2.5.
Global overview of Rwanda health insurance schemes
Mutual insurance schemes can be broadly defined as systems
based on voluntary engagement and the principles of solidarity and reciprocity,
members usually have to meet certain obligations, e.g. payment of premiums, and
are bound together by a common objective and a strong local affiliation. Many
times, these schemes evolve out traditional systems or form as a response to
the low coverage provided by formal systems». (Jutting, J, 2003:60).
However great difficulties in instituting private health
insurance schemes in rural areas in Africa where most beneficiaries live have
greatly diminished the rate of private financing of health services among
beneficiaries. He went further to propose the synergy concept in healthcare
provision and financing to show how various groups in society can make a
contribution to the process of health development in coordinated fashion. The
concept synergy or mutual reinforcement of various participants in the process
of improving health status, required coordination of the type of health service
to be produced and their co-production and co-financing. (Schneider P, Diop F
& Bucyana S. 2000)
LUCAS et al. (1999), assert that while living is expensive,
illness is more so thus sound financial investment should offer preventive and
promotive health activities to an individual and to the society at large. A
sound financial policy for public health service therefore must be taken into
consideration not only for humanitarian and social gains but also some economic
advantages should be delivered there from. Public health is one of the best
forms of social and economic insurance, different studies which were undertaken
by various scholars have demonstrated that without coercive powers of the
state, and pressure groups, the sound of community health insurance would prove
futile.
According to Aisworth (1995:25), "experience with the user
charges in Zimbabwe, Uganda, Swaziland, Ghana, Egypt, Cameroon, Tanzania,
Kenya, Nigeria, among others, show that political elements and grass root
support are important tools in economic development due to their support in
health cost minimization. Mutual health organization can further be defined as
«a voluntary, non-profit insurance scheme, formed on the basis of an ethic
of mutual aid, solidarity, and the collective pooling of health risk, in which
the members participate effectively in its management and functioning»
(Atim. C 1999:46).
In providing insurance models, the officials originate from
the healthcare provider institutions (or from the ultimate provider
organization such as the government or mission health administration) and
manage both the insurance and the healthcare aspect of the scheme, similar to
Health Maintenance Organizations (HMO), (Atim. C 1999:46)
2.6. Principal objectives of insurance schemes
One is to bring about an increase in the Government's
financial distribution to the EPI by constantly presenting the case for the
importance of the EPI in terms of general policy.
Secondly is to increase the contribution from other donors
(bilateral and multilateral cooperation) with the aim of closing the gap
between needs and acquired resources and to reduce dependence on those donors
by a greater diversification of sources of funding by improving the financial
situation of the health facilities. Thirdly is to improve the population's
financial access to health services, this improved the health situation of the
population. Fourth is to increase the sustainability of funding, last but not
least is to increase the efficiency of the program so as to improve the
cost-benefit ratio. (Atim. C 1999:46)
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