Govt seeks alternative financing for Mutuelle de Santé services

Wednesday March 6 2019


Mutuelle de Sante card-holder being attended to at a Rwandan hospital.  

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The government is seeking alternative financing to plug a deficit in funding for the community based health insurance scheme — Mutuelle de Santé.

The deficit is caused by a mismatch between subscriber’s contributions and the amount the government should pay.

The Rwanda Social Security Board (RSSB) projected expenditure of Rwf95 billion for the fiscal year ending June 30, and about Rwf47 billion for the six-month period. However, half year expenses have already amounted Rwf54.2bn, meaning it has used 14 per cent more funds than expected.

RSSB, the body charged with running the scheme, has been struggling to cope with the effects of increasing drug prices and fraudulent practices by errant staff who connive with others to defraud the body.

“The government has already decided to get money from elsewhere to plug the funding gap and in one month it will have been endorsed the Prime Minister’s order so we can increase Mutuelle de Santé funds” said Richard Tusabe, the RSSB Director General.

He added that they are also facing the challenge of medicine becoming more expensive, possibly due to inflation, and the government is looking at ways of getting them cheaply.


Some pharmacies and clinics are conniving with customers to change drug prescriptions in a bid to increase the costs. He said RSSB is working with other relevant agencies to investigate and they will have the findings in three month time.

There have been cases of people working with RSSB employees to claim pension benefits of supposedly dead members. RSSB is also coming up with strict measures to clamp down on employers who have failed to pay pension contributions for their employees.

Currently, compliance is at 81 per cent while non-compliance stands at 19 per cent. The pension body has an annual tar- get of getting 1,400 new employers and 110,000 new pension contributors, but it got 507 new employers and 68,000 contributors.

Mutuelle de Santé coverage now stands at 85.6 per cent, a step up from 84.5 per cent in the previous year. The pension body is moving to modernise and integrate its IT systems with existing institutions that hold large amounts of data on citizens to enable seamless and integrated access to information.

Trade unions for pensioners have welcomed the government move to establish the long-term saving scheme (EjoHeza), which will operate alongside the conventional pensions body.

The long-term saving scheme is open to people of all age groups and economic clusters, including those who are already in the pension net. It is intended to create a savings pool that will financially cushion citizens in the future.

However, the scheme is yet to gain traction, as people are still reluctant to save money with the scheme, despite having registered in big numbers. About 37,000 people have so far registered with EjoHeza, but only 8,000 have saved a total of Rwf34 million.


Actuarial studies show that by 2050 up to 10 per cent of citizens will be over 60 years. Currently, five per cent of citizens are over 60 years old. RSSB has already made Rwf25 billion in profits in the first six months of this financial year, and is expecting to make Rwf60 billion profit in the next six months.

It targets to collect up to Rwf163 billion in contributions this financial year, having already exceeded its Rwf82 billion target for the first six months, after collecting Rwf85 billion.

RSSB expects to earn Rwf59 billion in revenues from its investments this, and six months into the year it has already earned Rwf32.5 billion, exceeding its six month target of Rwf29 billion.