Abstract:
Rwanda’s key social security schemes, the Mutuelle de Sante health insurance scheme is facing lower coverage in some of the districts of Rwanda. The study on the enrolment to the community based health insurance scheme, Community based health insurance (CBHI) with a case study of NYARUGURU District was conducted in order to address the following five objectives: To find out the source of information for better enrollment in the CBHI Programme; to find the reasons for enrolling in CBHI programme; to find the trend of CBI enrolment in Nyaruguru District, to identify challenges faced by CBHI stakeholders in NYARUGURU District. The study design used a triangulation approach and the study population were 31987 through which Cochran (1977) formulas was used to select a sample of 384 respondents. The questionnaire and interviews were used to obtain the information from the people enrolled and unenrolled to CBHI. The study found that most people get CBHI information through radio advertisements as responded by 95 among 384 which corresponds to 25% against 54.2 % of the respondents that indicated the pressure or mobilization from local leaders. On the study on challenges that CBHI faces, the ‘Poverty’ was mentioned as the biggest factor as to why people don’t contribute to CBHI scheme by 86 peoples out of 384 which corresponds to 22%, ‘Poverty and non-harmonized Ubudehe categories’ by 81 peoples corresponding to 21% and ‘Lack of Ubudehe category’ by 59 peoples corresponding to 15%. On the question about the difficulties in the management of CBHI in NYARUGURU district, the biggest difficulty mentioned by managers of CBHI was ‘Ignorance of Beneficiaries’ voted by 148 persons which corresponds to 39%. Hence, we recommend a continuous advertisement via radio and social mobilization in order to increase the number of people enrolled in CBHI. Again, increased involvement of people in Ubudehe would increase the money in the pocket of people in Nyaruguru District and would in return contribute to higher enrolment of people in CBHI and last, insure that prioritize premium payment is implemented during a follow up by mobilization committee’ as well as providing motivation to CBHI staff by increasing the salary of the health workers
