ABSTRACT Rwanda like other countries is facing the financial challenge for accessing health services. The Government has resorted to the promotion of mutual health organizations; however the sustainability of these deserves a particular attention. The general objective is to assess the sustainability of mutual health insurance in Musanze district. Specifically this study aims at identifying the roles played by the management and social factors on sustainability of mutual health insurance in Musanze, assessing whether mutual health has improved the access to healthcare, and finally proposing solutions. Different reports from sections of mutual health, interview with heads of sections and medical care providers, as well as a questionnaire addressed to heads of households served as a source of data. The choice of respondents at different levels was based upon a random sample. The sample size required number of 601 household heads. The organs of Musanze mutual health organization are all operational. Membership amounted to 66.6% in 2010. The use of medical care services for adherents was the triple the one observed in non-adherents. The premium and the proportion of medical expenses payable are affordable for patients, according to 86% and 96.4% of respondents respectively. Only 46.9% adhere because they appreciate services provided by mutual health organizations, while 48.4% adhere following the interventionist approach. However, due to the growing advantage offered by mutual health organizations, 89.2% members of MH are willing to adhere without any pressure. The financial situation has proved to be frail. There is unbalance between incomes and expenses. 76.7% of respondents recognize the advantages offered by risk sharing. Unfortunately, members are less involved in Mutual health activities. 46.3% of respondents attended at least a half of the meetings organized by Mutual health organizations. On the whole, the health risk- sharing policy in Rwanda is promising. The interventionist approach is only viewed an educational method which will ultimately end into members attitude change. Expenses incurred by mutual health organizations are superior to incomes. Competent authorities are recommended to gradually replace the interventionist approach with awareness campaign and marketing and to reduce the pooling risk rate. To other researchers, we suggest conducting a survey on the role that the involvement of prevention activities may play as a component of mutual health organizations.
TABLE OF CONTENT
DECLARATION A
DECLARATION B
APPROVAL SHEET
DEDICATION
ACKNOWLEDGEMENTS
ACRONYMS
TABLE OF CONTENT
LIST OF TABLES
ABSTRACT
CHAPTER ONE
THE PROBLEM AND ITS SCOPE
Back ground to the study
Statement of the Problem
Purpose of the study
Objectives of study
General objective
Specific objectives
Research questions
Scope of the study
Significance of the study
CHAPTER TWO
REVIEW OF RELATED LITERATURE
viii
ii
iii
iv
V
vi
vii
viii
xi
xii
1
1
1
4
5
5
5
5
6
6
8
9
9
Concepts, Ideas, Opinions from Authors/ Experts
Demand side of mutual health
Supply side of mutual health
Determinants of viable mutual health insurance
Sustainability of a mutual health
Mutual health insurance in Rwanda
Theoretical perspective
Related studies
Challenges faced by mutual health insurance
CHAPTER THREE
METHODOLOGY
Research Design
Research Population
Sampling Procedures
Research instrument
Validity of the research instruments
Data gathering procedures
Data analysis
Ethical Considerations
Limitations of the study
CHAPTER FOUR
PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA
Introduction
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9
10
11
18
18
22
22
25
26
26
26
26
28
29
29
30
30
30
31
32
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32
Demographic and socio-economic characteristics of heads of households surveyed 32
Factors of the sustainability of Musanze mutual health 38
A.Factors of sustainability of the mutual health related to the design 38
B. Factors of sustainability of the mutual health related to the management 43
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C. Factors of sustainability of the mutual health insurance related to the socioeconomic status of beneficiaries 48
D. Factors of sustainability of the mutual health related to environment of
healthcare service providers
CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSIONS AND RECOMMENDATIONS
SUMMARY OF KEY FINDINGS
CONCLUSIONS AND RECOMMENDATIONS
REFERENCES
APPENDIX I: TRANSIMITAL LETTER FOR THE RESPONDENTS
QUESTIONNAIRES
APPENDIX 2: INTRODUCTORY LETTER
APPENDIX 3: APPOINTMENT LETTER
APPENDIX 4: CURRICULUM VITAE
Desire, S (2022). Management and Social Factors On Sustainability of Mutual Health Insurance in Musanze District 2008 - 2011. Afribary. Retrieved from https://tracking.afribary.com/works/management-and-social-factors-on-sustainability-of-mutual-health-insurance-in-musanze-district-2008-2011
Desire, SENZEYI "Management and Social Factors On Sustainability of Mutual Health Insurance in Musanze District 2008 - 2011" Afribary. Afribary, 26 Sep. 2022, https://tracking.afribary.com/works/management-and-social-factors-on-sustainability-of-mutual-health-insurance-in-musanze-district-2008-2011. Accessed 09 Nov. 2024.
Desire, SENZEYI . "Management and Social Factors On Sustainability of Mutual Health Insurance in Musanze District 2008 - 2011". Afribary, Afribary, 26 Sep. 2022. Web. 09 Nov. 2024. < https://tracking.afribary.com/works/management-and-social-factors-on-sustainability-of-mutual-health-insurance-in-musanze-district-2008-2011 >.
Desire, SENZEYI . "Management and Social Factors On Sustainability of Mutual Health Insurance in Musanze District 2008 - 2011" Afribary (2022). Accessed November 09, 2024. https://tracking.afribary.com/works/management-and-social-factors-on-sustainability-of-mutual-health-insurance-in-musanze-district-2008-2011