L’assurance mutualiste au Rwanda : regard critique sur les aspects organisationnels et fonctionnels des mutuelles de santé

Abstract

EXECUTIVE SUMMARY The mutual health insurance scheme is a system which functions essentially by means of contribution fees of its members, and covers their health-related risks. In 2007, the law n° 62/2007 of 30/12/2007 created in each district of Rwanda a mutual health insurance scheme, and the present paper describes, analyses and criticises the organisation and functioning of this scheme as some of its aspects raise some questions. In fact, Rwandan Mutual health insurance scheme is coordinated at each district level by a mutual health insurance fund, which has legal personality and is administratively and financially autonomous. The contribution fees of its members consist of a fixed sum of money. The way this scheme is conceived raises a number of questions, among others, the question of easy access by each member to services it offers, especially when he falls in need being out of his district. Another important issue concerns the mode of contribution by members: the contribution fee consisting of a fixed sum of money, this seems to not comply with the principle of solidarity, which is however an important pillar in mutual insurance scheme constitution. This image of mutual health insurance scheme in Rwanda is the main reason why a research in that domain was undertaken, to analyse in details different aspects of the organisation and the functioning of the Rwandan mutual health insurance scheme that merit some attention and consideration, and, where possible, to find out and suggest solutions which could help improve or to build a scheme that can serve better the beneficiaries. Not only the research provides a tool that can help to get clarity on what is mutual insurance scheme in general and mutual health insurance scheme in particular, as well as on the organisation and the functioning of mutual health insurance scheme in Rwanda, it can also help whoever it may concern to find important information on various aspects of Rwandan mutual health insurance scheme, information which can play as a good guide to better reforms. This work consists of three chapters, talking about mutuality in general and mutual health insurance scheme in particular (chap I), the Rwandan mutual health insurance scheme in details (chap. II) to finally suggest what can render the scheme better more helpful (Chap. III).