Lawmakers have expressed the need to review kidney patients’ therapy by dialysis under the community-based health insurance scheme (CBHI) – commonly known as Mutuelle de Santé – as currently, they are only entitled to six-week treatment.

They were speaking on Friday, May 29, 2020 during a budget hearing session with the Parliamentary Standing Committee on National Budget and Patrimony in which the Ministry of Health and its affiliated agencies were presenting proposed budget allocation in the 2020/2021 financial year.

Dialysis is a procedure that is needed when a person’s kidneys stop working properly.  It consists of removing waste products and excess fluid from the blood, by cleaning it by an appropriate machine – dialyser.

It is one of the costly medical services. Estimates from the University Teaching Hospital of Kigali (CHUK) suggest that each medical appointment costs between Rwf100,000 and Rwf120,000, while each patient needs  it three times a week, translating to between Rwf1.2 million and about Rwf1.5 million a month.

CBHI covers 90 percent of the cost of healthcare provided, while a patient subscribed to it pays 10 percent.

MP Christine Mukabunani said that the treatment was too expensive for low-income earners.

"When a [needy] patient has to cover 100 percent of the dialysis treatment cost; it is a challenge for them. There should be a way to help them afford it,” she said.

Regis Rugemanshuro, Director General of the Rwanda Social Security Board (RSSB) which manages Mutuelle se Santé said that the six-week treatment limit was provided for in the ministerial instructions of 2014 which were revised by the Ministry of Health in 2016.

"The instructions allow a patient [who is a member of Mutuelle de Santé] to get treatment for acute kidney disease,” he said explaining that normally, acute kidney condition is curable in six weeks.

"When it has gone beyond six weeks, it has become chronic, which requires more means,” he observed.

MP Omar Munyaneza, Chairperson of the Standing Committee on National Budget and Patrimony said that the ministerial order needs to change in order to provide Mutuelle de Santé affiliates with improved healthcare.

"As parliamentarians, we will discuss the instructions in question with responsible entities so as to consider how the problem can be addressed,” he said.

Mutuelle de Santé covers more than 80 percent of Rwanda’s 12 million people.  As of February 13, 2020, the scheme’s coverage rate was 78.6 per cent with more than 9 million beneficiaries, according to statistics from RSSB.