Rwanda Health Service Costing: Health Center Analysis

October 2011

The Rwandan Ministry of Health, in collaboration with the USAID-funded Integrated Health Systems Strengthening Project (IHSSP), carried out a study to determine the costs of providing health centre services. The results of the costing were intended for use in re-designing insurance reimbursement mechanisms and levels. The results can also be used for other purposes, such as resource allocation, budgeting and comparisons of efficiency.

Actual expenditure data were collected for a sample of seven well-performing health centres. Averages of these data, together with standard costs, utilization, and catchment population were entered into a stand-alone version of the costing tool, which was named the Health Centre Cost Model. The MOH will be able to use this model to update and modify the costs as necessary.

Using the model, it is estimated that a health centre serving a standard population of 20,000 people should have a total annual recurrent cost of 120 million RWF, with approximately 47 million RWF spent on salaries (technical and admin staff), 55 million RWF spent on drugs, and 19 million RWF on operating costs. Sixty-one individual services were costed, ranging from immunizations to short inpatient stays, such as for normal deliveries. 

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