Social security experts are calling on East African governments to emulate Rwanda in subsidising community-based health insurance schemes to widen universal healthcare coverage.
The East and Central Social Security Association (Ecassa) — a regional lobby for social protection — cites high levels of poverty as a reason for the low health insurance coverage in the region. This means the bulk of people in countries in the region are unable to pay health insurance premiums.
According to the association, which held its 11th Social Protection Policy Makers Conference in Kigali on November 22 and 23, Rwanda, which heavily subsidises its community-based health insurance — Mutuelle de Santé — has increased the population under health insurance cover.
Official data indicates that the health insurance cover has grown from 7 per cent in 2004 to 92 per cent mid-November 2018, boosted by the informal sector.
The coverage grew from 74 per cent in 2007 to 85 per cent in 2008, reaching 86 per cent in 2009, and 91 per cent in 2010.
The World Health Organisation says every government should ensure that all citizens are able to access essential quality health services without facing financial difficulties.
The Rwandan government directly pays 16 per cent of premiums for the needy, who are estimated to be two million people, according to Health Minister Diane Gashumba.
To sustain the scheme, Rwanda also widened its revenue generation base by imposing a levy on tobacco, alcohol and also a Rwf10 per ($0.011) per minute fee on mobile phone airtime.
There is also a 5 per cent contribution by public and private health insurance schemes to Mutuelle de Santé to ensure that the scheme remains affordable.
Health also has the biggest allocation, with at least 15 per cent of the budget — above the 10 per cent benchmark set by WHO.
In Tanzania, with a population of over 50 million people, only 10 million have health insurance cover.
Kenya, East Africa’s largest economy has a booming insurance industry, and has increased its health insurance service through the National Hospital Insurance Fund.