochrane Center Collectively and disseminating information about what works and what doesn’t in healthcare. Professor Charles Shey Wiysonge, Director of Cochrane South Africa and Senior His Director of the South African Medical Research Council, said that Rwanda’s Minister of Health, Dr. Sabin Nsanzimana, has given the country’s universal health his coverage load. We talked about maps.
Charles Wysonge: What does Rwanda’s universal healthcare system look like?
Sabin Nsanjimana: Over the past decade, there has been a growing call for increased efforts to achieve universal health coverage. Many countries, especially in Africa, are committed to universal health coverage. This has led to many health reforms.
Rwandan President Paul Kagame appointed Recognized by other African Heads of State as national health financing leaders in the February 2019 AU General Assembly Declaration. The purpose of the Declaration was to increase investment in health and to have Member States spend efficiently and effectively to achieve better health outcomes.
In recent decades, Rwanda has improved the health and well-being of all people. This was done through a combination of evidence-based, person-centred strategies and interventions. The country has been able to make substantial progress in:
- On the supply side, the country has established a healthcare delivery system for primary care. Individuals and communities are at the heart of what we do.Increase in medical facilities (From 1,036 in 2013 to 1,457 in 2020) Improved geographical access to health care. It also helps reduce the average time it takes for Rwandans to reach medical facilities.average time to reach The nearest health facility has decreased from 95.1 minutes in 2010 to 49.9 minutes over the past decade.
- On the demand side, risk pooling has improved significantly. Community-based health insurance systemThese will enable a large portion of the population to access health services and improve access to quality services. Insurance has also reduced the out-of-pocket costs, especially for the poorest and most vulnerable (equivalent to his 4% of total medical costs).Areas covered by community-based health insurance 85% or more of the population.Percentage of the population with some kind Health insurance It has increased from 43.3% in 2005 to 90.5% in 2020. This helped protect households from the financial risks associated with the disease.
- Government spending on health (15.6% as of FY2019/2020) 15% Mandated by the 2001 Abuja Declaration. This demonstrates the country’s high commitment to developing health sector financing.
Charles Wysonge: Where are the gaps and why do they exist?
Sabin Nsanjimana: Progress towards universal health coverage is an ongoing process. It responds not only to changing demographic, epidemiological and technological trends, but also to people’s socioeconomic status and expectations. For Rwanda to achieve her goal of achieving universal health coverage by 2030, it needs to become more ambitious to leave no one behind.
Additional health financing reforms and actions are needed to sustain the gains achieved and further improve health outcomes. The fact that the country has moved closer to universal health coverage is a major achievement in itself. However, some people are still uninsured. We need to identify policy options to extend coverage to hard-to-reach people in the informal sector. Health insurance has a positive impact on access to services and equity. However, further improvements are needed. There is a need to expand the reach of services where necessary, especially to reduce the cost burden of secondary and tertiary care.
Sustainability of healthcare financing is also an important issue. We need to find innovative ways to mobilize domestic resources and adopt better resource pooling mechanisms and effective strategic purchasing mechanisms. These should ensure fair and efficient use of available resources and value for money.
Charles Wysonge: What else do you need?
Sabin Nsanjimana: Evidence-based policies that provide direction for long-term models for service delivery (focusing on primary health care level) and health financing in Rwanda to go deeper towards universal health coverage. Reform is needed. This requires greater awareness among policy makers, building capacity in these areas and sharing understanding of Universal Health’s coverage to support necessary reforms.
Charles Wysonge: What can other countries on the African continent learn from Rwanda’s experience?
Sabin Nsanjimana: Strong leadership that sets a clear vision for the future is essential. Countries need inclusive development models. Such models must consider gender equality, anti-poverty, solidarity and solidarity.
Most important is a robust institutional and legal framework driven by good governance.
- Accountability, Citizen Participation and Decentralization
- Results Oriented – Performance Contracts
- Investing in human capital – primarily capacity building.
Charles Shay WysongeDirector, Cochrane South Africa, South African Medical Research Council
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