Rwanda has made tremendous progress since the 1994 genocide against the Tutsi. The country now has an innovative type of health insurance, mutuelle de sante. It is family-based health insurance, in which each family member has to pay $4 per year. Since this is family-based health insurance, each family member has to pay before anybody can receive medical care. Rwandan families are large (average=6) and some families are unable to afford such an amount, and in that case, the one with diabetes becomes a victim.
If the family is able to afford the health insurance, once the family is insured, their overall medical cost becomes only 10% of the original total cost. For instance, a diabetes patient will pay $2 for 2 bottles of insulin each month instead of $20, a largely unaffordable amount to the general Rwandan population. In other words, $25 per year will cover insulin for an entire year. The average cost of the round trip to hospital is also $2, therefore we estimate that $50 can cover both insulin and transport per a year. However, based on our experience, some families are unable to pay the $50, and PoH will help them until they can do so.
Health insurance is not just for diabetes, but also for other frequent endemic diseases such as malaria, along with other medical needs like maternal and child issues or accidents. The Health Insurance also injects cash into health systems and makes easier for all the stakeholders involved in diabetes care.
By covering health insurance and annual expenses, this allows the child to attend his/her monthly checkup, and families to get more involved in their child’s care, and increase their communication with the medical providers, therefore contributing to a better blood sugars control of the child.
PoH will also support the nurses to visit families and directly get to know the family situation in order to better help the child(ren) with T1D.