Page 275 - GHES-3-3

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

(v) Quality health-care system performance: Rwanda monitoring: The government’s health budget ensures
ranked 70 globally for best health-care systems quick responses to health emergencies and efficient
th
in 2023, with a health-care system score of 58.2. resource use. Regular monitoring through quarterly
This marks a significant improvement from its business plans and biannual meetings will strengthen
nd
172 position among 190 WHO member states in routine public financial management, accountability,
the 2000 ranking (World Health Organization, 2000). and transparency in Rwanda’s UHC Model
(iii) Health taxes: Taxes on harmful products, such as
4.3. Factors conducive to the success of UHC in tobacco, alcohol, and sugary drinks, will promote
Rwanda public health and generate revenue. A proposed
In addition to the structural achievements, Rwanda’s UHC generalized tax levy, the “minimum 1% specific tax for
success can be attributed to several hidden enabling factors: UHC and HRV 2050,” will further support these goals
(i) Good governance and stewardship: Political (iv) Innovative and strategic funding: Scenarios propose
leadership and strong governance align resources a 1% tax to fund Rwanda’s UHC and HRV 2050 goals.
with population health needs, contributing to Private sector involvement will be critical in reducing
national and global health goals the government’s financial burden and will be the
(ii) Integration of faith-based health-care system: Faith- main funding source of the P/A health-care system
based organizations manage approximately 40% of (v) Sustainable health progress: Rwanda’s UHC model
health facilities, integrated with the public health focuses on resilience and financial sustainability,
system while maintaining autonomy ensuring long-term access to quality health care
(iii) Decentralization: Rwanda’s decentralized health (vi) Nobody behind, vertical equity, and special
system improves both access to care and UHC inclusion: Efforts will focus on protecting vulnerable
delivery by incorporating local governance groups from financial hardship, expanding
(iv) Adaptation of global health goals: Rwanda tailors subsidized/affordable quality health-care services,
global health targets, such as the Millennium and tackling social costs, including those of feeding
Development Goals, to its context, facilitating and dietetics services
remarkable health outcomes (vii) Coordination and solidarity: Effective collaboration
(v) Homegrown innovations: Programs such as CBHI, between ministries, the National Bank of Rwanda,
performance-based financing, and community the RSSB, and the private sector will ensure long-
health workers are pivotal in expanding UHC term UHC and HRV 2050 success
(vi) Community health workers: Community health (viii) Tackling health inequality: Rwanda has strongly
workers provide essential health services, particularly emphasized equity, ensuring that marginalized and
in rural areas, addressing 80% of local health needs rural populations benefit from health-care services.
(vii) Inter-sectoral collaboration: Rwanda’s health (ix) Tackling health workforce shortages: Through
system thrives on cross-sector cooperation through training and retention programs, such as the 4×4
frameworks, including the Sector Wide Approach Health Reform, Rwanda is ensuring an adequate
and Joint Action Development Forum and skilled health workforce.
(viii) Aid coordination and mutual accountability: (x) Tackling non-communicable diseases: Rwanda
Transparent aid management has fostered trust is responding to the growing burden of non-
and efficiency, ensuring mutual accountability in communicable diseases by promoting prevention
resource allocation. programs and integrating care for these diseases into
the national health strategy. Rwanda’s experience
4.4. Capability to address current and emerging in handling health crises, such as COVID-19 and
challenges in the UHC scheme amid a changing Ebola, has demonstrated its readiness to tackle
global landscape emerging health concerns through rapid response
Rwanda is well-positioned to tackle both existing and systems, effective containment measures, and
emerging health challenges through strategic financing international collaboration.
and policy implementation:
(i) Health financing: Key approaches include social 4.5. Fee-for-service mechanism versus fully active-
mobilization via CBHI, revenue generation through strategic purchasing mechanism
various funding sources, and pooling funds to This study compares FFS and FASP payment mechanisms
improve financial protection in Ghana, Indonesia, and Thailand. When social health
(ii) Public spending on health control and/or insurance uses DRGs, high-cost providers may refrain from

Volume 3 Issue 3 (2025) 267 https://doi.org/10.36922/ghes.5842