The Community-Based Health Insurance (CBHI) programme is facing financial crisis due to non-remittance of contributions by beneficiaries.

The government now wants leaders to sensitise the public on the importance of remitting contributions if health insurance for all is to be achieved by 2015.

The Ministries of Local Government and Health, insurance boards and the Kigali City Council have met to analyse the status of health insurance and strategise on how to compel contributors to clear arrears.

“It is in the interest of the nation to have everybody covered. As a result, leaders should make it a priority so that by November 20, all the beneficiaries identify ways of clearing their arrears,” said Local Government Minister James Musoni.

The insurance scheme, popularly known as Mutuelle de Santé, depends on citizens making contributions based on their economic status, though the government pays for those in category one.

However, it has since been discovered that some members pay lower charges than they are supposed to.

Currently, contributions are made yearly, but reports show that 38 per cent of beneficiaries are yet to pay their dues this year.

In 2010, the health scheme had enrolled 8.5 million members, who contributed Rwf34.5 billion.

Diseases covered

The scheme insures members against non-communicable diseases.

Category one people pay Rwf2,000 that is settled by government on their behalf, while the rest pay between Rwf3,000 and Rwf7,000, based on categories.

At the Kigali meeting the Ministries of Health and Local Government agreed to deal with beneficiaries who cannot afford to pay for their own health insurance before embarking on other groups.

The two also agreed on the need to review categories of members after it emerged that some people may have been placed in the wrong groups.

Anastasie Urusaro, a health insurance officer in Muhanga District, told Rwanda Today that the insurance scheme risks running into financial problems due to wrong profiling of the beneficiaries.

Other insurance plans

“Some of the beneficiaries were wrongly categorised, which could have caused their failure to pay the premiums, while others were placed in lower categories when they can afford to pay,” said Mrs Urusaro.

According to Health Minister Agnes Binagwaho, if the scheme is managed well, it could handle other diseases as well.

“With a very good and common health care system, we can handle not only non-communicable diseases, but also chronic diseases like cancer, heart problems and others. We only need to agree on a viable and appropriate methods to mobilise sources,” she said.

Mrs Binagwaho made the remarks at a health experts’ summit held in Kigali last month.

Households in the higher wealth quintiles are generally better insured than those in the lower categories.

Mutuelle de Santé is the biggest scheme with at least one individual in the household being a member.

Other health insurance plans that draw membership from citizens are La Rwandaise d’Assurance Maladie (RAMA), Military Medical Insurance (MMI), and private insurance policies.

According to the Ministry of Health’s 2011 health report, the Community Based Health Initiative (CBHI) focuses mostly on ordinary citizens.

CBHI is co-ordinated at the district level, where each of the 30 districts in the country hosts a “Fonds de Mutuelle de Santé.”

They are managed by a director appointed by Health Minister and in each health centre.