Community mobilisation for health insurance financing and decentralised care: Case studies from Rwanda and the Africa region

Rwanda’s Community-Based Health Insurance (CBHI), or “Mutuelle de Santé,” was created to make healthcare accessible and affordable, particularly in rural areas. Initially piloted in three districts, it has since expanded nationwide, covering about 90% of the population. A key factor in its success is decentralized management at the district and community levels, which has improved local adaptation and administration. This approach has increased community ownership and participation, enabling CBHI to evolve from covering primary healthcare to offering specialized care for chronic conditions, including non-communicable diseases (NCDs).

CBHI’s universal health coverage, funded by government and community contributions, has made healthcare more affordable and accessible for all, especially for NCDs, which are often costly due to their chronic nature. Community members actively contribute annually, understanding the program’s role in reducing financial hardship and enhancing healthcare access.

The session will showcase CBHI as a model for achieving equitable universal health coverage (UHC) in Rwanda, focusing on the role of community mobilization and education in sustaining the program. It will also discuss ongoing reforms to improve NCD care coverage and highlight successful strategies from other countries that have adopted similar community-based health insurance approaches for achieving UHC.