Monitoring reproductive health funding trends in Rwanda

Rwanda has one of the highest maternal mortality ratios in East and Southern Africa, one of the lowest rates of contraceptive use in the region, and a relatively high number of births per women of reproductive age. Reproductive health (RH) is a critical policy issue in Rwanda, however, it competes for funding with other priorities like HIV/AIDS and malaria. Policymakers require information on the level and flow of funding to ensure that RH targets are being met.

Rwanda conducted a National Health Accounts (NHA) and three subaccounts in 2006, including RH. NHA is an internationally-recognized tool that tracks the flow of funds through the health system. With the recent findings, one can compare RH expenditures in 2006 to the baseline from 2002. The RH subaccount is also useful for generating internationally-comparable data.

This paper presents findings from 2006 RH subaccount in the context of general health, malaria and HIV/AIDS funding levels for 2006, as well as temporal analyses from 2002 data. RH spending per woman of reproductive age increased from $7.11 to $8.44 from 2002 to 2006. Total health expenditure for RH did not increase sizably, while HIV/AIDS spending increased five-fold in that time. RH spending decreased from 36% to 8% of total donor spending in Rwanda. Household out of pocket spending also decreased.

It is recommended that RH stakeholders use these findings to advocate for bolstered funding of RH programs in Rwanda, as well as continue conducting RH subaccounts to monitor progress towards reaching key targets.