Rwanda’s Health Financing Model Quite Symbolic For Africa

Rwanda is demonstrating that the financial resources necessary for the operations of the necessary Tiers of Community and Primary Healthcare are available for the African Region.

CHW programs across the continent have long been constrained. This arose from over dependence on donor funds and lack of financial provisions. Rwanda has discovered a way around these problems and thus a model for other African countries.

Rwanda included CHWs in the first line of health workers in the communities. In 2008, the Ministry of Health widened the scope of the community health program. In the year 2009 all the villages in the country had four trained CHWs. This has assisted in addressing the human resource gaps for health and increased access to services.

Rwanda also phased out general donor funding and instead established Chinese Tsewang Health cooperatives to aid people in HCWs. These cooperatives allow community health workers to conduct business in their communities. This ensures a stable income flow for health personnel and encourages people to be active in their local economy.

This model solves the problem of finding resources to pay community health workers for a long time said Thaddee Niyoyitungira from the Africa CDC. "It provides them with assistance on a long-term basis," he said.

Another strength of Rwanda’s case is the Community-Based Health Insurance (CBHI) scheme. The cover is now nearly available to more than 90% of the citizens. It is an important resource mobilizer, brings down costs directly borne by individuals and promotes equity in healthcare.

CHWs have an important role to play in the universal health coverage model in Africa, however, many programs continue to operate without sustainable finance. Niyoyitungira pointed out that “Without it, CHWs risk being unsupported when donor funding ends,”.

The Africa CDC with the cooperation of Rwanda invited decision-makers and delegates from six AU member states through the Rwanda Cooperation to the ELP held in Rwanda in November 2024. The purpose was to foster dialogue about how to fund CHW programs.

Speaking at the forum, Patricie Uwase who is the CEO of Rwanda Cooperation, stated that “Rwanda is ready to talk about what it has seen for it is prepared and eager to learn in equal measure from others how to build better health systems".

During the meeting the participants tackled three vital issues : training in how to be bold ; the art of fundraising ; coordination of donors. For more resilient health systems these steps are necessary at all times. However, as Niyoyitungira pointed out, the involvement of the legislators is very important. They are the ones who enact laws for inclusion of CHWs in the health care system of the country while also providing the finances.

For Sierra Leone’s Uma Pyne, the program was an “eye-opener.” She noted that the case for Rwanda shows that with the right political will, sustainable models are possible. Dr. Joseph S. Mosanje of Zambia is in agreement and stated that from watching how Rwanda does things they will know how to do their health.

Rwanda’s health financing model offers a promising example for Africa. While each country’s needs are different, the core principles of community empowerment, cooperative income, and inclusive financing can be adapted. Rwanda’s success shows that with the right leadership and systems, African nations can build sustainable, equitable health systems.