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Citation Information

Type Working Paper
Title Role of Insurance in the Demand for Healthcare in Rwanda: A Household Level Investigation
Publication (Day/Month/Year) 2016
URL http://ju.se/download/18.b50f8081553242769960d4/1465522640424/EARP-EF+2016-03+Ruhara.pdf
In the 2000s the Government of Rwanda initiated health sector reforms aimed at increasing
access to healthcare. Despite these reforms there has not been a corresponding increase in
demand for health services, as only about 30 per cent of the sick use modern care (NISR,
2011). The objective of this paper is to examine the factors influencing outpatient care
demand in Rwanda and suggest appropriate measures to improve utilization of health
services. The source of data is the Integrated Household Living Conditions Survey
(EICV2) conducted in 2005 by the National Institute of Statistics Rwanda (NISR). A
structural model of demand for healthcare is estimated to measure demand effects of
covariates. The findings indicate that health insurance is a significant determinant of
outpatient medical care. In addition, the price of healthcare and household income are
among the main drivers of utilization of healthcare. Women are more likely to seek
outpatient healthcare. Two main policy recommendations emerge from these findings.
First, the government should reduce out-of-pocket healthcare expenditures (OOPE)
through subsidies for public health facilities. Second, the government should reduce the
premiums for Community Based Health Insurance Schemes (CBHIs) to increase coverage

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