Prime Minister Justin Nsengiyumva has outlined a series of measures aimed at addressing persistent medicine shortages in public health facilities, a problem that has particularly affected members of the Community-Based Health Insurance (CBHI), commonly known as Mutuelle de Santé. He made the remarks on Thursday, March 26, while appearing before a joint sitting of Parliament to present government activities under the “citizen-centred approach.” Lawmakers raised concerns about continued gaps in access to medicines despite a recent increase in Mutuelle contributions. ALSO READ: Mutuelle reforms ease payment burden with instalment option “There is a shortage of medicines in health facilities, especially in provinces. Patients are consulted and then referred to private pharmacies where CBHI does not apply, making treatment unaffordable for some,” MP Pie Nizeyimana said. MP Christine Mukabunani echoed similar concerns, noting that Mutuelle users still face limitations when accessing medicines, particularly in private pharmacies, unlike beneficiaries of other insurance schemes. She also pointed to issues with misclassification under the Imibereho social registry system, which affects contribution levels. Nsengiyumva acknowledged the challenges, linking them to financial constraints within the scheme. ALSO READ: Minister Habimana clarifies what Mutuelle de Santé reforms mean for contributors “Especially at health posts, there are sometimes shortages of medicines, and this has been linked to insufficient contributions that did not match the actual cost of services,” he said. To address the issue, the government has introduced a new financing model for primary healthcare facilities under CBHI. “Under the new system, health facilities will receive funds in advance based on the number of members they serve. This will help them procure medicines and equipment on time,” he explained. Facilities will be required to account for the use of funds before receiving additional disbursements. The model was piloted in Eastern Province in December 2025, with early indications pointing to improved service delivery. It is expected to be rolled out nationwide. The Prime Minister said delays under the previous reimbursement system often left facilities without sufficient operational funds. “There were delays in payments, which caused some facilities to run out of funds, affecting service delivery,” he said. Beyond financing reforms, the government has expanded the scope of services covered under CBHI to include costly conditions affecting many Rwandans, such as cancers, kidney diseases, heart conditions, and bone and spinal surgeries. ALSO READ: Why we must all back the new reforms in Mutuelle de Sante Coverage has also been extended to include hip replacements, prosthetics, and assistive devices for people with disabilities. The number of medicines covered has increased significantly, from 850 to 1,450. “This expansion of services and medicines requires stronger financial capacity. That is why increasing contributions goes hand in hand with expanding benefits,” Nsengiyumva said. He noted that expenditure under the Mutuelle scheme has more than doubled over the past decade, rising from Rwf39 billion in 2015/2016 to Rwf98 billion in 2024/2025. The Prime Minister also highlighted progress in strengthening healthcare infrastructure across the country. Rwanda currently has 518 health centres at sector level, including eight high-volume facilities upgraded to provide enhanced services as medicalised health centres. At the district level, there are 34 hospitals, in addition to three provincial and Kigali City hospitals, five referral hospitals, and five specialised hospitals nationwide. Since 2017, at least 10 hospitals have been constructed or upgraded, including Gatunda, Gatonde, Munini, Nyabikenke, Byumba, Nyarugenge, Masaka, Kabgayi, Kibogora, and Shyira hospitals.
