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

dc.contributor.advisorAtaguba, John Ele-Ojo
dc.contributor.advisorObse, Amarech
dc.contributor.advisorCunnama, Lucy
dc.contributor.authorHakuzimana, Alex
dc.date.accessioned2025-11-18T13:59:35Z
dc.date.available2025-11-18T13:59:35Z
dc.date.issued2025
dc.date.updated2025-11-18T13:57:20Z
dc.description.abstractLike 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.
dc.identifier.apacitationHakuzimana, A. (2025). <i>A critical assessment of the Rwandan health financing system: implications for health service utilisation</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/42266en_ZA
dc.identifier.chicagocitationHakuzimana, Alex. <i>"A critical assessment of the Rwandan health financing system: implications for health service utilisation."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025. http://hdl.handle.net/11427/42266en_ZA
dc.identifier.citationHakuzimana, A. 2025. A critical assessment of the Rwandan health financing system: implications for health service utilisation. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/42266en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Hakuzimana, Alex AB - 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. DA - 2025 DB - OpenUCT DP - University of Cape Town KW - Rwanda KW - health financing reforms LK - https://open.uct.ac.za PY - 2025 T1 - A critical assessment of the Rwandan health financing system: implications for health service utilisation TI - A critical assessment of the Rwandan health financing system: implications for health service utilisation UR - http://hdl.handle.net/11427/42266 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/42266
dc.identifier.vancouvercitationHakuzimana A. A critical assessment of the Rwandan health financing system: implications for health service utilisation. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2025 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/42266en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectRwanda
dc.subjecthealth financing reforms
dc.titleA critical assessment of the Rwandan health financing system: implications for health service utilisation
dc.typeThesis / Dissertation
dc.type.qualificationlevelDoctoral
dc.type.qualificationlevelPhD
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