The contribution of rwandan health insurance in economic development of rwanda

LIST OF ABBREVITIONS

$: Dollars

BPR: Banque Populaire du Rwanda

CBHI: Community Based Health Insurance

CBI: Community Based Insurance

CPI: Consumer Price Index

CTAMs: Community Threat Assessment Matrices

EDPRS: Economic Development and Poverty Reduction Strategy

EPI: Economic Policy Institute

GDP: Gross Domestic Product

GNP: Gross National Product

GTZ: Deutsche Gesellschaft fur Technische Zusammenarbeit (German                         International Development assistance program)

HIWTP: Health Insurance and Willingness to Pay

HMOs: Health Maintenance Organizations

IT: Information and Technology

LDCs: Least Developed Countries

MDGs: Millennium Development Goals

MH: Mutual health

MHI: Mutual Health insurance

MINISANTE: Ministère de la Santé

MMI: Military Medical Insurance

MOH: Ministry of Health

NGOs: Non Governmental Organizations

PHI: Paraprofessional Healthcare Institute

PPOs: Preferred Provider Organizations

PRS: Psychiatric Rehabilitation Services

RAMA: La Rwandaise d'Assurance Maladie

RSSB: Rwanda Social Security Board

SACCO: Savings and Credits Cooperative

UNDP: United Nations Development Programme

UP: Umutara Polytechnic

WHO: World Health Organization

WTP: Willingness to Pay

LIST OF TABLES

Table 1: Distribution of age 37

Table 2: Distribution of sex 38

Table 3: Distribution of marital status 39

Table 4: Distribution of level of education 40

Table 5: Distribution of source of information on MHI 41

Table 6: The motivator of beneficiaries to join MHI 42

Table 7: Number of children in the family 43

Table 8: Contributions/Premium 44

Table 9: Perception on the value of amount contributed 44

Table 10: Respondents point of view on health services offered to them 45

Table 11: Collaboration with mutual health insurance 47

Table 12 : Problems that hinder MHI 49

Table 13: Distribution of age 50

Table 14: Distribution of sex 50

Table 15: Workers' distribution according to marital status 51

Table 16: Level of education of workers 52

Table 17: Distribution of staffs respectively with the post held in the sector 53

Table 18: Distribution of respondents about willingness to pay (WTP) 56

Table 19: Problems hinder MHI to contribute a hundred percent on economic development 56

Table 20: Provider of the best solutions to the problems hinder MHI 57

LIST OF APPENDICES

i. Questionnaires

ii. To whom it may concern

iii. Official form for supervision of research project

TABLE OF CONTENTS

DECLARATION I

APPROVAL II

DEDICATION........................................................................................................................III

ACKNOWLEDGEMENT IV

LIST OF ABBREVITIONS V

LIST OF TABLES VII

LIST OF APPENDICES VIII

TABLE OF CONTENTS IX

ABSTRACT XII

CHAPTER ONE: GENERAL INTRODUCTION

1.1 Introduction 1

1.2 Background of the study 1

1.3. Statement of the problem 2

1.4. Purpose of the study 2

1.5. Objectives of the study 3

1.5.1.General objective.................................................................................3

1.5.2.Specific objectives...............................................................................3

1.6. The research questions 3

1.7. Scope of the study 3

1.8. Significance of the study 4

1.9. Organization of the study 5

CHAPTER TWO: LITERATURE REVIEW

2.1. General introduction 6

2.2. Definition of key concepts 6

2.2.1. Health insurance.................................................................................7

2.2.2. Economics......................................................................................10

2.2.3. Development...................................................................................11

2.3. Community health insurance schemes in Rwanda 18

2.4. Current problems of mutual health insurance schemes in Rwanda 18

2.5. Global overview of Rwanda health insurance schemes 20

2.6. Principal objectives of insurance schemes 21

2.7. The interventions on the policy of health insurance 22

2.8. Organization and management 23

2.9. Challenges of health insurance schemes in Africa 24

2.10. Health insurance and willingness to pay (WTP) 27

2.11. The situation of mutual health insurance schemes in Rwanda 28

2.12. An overview of literature review 30

CHAPTER THREE: RESEARCH METHODOLOGY

3.1. Introduction 32

3.2. Research design 32

3.3. Areas of the study 32

3.4. Sources of data collection 32

3.4.1. Primary data ....................................................................................33

3.4.2. Secondary data ................................................................................33

3.5. Analytitical frame work 33

3.6. Study population 33

3.7. Sample selection and sample size 34

3.8. Data collection instruments 34

3.8.1. Interview guide ................................................................................34

3.8.2. Observation.....................................................................................35

3.8.3. Documentation ................................................................................35

3.8.4. Questionnaire .................................................................................35

3.9. Data processing and data analysis 35

3.9.1. Data processing ...............................................................................35

3.9.1.1 Editing ........................................................................................36

3.9.1.2. Tabulation ....................................................................................36

3.9.2. Data analysis...................................................................................36

3.10. Limitations and delimitations of the study 36

CHAPTER FOUR: DATA ANALYSIS, PRESANTATION AND INTERPRETATION OF FINDINGS

4.1. Introduction 37

4.2. Analysis, Presentation and Interpretation of data part one (Beneficiaries) 37

4.3. Analysis, Presentation, and Interpretation of data part two (Staffs) .........................51

CHAPTER FIVE: SUMMARY OF FINDINGS, CONCLUSION, RECOMMENDATIONS AND SUGGESTION FOR FURTHER RESEARCH

5.1. INTRODUCTION 59

5.2. SUMMARY OF THE MAJOR FINDINGS. 59

5.3. CONCLUSION 62

5.4. RECOMMENDATIONS 63

5.5. SUGGESTION FOR FURTHER RESEARCH 64

APPENDICES 67