Bernard Kayumba and Jean Baptiste Habyarimana, the mayors of Karongi and Nyamasheke districts, respectively, resigned their positions yesterday in what sources said could be linked to a comprehensive audit into the management of the home-grown community based health insurance, best known as Mutuelle de Sante.
The two men stepped down over what they officially said was ‘personal reasons’ just two days after Police arrested their Rusizi counterpart Oscar Nzeyimana in connection with suspected fraud surrounding ‘Mutuelle’ premiums in the south-western district.
Kayumba and Habyarimana, who tendered in their resignations to their respective district councils, are believed to have presided over mismanagement of ‘mutuelle’ premiums – findings which came to light during a recent audit commissioned by the Western Province authorities.
According to sources close to the exercise, the provincial audit followed a nationwide assessment of mutual health insurance scheme, which, among others, indicated fundamental inconsistencies between the recorded number of beneficiaries and the total premiums.
“It all started when government took the decision to transfer Mutuelle de Sante from the Ministry of Health to the Rwanda Social Security Board,” the source, speaking on condition of anonymity because they are not authorised to speak to the media on the issue, told The New Times.
“The preliminary findings unearthed what looked like massive fraud, particularly in Western Province. That provoked the provincial authorities to commission its own audit to ascertain the extent and nature of the problem.”
The decision to conduct a nationwide assessment of Mutuelle de Sante came amid growing concerns that the programme was being weighed down by a heavy debt (about Rwf2.3 billion), an issue government agreed to resolve before transferring the management of the Fund to RSSB.
Both Kayumba and Habyarimana were unavailable for comment.
In Karongi, the chairperson of the district council, Emile Nsanzabaganwa, confirmed Kayumba’s resignation over “personal reasons” but gave no further comment.
However, Leonce Ndashimye, the vice chairperson of Nyamasheke District Council, told The New Times that while Habyarimana cited personal reasons in his resignation letter, he told his colleagues in the Council that he had resigned after realising that his performance had weakened over the years.
Habyarimana had been Nyamasheke mayor since 2009, while Kayumba had served for nine years. Mayors can serve two non-renewable five-year terms.
Top officials at the provincial level confirmed to this newspaper that a thorough audit into the community-based health insurance scheme had been conducted in all the seven districts of Western Province, but were cagey as to whether this was directly linked to the two mayors’ departure.
However, the provincial governor, Caritas Mukandasira, confirmed that Rusizi, Nyamasheke and Karongi were found to be the most indebted districts in the province, with Rusizi and Nyamasheke recording around Rwf700 million each, while Karongi recorded between Rwf300 million and Rwf400 million in Mutuelle arrears.
At the national level, government accumulated over Rwf2.3 billion in arrears owed to district hospitals and over Rwf400 million to national referral hospitals and health centres, according to official figures.
“It is true we conducted an audit and shared our findings with concerned authorities but the exercise is continuing and, therefore, I can’t be certain that that’s what made them resign, I can’t be 100 per cent sure,” the governor said.
The provincial Executive Secretary Paul Jabo, who said last evening that he was locked in a meeting with detectives that were examining “technical issues” in the management of the Mutuelle Fund in the province, said they could not sit back and watch as “bad practices were threatening a very important programme.”
But he did not divulge details of the said malpractices.
“Mutuelle de Sante is a highly successful programme, it’s a huge success story and, as leaders, we are under obligation to protect it,” Jabo said.
He admitted there were serious mismanagement issues that were discovered during the provincial audit but refrained from openly linking it to Kayumba and Habyarimana’s resignations.
Sources close to the audit exercise said the alleged malpractices included connivance with pharmacies to ‘doctor’ prescriptions by lying about the amount of medication given to individual patients, which inflated medical bills, parallel Mutuelle receipts which led to diversion of some premiums, mismatches between the number of subscribers and collected premiums, among others.
Mutuelle subscription in Western Province stands at 78 per cent, according to Governor Mukandasira. The figure is higher than the national average of 73 per cent for the Financial Year 2013/14 – a notable decline from 80.7 per cent and 90.7 per cent in the 2012/13 and 2011/12 financial years, respectively.
And, while Health minister Agnes Binagwaho last evening linked the earlier arrest of Rusizi mayor, his deputy (social affairs) and several other officials at the district to documented mismanagement of the Fund, she could not link yesterday’s resignations to the audit exercise.
“For Rusizi, yes there were issues; the process is such that we investigate, prove (malpractices) and then probably arrest,” Dr Binagwaho said, referring this newspaper to her Local Government counterpart Francis Kaboneka.
However, by press time Kaboneka was said to be in a meeting and could not be reached for a comment.
Meanwhile, the vice mayors in charge of economic affairs in both Karongi and Nyamasheke, Sebastien Hakizimana and Charles Bahizi, respectively, took over as acting mayors.
By-elections for new mayors are expected in the next few days.
Yesterday’s resignations dramatically increased the number of mayors who have stepped down for varying reasons, especially linked to their performance, since October to six. The seventh was arrested.