Technical Brief: The Development of Community-Based Health Insurance in Rwanda - Experiences and Lessons

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Community-based health insurance (CBHI) is much debated as a way of tackling the challenge of providing access to health care for the poor in developing countries without worsening their economic situation. Proponents argue that CBHI schemes can be effective for reaching a large number of poor people who would otherwise have no financial protection against the cost of illness, especially in countries where national insurance schemes do not exist. Opponents argue that the risk pool is often too small, that the schemes are heavily dependent on subsidies, and that financial and managerial difficulties arise. More than a decade of implementation and refinement of CBHI in Rwanda has provided an ideal learning environ ment to draw lessons that may also benefit other countries.

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