Page 271 - GHES-3-3

Global Health Economics and
Sustainability
Sustainability of Rwanda’s UHC: 2011–2021 and vision 2050

infrastructure, including digital diagnostic technology, “new generation” approach. Supportive supervision and
advanced medical equipment, automation of financial on-the-job training will be organized regularly.
management and billing systems, and other uncovered (v) Specialists, doctors, and health professionals will
capital cost areas, as shown in Figure 5. Of this amount, undergo a 3-month training to become future
RWF 1,764.68 billion (25.26%) will be directed toward trainers. The MOH, the Ministry of Finance and
modernizing health infrastructure, acquiring advanced Economic Planning, and stakeholders will develop
medical equipment, digital diagnostic technologies, a hospital investment plan, focusing on essential
and laboratory tests, as well as automating financial specialties. Geographic access to quality specialty
management and claims payment (Table S11). The care will be equitably programmed at both central
remaining RWF 1,705.66 billion (see the lower row of and decentralized levels.
Table S11) will be allocated as follows: (i) RWF 1,007.09 b. From 2031/2032 to 2035/2036
billion (14.42%) for clinical capacity development, (ii)
RWF 307.37 billion (4.4%) for special medical inclusion This phase will implement “target-based planning
with advanced assistive devices for people living with and budgeting (TBPB) health interventions,” focusing on
disabilities, (iii) RWF 307.37 billion (4.4%) for elderly specialized universal access for the first time by combining
socioeconomic empowerment to complement the previous resources with 13 new funding sources (Table 3).
current Vision 2020 Umurenge Program’s monthly direct Alongside input-based planning and budgeting, the
support, aiming to enable this vulnerable subgroup to systems will integrate all resources, including the new
withstand shocks, as well as combat extreme poverty and funding sources, to provide specialized care to CBHI
malnutrition. In the first time, the complement will match beneficiaries. From 2031/2032 to 2035/2036, this approach
the current monthly allocation through 2027/2028 and will will enable Rwanda to fully cover all CHFP costs as a third-
be adjusted periodically based on available reserves or the party payer for health interventions in Scenarios II and IV,
country’s economic growth; and (iv) RWF 83.83 billion thereby reflecting a TBPB implementation model.
(1.2%) for technical assistance and advisory services c. From 2036/2037 to 2040/2041
(Figure 5).
Between 2036 and 2041, the CHFP will address any
3.4.8. The roadmap of the long-term HRV 2050’s delayed programs, health interventions, or unmet health-
sustainable development strategy service needs related to Rwanda’s UHC model, aligned with
This section outlines the roadmap of the long-term HRV the WHO’s UHC CUBE. During this period, planning,
2050’s sustainable development strategy. budgeting, and execution will incorporate systemically all
preventive, promotional, rehabilitative, and palliative care,
a. First year of implementation to 2029/2030 primarily utilizing internal resources from an autonomy/
This phase includes: self-reliance (agaciro) perspective.
(i) Rwanda’s UHC (CBHI and P/A health-care system) d. From 2040/2041 to 2045
aims to meet UMIC health-care system standards,
providing near-free access to specialized care, with This period will involve systemic planning and
reimbursement via CBHI/CHFP through a third- budgeting for all activities related to CBHI and the health-
party payment system care delivery system, primarily using internal resources
(ii) The pilot phase from the first year of FASP PPM until (manpower, money, materials, and methods).
2027/2028 will follow “input-based planning and In addition, the TBPB system will integrate and
budgeting” or selective planning. From 2028/2029 manage, alongside the CHFP and other health care-related
to 2030/2031, planning will be semi-selective, interventions, the salaries of support staff.
combining existing resources with additional e. From 2046 to 2050
funding from 13 new resources (Table 3)
(iii) The CHFP will assume new responsibilities, This phase will reflect the sovereignty standard of
implementing reforms, innovations, and cost- Rwanda’s UHC model, as demonstrated through the
control measures. Clinical skills will be strengthened TBPB system alongside the CHFP and health care-related
through coaching by specialists, doctors, and other interventions. It will also include the integration of salaries
health professionals in hospitals for all health workforce, in addition to the support staff
(iv) At the primary health-care level, community health already integrated within the CHFP financial management
workers will provide home-based psycho-social-medical framework.
support, and health centers will be introduced with a f. Post-2050 era

Volume 3 Issue 3 (2025) 263 https://doi.org/10.36922/ghes.5842