ASSESSMENT OF THE
SUSTAINABILITY OF THE COMMUNITY BASED HEALTH INSURANCE SCHEME IN RWANDA
SUSTAINABILITY OF THE COMMUNITY BASED HEALTH INSURANCE SCHEME IN RWANDA
Background
The
Community Based Health Insurance (CBHI) in Rwanda is known to be among the most
successful CBHI schemes in Africa. It covers more than 90% of the Rwandan
population and allows them to have access to health care to all levels of the
Health Sector (from the primary to the most specialized level). The CBHI has
Community Based Health Insurance (CBHI) in Rwanda is known to be among the most
successful CBHI schemes in Africa. It covers more than 90% of the Rwandan
population and allows them to have access to health care to all levels of the
Health Sector (from the primary to the most specialized level). The CBHI has
been adopted as a government policy since 2004 and many facts showed that it
has improved financial access of the population and consequently the use of
Health Services. As an example, the percentage of the poorest households
experiencing catastrophic expenditure has been reduced by 4 times and by 1.5
times for all households, while utilization services increased from 24.6% in
2001 to 71.9 in 2007. Those facts show that CBHI is among the main pillars of
the Rwandan Health Sector.
While
there is compelling evidence of the positive impact of the CBHI, the main
challenge that is on top now is the questioning about its sustainability both
financially and programmatically. Some efforts have been started to work on the
challenge, in 2010 the Government of Rwanda change the CBHI Policy and
introduced the payment of premiums according to the socio economic categories
of the population and In addition to that, the government recently proposed to
move the management of CBHI from the Ministry of Health to the Rwandan Social
Security Board (RSSB)
there is compelling evidence of the positive impact of the CBHI, the main
challenge that is on top now is the questioning about its sustainability both
financially and programmatically. Some efforts have been started to work on the
challenge, in 2010 the Government of Rwanda change the CBHI Policy and
introduced the payment of premiums according to the socio economic categories
of the population and In addition to that, the government recently proposed to
move the management of CBHI from the Ministry of Health to the Rwandan Social
Security Board (RSSB)
The
USAID Integration Health Systems Strengthening Project (IHSSP) implemented by
Management Sciences for Health has worked hand in hand with the Ministry of
Health to make the scheme a success and is concerned about CBHI sustainability.
USAID Integration Health Systems Strengthening Project (IHSSP) implemented by
Management Sciences for Health has worked hand in hand with the Ministry of
Health to make the scheme a success and is concerned about CBHI sustainability.
Objective
The
purpose of this consultancy is to conduct deep assessment of the CBHI scheme
sustainability within the big picture of the Health Financing system in general
and provide support in finalizing plans to move CBHI to RSSB.
purpose of this consultancy is to conduct deep assessment of the CBHI scheme
sustainability within the big picture of the Health Financing system in general
and provide support in finalizing plans to move CBHI to RSSB.
Key activities
- Develop a detailed assessment
of different functions of the CBHI scheme using the Organizational
Assessment for Improving and Strengthening Health financing (OASIS)
framework - Conduct a review of the core
functions of CBHI and performance indicators (including underlying
parameters) related to;
a.
Enrollment (coverage)
Enrollment (coverage)
b.
Financial situation including financial risk-sharing and adequate and equitable
distribution and access (benefit packages) to health services
Financial situation including financial risk-sharing and adequate and equitable
distribution and access (benefit packages) to health services
c.
Monitoring and Evaluation System
Monitoring and Evaluation System
- Institutional, organizational
evaluation in order to provide structures that will support the transition
of CBHI to RSSB (providing institutional and organizational alternatives
and identify possible ways of ensuring smooth transition). - Perform CBHI Financial data
analysis for the 3 years of the 2010 policy - Conduct interview/
consultations and focus group discussions with key actors including
community members; - Visit the CBHI scheme from the
lowest level to the National level collecting information - Provide recommendations to
improve the scheme through institutional and organizational modifications
Deliverables
- An inception report that
provides a summary of proposed methodology of the study. This inception
report should be followed by a workshop with stakeholders’ presentation in
PowerPoint format. - Draft report in word and power
point format - CBHI scheme assessment plan
including methodologies, and timeline - A detailed CBHI situational
analysis report - Existing factors that can
promote or block the CBHI sustainability - Detailed recommendations for
the sustainability of the CBHI scheme including in regards of the move of
the scheme to RSSB. - Final report in Word) format,
clearly outlining final recommendations. - Trip report respecting the
IHSSP/MSH template
Methodology
For
this consultancy to be successful, the following methodologies are proposed:
this consultancy to be successful, the following methodologies are proposed:
- Desk review of CBHI related
document - Interviews/ Consultations with
key actors of the CBHI scheme - Field visit to the CBHI schemes
to collect any needed data and meet/ discuss with all stakeholders
Expertise required
The
Consultant must have educational background in economics, health financing or
public health and work experience in the following areas:
Consultant must have educational background in economics, health financing or
public health and work experience in the following areas:
- At least 7 years international
experience in health financing - International experience and
knowledge on health insurance mechanisms - Knowledge on the functionality,
management and regulation of the health system in Rwanda or in Africa - Excellent communication and
interpersonal skills. - Fluent in English (spoken and
written).
Submission Procedures
Interested
consulting firms will submit their expressions of interest including:
consulting firms will submit their expressions of interest including:
1)
Company profile
Company profile
2)
Company registration certificate
Company registration certificate
3)
RRA clearance certificate (taxes)
RRA clearance certificate (taxes)
4)
RSSB clearance certificate (social security)
RSSB clearance certificate (social security)
5)
Reference of previously performed similar assignments
Reference of previously performed similar assignments
6)
Detailed curriculum vitae of the consultant(s) who will perform the assignment
Detailed curriculum vitae of the consultant(s) who will perform the assignment
7)
Description of the understanding of the assignment (1/2 page)
Description of the understanding of the assignment (1/2 page)
8)
Description of technical approach you intend to use to perform the assignment
(one page)
Description of technical approach you intend to use to perform the assignment
(one page)
9)
Cost proposal sealed in a separate envelop.
Cost proposal sealed in a separate envelop.
Documents
should be submitted in a sealed envelope addressed to the Chief of Party,
IHSSP; Management Sciences for Health; KK 21 Avenue (Niboye Road), Plot no. 41,
Kicukiro Area, P. 0. Box 371 Kigali, Rwanda. The submission deadline is Monday, April 2, 2014 at 5pm.
should be submitted in a sealed envelope addressed to the Chief of Party,
IHSSP; Management Sciences for Health; KK 21 Avenue (Niboye Road), Plot no. 41,
Kicukiro Area, P. 0. Box 371 Kigali, Rwanda. The submission deadline is Monday, April 2, 2014 at 5pm.
