Universal Health Coverage

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UNIVERSAL HEALTH COVERAGE Scoping Report: Rwanda

Introduction

According to the WHO, Universal Health Coverage ensures the provision of affordable, good quality health care services, which are easily accessible to those in need. Two key aspects of UHC include Health Service Coverage and Financial Risk Coverage. The latter is key, according to the WHO, because it provides the assurance that patients will not suffer severe financial hardship as a consequence of seeking medical care. Indicators that clearly illustrate the state of universal health coverage have been selected based on the above requirements as well as those used to measure progress for relevant Millennium Development Goals.

Rwanda is a low-income country as dictated by the World Bank ($1035 or less), which suffered a massive civil war in 1994. The Government claims this has resulted in lasting socioeconomic damage as well as destroying its health infrastructure. Healthcare is funded by the state as well as individual contributions through health insurance and direct fees for services. Communicable diseases account for 77% of all deaths according to a WHO health report. Geographically many of the inhabitants live in rural areas reducing the scope of healthcare coverage. As part of its health initiative Vision 2020 healthcare in Rwanda has improved significantly building many hospitals where poor people are treated for free.

Analysis of Indicators

Under Five Mortality Rate (U5MR)

This is the probability of dying between birth and exactly five years of age expressed per 1000 live births (UNICEF). In 2011 the U5MR was 54 for both sexes, significantly below the average of 107 for Sub-Saharan Africa. The data shows significant improvement in reducing U5MR s...

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...ssing healthcare. Evans et al “defined expenditure as being catastrophic if a household’s financial contributions to the health system exceed 40% of income remaining after subsistence needs have been met.” On this basis Rwanda’s expenditure has taken a turn for the worse and become catastrophic.

The data is calculated from a combination of reports and household surveys which may suffer from sampling error. It is suitable for Rwanda, which has a relatively small elderly population that would otherwise contaminate the data since the elderly require extensive medical care, which may provide a misleading picture. Data may once again prove more informative if it is calculated separately for rural and urban areas.

Prevalence of Tuberculosis

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