How innovative community health insurance made Rwanda win global social security award

By The Inspirer staff writer

When Rwanda formally launched Mutuelle de Santé scheme, in 2005, it was not clear whether this Community-Based Health Insurance (CBHI) would sustainably make Rwandans get timely treatment, and save their lives.

The mutual health insurance system in Rwanda is considered one of the most extensive community-based health insurance schemes operated in Sub-Saharan Africa covering over 90 percent of the population, according to information from the Ministry of Health.

On Friday, October 18, 2019, Rwanda was presented with the 2019 Award for Outstanding Achievements in Social Security, a statement from the International Social Security Association (ISSA) says.

That recognition took place at the closing of a five-day World Social Security Forum (WSSF) in Brussels, Belgium. The summit, hosted by the public social security institutions of Belgium, ran from October 14-18.

The statement by ISSA – a grouping of 330 national social security administrations and agencies from 158 countries across the word – indicates that Rwanda got such a prestigious award for achieving almost full health insurance coverage in less than 20 years and reaching the highest health coverage rates in Sub-Saharan Africa, a statement.

According to the statement, Rwanda lived through a traumatic genocide in 1994 and a subsequent breakdown of the health system.

But, it added that based on sound political commitment, good governance and management, along with long-term planning, Rwanda made impressive strides towards universal health coverage starting with a pilot in 1999 and reaching more than 90 percent coverage in 2018.

The success of Rwanda lies in its innovative model of “national community-based health insurance (CBHI) [– also known as Mutuelle de Santé]”, the statement indicated.

“The insurance scheme is based on “complementary community-based health insurance schemes combined with the advantages of compulsory health insurance”, which it also combines “community-level schemes with the professional management structures of the existing social security scheme.”

ISSA says the scheme, best known in Rwanda as Mutuelle de Sante, is also characterised by “important domestic financing input complemented by donor funds instead of the other way around.”

“Rwanda has achieved something truly unique in moving towards universal health coverage in record time, and this Award is in recognition of the impressive work done by Rwandan authorities over the last two decades,” ISSA Secretary General Marcelo Abi-Ramia Caetano is quoted in the statement as saying.

The progress in CBHI has en­abled Rwandan citizens to seek medical treatment on time, and medical consulta­tions have tripled compared to the num­bers recorded in 2000, which is an import­ant aspect in healthcare provision, according to information from the Ministry of Health.

The insurance covers about 90 percent of the health service cost, while the benefi­ciary pays 10 percent. Figures from RSSB indicate that contributions to Mutuelle were estimated at over 13.3 billion in the last six months from July to December 2018.

Most of the citizens contrib­ute Rwf3,000 annually, while the government pays Rwf2,000 for each person under the first Ubudehe category – that of the poorest who can’t afford it. Such contributions are relatively small given the cost of healthcare.

Dr. Solange Hakiba, Deputy Director-General of the Rwanda Social Security Board (Centre) receiving the Global Social Security Award on behalf of the Government of Rwanda (Courtesy)

The award implications

The Award offers worldwide recognition of a country’s exceptional commitment and achievements in the field of social protection in line with the ISSA’s vision of Dynamic Social Security.

Receiving the Award on behalf of the Government of Rwanda, Dr. Solange Hakiba, Deputy Director-General of the Rwanda Social Security Board (RSSB) indicated that investing in the social security of the Rwandan people remains a Government priority informed by the knowledge that the country’s most important resource is her people.

“Rwanda attributes its current successes to the exceptional sacrifices and commitment of its people from all walks of life who have worked hard to defy its dark past. Investing in a social security regime which guarantees social protection was and remains a natural priority that the Government of Rwanda is committed to advancing,” she said.

“We are humbled by the International Social Security Association’s recognition of these efforts by the Government and people of Rwanda and pledge to work together with you and all other member organisations in advancing the cause of attaining social security for all the world’s inhabitants,” she observed.

The Award is presented every three years at the World Social Security Forum, which this week gathered 1300 social security leaders and experts from around the world in Brussels, Belgium, the ISSA said.

In presenting the Award to Rwanda, ISSA also “signalled the belief that several aspects of this approach can serve as model and inspiration to other countries”.

The global social security body says “universal health coverage scheme of Rwanda contributed significantly to the improvement of several key social development indicators.”

Notably, it cited reduced emergency health expenditures (and therefore poverty); reduced infant and maternal mortality rates by two-thirds since the year 2000, increased health education and family planning for women, and increased social equality and equity.

Rwanda becomes the third country to receive the Outstanding Achievements in Social Security Award after Brazil and the People’s Republic of China, which received similar recognition in 2013 and 2016 respectively.

In addition to the community-based health insurance scheme, RSSB as the Government’s department for social security administration, including a pension scheme, occupational hazards insurance, and medical insurance for professionals, and maternity leave benefits insurance which ensures three months of fully paid maternity leave for women.



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Elias Hakizimana

Elias Hakizimana, CEO&Founder of The Inspirer Ltd,( is a professional Rwandan Journalist with Bachelor’s Degree in Journalism and Communication, received from University of Rwanda’s College of Arts and Social Sciences (CASS) in 2014. He served various media houses in Rwanda including Rwanda Broadcasting Agency (RBA) in 2013 and became passionate with English Online and Print Media Publications where he exercised his talent as a Freelance News Reporter for The New Times, The Independent, The Rwanda Focus, Panorama and more before he became a Self-Entrepreneur as the CEO and Founder of The Inspirer Limited in early 2017.

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