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A critical assessment of the Rwandan health financing system: implications for health service utilisation

Like many other countries, Rwanda has embraced major health financing reforms to achieve universal health coverage goals and improve access to quality health services without undue financial hardship for its citizens. The public health sector provides most health services in the country, and fragmen...

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Main Author: Hakuzimana, Alex
Other Authors: Ataguba, John Ele-Ojo
Format: Thesis
Language:English
English
Published: Department of Public Health and Family Medicine 2025
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access_status_str Open Access
author Hakuzimana, Alex
author2 Ataguba, John Ele-Ojo
author_browse Ataguba, John Ele-Ojo
Hakuzimana, Alex
author_facet Ataguba, John Ele-Ojo
Hakuzimana, Alex
author_sort Hakuzimana, Alex
collection Thesis
description Like many other countries, Rwanda has embraced major health financing reforms to achieve universal health coverage goals and improve access to quality health services without undue financial hardship for its citizens. The public health sector provides most health services in the country, and fragmentation is a major challenge to its health financing system. Literature suggests that fragmentation of health financing may negatively impact the health system's equity, efficiency, and sustainability. Considering the currently available literature, this thesis critically assessed Rwanda's health financing system in relation to the equitable use of health care services, one of the goals of universal health coverage. Various methodological approaches to address different objectives are explored. A case study qualitative approach combining document review and in-depth interviews of key informants indicates that the Rwandan health financing system is fragmented. Using the data from the 2005/2006 and 2010/2011 Integrated Household Living Conditions Surveys, this research shows that despite this fragmentation and contrary to findings from other studies, there was no inequality in public health services use during the two separate periods. These results provide further opportunities for more health sector reforms to improve access to affordable public health services in Rwanda. They also support recommendations to conduct similar analyses to compare these findings with the most recent data to capture the current reality on the equitable use of health care services in public health facilities.
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institution University of Cape Town (South Africa)
language English
eng
last_indexed 2026-06-10T12:32:21.936Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
publishDateRange 2025
publishDateSort 2025
publisher Department of Public Health and Family Medicine
publisherStr Department of Public Health and Family Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/42266 A critical assessment of the Rwandan health financing system: implications for health service utilisation Hakuzimana, Alex Ataguba, John Ele-Ojo Obse, Amarech Cunnama, Lucy Rwanda health financing reforms Like many other countries, Rwanda has embraced major health financing reforms to achieve universal health coverage goals and improve access to quality health services without undue financial hardship for its citizens. The public health sector provides most health services in the country, and fragmentation is a major challenge to its health financing system. Literature suggests that fragmentation of health financing may negatively impact the health system's equity, efficiency, and sustainability. Considering the currently available literature, this thesis critically assessed Rwanda's health financing system in relation to the equitable use of health care services, one of the goals of universal health coverage. Various methodological approaches to address different objectives are explored. A case study qualitative approach combining document review and in-depth interviews of key informants indicates that the Rwandan health financing system is fragmented. Using the data from the 2005/2006 and 2010/2011 Integrated Household Living Conditions Surveys, this research shows that despite this fragmentation and contrary to findings from other studies, there was no inequality in public health services use during the two separate periods. These results provide further opportunities for more health sector reforms to improve access to affordable public health services in Rwanda. They also support recommendations to conduct similar analyses to compare these findings with the most recent data to capture the current reality on the equitable use of health care services in public health facilities. 2025-11-18T13:59:35Z 2025-11-18T13:59:35Z 2025 2025-11-18T13:57:20Z Thesis / Dissertation Doctoral PhD http://hdl.handle.net/11427/42266 en eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences
spellingShingle Rwanda
health financing reforms
Hakuzimana, Alex
A critical assessment of the Rwandan health financing system: implications for health service utilisation
thesis_degree_str Doctoral
title A critical assessment of the Rwandan health financing system: implications for health service utilisation
title_full A critical assessment of the Rwandan health financing system: implications for health service utilisation
title_fullStr A critical assessment of the Rwandan health financing system: implications for health service utilisation
title_full_unstemmed A critical assessment of the Rwandan health financing system: implications for health service utilisation
title_short A critical assessment of the Rwandan health financing system: implications for health service utilisation
title_sort critical assessment of the rwandan health financing system implications for health service utilisation
topic Rwanda
health financing reforms
url http://hdl.handle.net/11427/42266
work_keys_str_mv AT hakuzimanaalex acriticalassessmentoftherwandanhealthfinancingsystemimplicationsforhealthserviceutilisation
AT hakuzimanaalex criticalassessmentoftherwandanhealthfinancingsystemimplicationsforhealthserviceutilisation