Improving health financing in response to the sustainable development goals

Improving health financing in response to the sustainable development goals

The Ministry of Health of Rwanda organized from 29th to 31st March 2016, in Bugesera District,  a three day International Conference on health financing in collaboration with its partners including WHO.  The theme of the Conference was “Health financing reforms in the eve of sustainable development goals: a look at the past 15 years of health reform”.

The Conference was opened by Honourable Minister of Finance and Economic Planning and Honourable Minister of Health. Bilateral and Multilateral Cooperation were represented, such as USAID, Management Sciences for Health, Global Fund, Belgian Technical Cooperation, Swiss Development Cooperation, etc… WHO was represented by the Health Financing Regional Adviser for Africa and three technical officers from the WHO Country Office in Rwanda (Health Promotion Officer, Essential Medicines Officer and Health Economist).

During the opening ceremony, the Minister of Health oriented the meeting by saying that all health financing efforts should be linked to Sustainable Development Goals: “We are looking for effective solutions for the future well being of our communities”. The Minister of Finance and Economic Planning, in his opening speech, stressed the importance of health in sustainable development and higlighted the commitment of the Government of Rwanda in health planning and in health financing: “We need to use innovative ways for sustaining our achievements in health financing,ensure a better future for rwandan population and inform policy makers”.

The goal of the Conference was to bring national and international experts, especially those who have contributed to the design and implementation of health financing reforms in Rwanda or in other countries , discuss the current state of health financing policies and brainstorm about the future directions. The discussions from the meeting will feed into the current government process of developing a health sustainability plan for the whole health sector.

The key outcomes of the Conference were to:

Understand the current status of global health financing reforms in the areas of universal health coverage.
Review of different approaches to ensure sustainable quality improvement and exploration of ways to link financial reforms with innovative quality improvement (e.g linking Performance Based Financing and Accreditation). 
Identify challenges experienced in scaling up health financing reforms in Rwanda and brainstorm about global strategies that can be applied in Rwanda to overcome these challenges.
Draw the recommendations  to sustain the gains achieved and to address challenges in Rwanda from the implementation of innovative financial reforms
After 15 years of scaling up innovative health financing reforms and achieving majority of the MDGs, Rwanda is in a cross road for sustaining the gains of the past and ensuring a great start to achieve the Sustainable Development Goals.

WHO has provided instrumental and consistent support to the Health Financing reforms through key interventions such as:

Rwanda Community-Based Health Insurance (CBHI) institutional capacity building (training of staff in CBHI management; development of guidelines and management tools ; “Ubudehe” socio-economic categorization processes; Ministry of Health, Rwanda Biomedical Center, Rwanda Social Security Board, and School of Public Health staff training in Health Financing for Universal Health Coverage; etc.);

Support review of  the Rwanda Health Financing Systems  which recommended among others the introduction of stratified premium contribution (adopted and integrated in the CBHI policy since 2010);

Financial and technical support to the Health Financing and CBHI policies development;

Advocacy  and effective mainstreaming of the Universal Health Coverage principles in the health sector policies and strategies with focus on equitable access to health care and financial protection of the population especially the most vulnerable;

Participation in the development of the proposal on transfer of Community Based Health Insurance to Rwanda Social Security Board for Cabinet and Parliament consideration;

Support to the organization and facilitation of the East African Community (EAC) Member States Ministerial Conference on “Social Health Protection EAC Regional Integration” and follow-up meetings for the implementation of the Kigali Declaration from that conference.

WHO also, among other partners, provided technical and financial support to the organization of this Conference and was acknowledged for its valuable support.

The Participants of the Conference were national, international experts and practitioners in health financing and community health. Some participants came from African countries such as Ethiopia, Senegal and Sierra Leone, and shared their experiences. In addition, Universities from the USA participated and shared their knowledge.

The Conference provided a platform to participants to better understand how innovative financing mechanisms should contribute to the improvement of community health towards universal health coverage. It included plenary and group work sessions with extensive discussions on the challenges and strategies to address them in view to sustain the path towards universal health coverage and embrace the integration of the Sustainable Development Goals.  

At the end of the conference, final recommendations were formulated on health financing reforms with focus on the following areas: 

Innovative health financing strategies: options for mobilizing domestic resources;
Health Insurance in general and CBHI in particular as a strategic mechanism to move towards universal health coverage;
Performance Based Financing and Accreditation;
Community health financing in  Rwanda.  
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For more information, please contact:

Mrs Diane MUHONGERWA, HEC, e-mail: muhongerwad [at] who.int
Mr. Jean Bosco GASHEREBUKA, HPR, e-mail: gasherebukab [at] who.int

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