Presentation on theme: "THE COMMUNITY BASED HEALTH INSURANCE (CBHI)"— Presentation transcript:
1THE COMMUNITY BASED HEALTH INSURANCE (CBHI) 11/20/00THE COMMUNITY BASED HEALTH INSURANCE (CBHI)MoH/Health Financing UnitPresented by :MIGISHA BenjaminIn charge of Health Insurance PolicyMob(+250)
2GOALS AND OBJECTIVES Goal 11/20/00GOALS AND OBJECTIVESGoalTo provide the population of Rwanda with a universal and equitable access to quality health servicesObjectiveTo give orientations for the development and strengthening of the community based health insurance (CBHI ) in Rwanda in order to improve the financial accessibility of population to health care, protect households against the financial risks associated to diseases and strengthen social inclusion in the health sector.
3SPECIFIC OBJECTIVESFavor the membership in CBHI for people in the informal sector and rural areas;Strengthen the financial viability of the CBHI;Strengthen management capacities of the CBHI system
4Back ground of rwanda cbhi : Free Care , Reintroduction of the system of cost recovery , Introduction to the formal approach to mutual health (pilot in 3 health Districts : District Kabgayi, Byumba and Kabutare: 52 health centers and 3 hospitals In 1999, Development of management tools, modules and awareness brochures, manuals and training management
5Cont’dIn , development of the strategic document "Policy of mutual health insurance in Rwanda’’ ministerial directive of the Ministry of Health, expansion of health insurance schemes .CBHI is regulated under the law n°62 / 2007 of 30/12/2007 relating to the creation, organization, functioning and management of CBHI and published on March 20th, 2008 in the official gazette.At the same time, utilization of health services increased considerably from 30.7% in 2003 to 85% in (HMIS).Presently, all operational health centers of the country shelter a CBHI section; which presumes 100 % geographic coverage
6WHY CBHI Scheme IN RWANDA? 11/20/00WHY CBHI Scheme IN RWANDA?Reasons to start CBHI in Rwanda:Very low levels of utilization (0.3 visits/C in 2001) and studies show that financial barriers to access are causing this.Financial losses in health facilities due to unpaid billsNeed of Social Protection for all population especially the poor categoryNeed to create a mechanism for Health Insurance for those in informal employment
7INCREASE of cbhi COVERAGE rate Année2003200420052006200720082009201020112012Coverage rate7%27%44%73%75%85%86%91%83%90.7%Utilasation rate30.7%39%46.8%60.7%72%95%
8Financial sources 1) Contributions from beneficiaries; 2)Contributions from Government and development partners;3) Contributions from RSSB and MMI;4) Contributions from private Insurance companies;
10CBHI population categories and PREMIUMS UBUDEHE CategoriesCBHI CategoriesAmount per capita (RwF)1&2Very poor12,000 (To be paid by Government)3 &4Middle category23,0005 &6Rich37,000
11Estimation of Population/ Category (source: New Policy) CategoriesEstimated %age126258316Total100%
12Covered Health Services Packages Health Center Level: Minimum Health Services PackageDistrict Hospital: Complementary PackageReferral Hospital: Tertiary PackageAmbulances cost is also covered
13ACHIEVEMENTSThe law n°62 / 2007 of 30/12/2007 relating to the creation, organization, functioning and management of CBHI.Elaboration of Ministerial Instructions relating to the organization, functioning and management of CBHI at all levels and their publication.Revision of CBHI policy and its implementationSensitization program made across the countryUtilization of all media (radio, television, news papers etc.)
14Cont.Elaboration of the new management procedures manual of CBHI and its implementation.Trainning of all CBHI Districts Directors, Sections managers and accouantants on the new management procedures manual of CBHI
15CHALLENGESLack of computerization system and internet access of CBHI sections for good reporting systemLack of facilities( offices, electricity, …) for some CBHI Sections.Some case of fraud by persons not yet covered by any medical insurance scheme;Misanderstanding on CBHI scheme for some individuals
16Perspective of coming years Magnetic cards;Computerization of all sections;CBHI infrastructure.
17conclusionThe objectives of the development policy of CBHI are clearly defined and well shared. They strongly reflect the ambition of the Rwandan government to promote the accessibility of quality health care to all Rwandans, particularly the most destitute.This determination is shown by the implication of local authorities in the improvement of the coverage by CBHI and the involvement of development partners in the development of CBHI. The challenges are certainly numerous, but the adherence and participation of Rwandans in the development of this policy will favor its success.