As part of the reconstruction of the health sector in Rwanda, the MOH is undertaking an array of reforms in the way health services are financed and delivered. With the help of the USAID-funded Partnerships for Health Reform Project, they have initiated a pilot effort in 3 rural districts to test the viability of reorganizing and financing PHC through prepayment schemes. Reforms in the 3 districts focus on improving access and utilization from a low of .25 visits per capita per year by organizing care into prepayment schemes with district and community management, altering the way providers are paid, and providing financial and non-financial incentives for increasing coverage and quality. The benefit package was designed with community participation and covers all primary care services and essential drugs offered at participating public and private health centers, as well as ambulance transfer to district hospital where a limited package of services is offered. This presentation will describe key features of the design and implementation of the pilot scheme and findings from the evaluation conducted after one year of operation. The evaluation, based on household and provider survey data, assesses the impact of the pilot on equity, quality, efficiency, and financial sustainability. This presentation will focus on how these results are affected by incentives created for consumers and providers by the new community participation, financing and organizational methods.
Learning Objectives: 1. Increase understanding of the impact of financing and organizational change on consumer utilization 2. Increase understanding of the role of changes in community participation, financing and organizational structures in motivating improved provider performance
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.