The New Times (Kigali)

17 July 2014

Rwanda: Mutuelle - Govt to Pay Rwf400 Million in Arrears

The government has set this financial year to complete payment of Rwf431 million owed to national referral hospitals as part of health insurance cover (Mutuelle de Santé), arrears that accrued over the last few years.

The revelation was made on Wednesday by Dr Uzziel Ndagijimana, the permanent secretary in the Ministry of Health, while giving an update on the arrears.

"Debts to referral hospitals have not been paid yet but they will be paid during the new budget 2014-2015," Dr Ndagijimana told this paper by e-mail.

The director-general of the University Teaching Hospital of Kigali (Chuk), Dr Theobald Hategekimana, also confirmed that the hospital is expecting to get paid during the current financial year the arrears of the past few years.

"They promised to pay by this financial year; so they are expected to pay up any time," he said.

A review, completed in March 2013 by Senators, indicated that the debt was about Rwf2.3 billion owed to district hospitals, some Rwf1 million to health centres, and about Rwf431 million to national referral hospitals.

Ndagijimana said Rwf2.3 billion that was due to district hospitals has already been paid, while debts due to health centres with Mutuelle service across the country remain a process.

While presenting their report to the Senate about an assessment they had made on the performance of the community health insurance scheme, members of the Senatorial Committee on Social Affairs, Human Rights and Petitions said the delay in payments to healthcare providers remained problematic since it often led to medical stock-out at hospitals.

After considering the findings from the report, the senators had given the central government three months to clear all the arrears that would not be fully cleared by different Mutuelle branches across the country.

Senator Gallican Niyongana, the vice-president of the Senate's Committee on Social Affairs, told The New Times on Wednesday that a lot has been done in paying Mutuelle arrears.

But he warned against the accumulation of new arrears in the health scheme, saying the Fund's efficiency would partly be measured against its ability to consistently pay up its dues.

"Carrying arrears was a sign that the scheme wasn't self-sufficient. Those managing the Fund have to ensure that no more arrears are carried," Niyongana said.

Subscription:

An estimated 73 per cent of Rwandans used Mutuelle de Santé for their health insurance in the last fiscal year 2013/14, down from 80.7 per cent and 90.7 per cent in the financial years 2012/13 and 2011/12, respectively.

Dr Ndagijimana said the Ministry of Health has rolled out a campaign to attract as many Mutuelle subscribers as possible in the current financial year.

"The mobilisation of the population is being conducted countrywide by the local governments to improve the membership rate to Mutuelle," he said.

The official said the model of ibimina (local informal saving groups) is being implemented to help the population with financial limitations to save small amounts of money slowly as a group for Mutuelle contributions.

Leaders and residents in different parts of the country have lauded ibimina saving groups for making the collection of Mutuelle contributions possible.

In small groups of between 20 and 30 families living in the same village, people pool funds together based on mutual trust so that they can pay their subscription.

The ministries of Health and Local Government are also planning to use radio talk shows to sensitise the population about the value of Mutuelle de Santé, Ndagijimana said.

Mutuelle de Santé enrolment:

2007 75%

2008 85%

2009 86%

2010 91%

2011/12 90.7%

2012/13 80.7%

2013/14 73%

Source: MINISTRY OF HEALTH

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