Description

Join us at the Fab for a research brown bag lunch with GHC Affiliate Researcher Zhubin Chen who will present his research on "Community-Based Health Insurance in Rwanda: Organization, Payment, and Practice".

Mutuelle de santé or community-based health insurance (CBHI) serves as the key instrument to achieve universal health coverage in Rwanda, but its impact on the practice of health care providers remains nebulous. To investigate the supply-side effect of CBHI, a multi-site ethnography was conducted at three representative district hospitals in urban and rural Rwanda. In total, more than 40 public providers and administrative staff at the studied hospitals were observed during their practice and 24 (including 11 general practitioners, 5 specialists, 3 nurses, 2 midwives, 1 intern student, and 2 finance officers) were further interviewed.

The ethnographic findings shed light on the impact mechanism of CBHI on provider practice and call attention from policymakers to the unintended effects. Its insurance trajectory not only guards the hierarchy of the referral-based health system in Rwanda, but also dictates the daily practice of health care providers. In so doing, the financial constraint on CBHI translates into the regulation of medical practices. Furthermore, the often delayed payment of CBHI to hospitals cripples the payment incentive installed to regulate and improve provider performance.

Zhubin's presentation will be followed by a Q&A and coffee chat. Don't forget to register to attend!