UHC Forward: Towards Universal Health Coverage

Rwanda’s community-based health insurance programme (Mutuelle de Santé) has been the focus of several large studies and much debate in global health policy. Comprehensive insurance reform enacted in mid-2011 transformed Mutuelle de Santé to a system of tiered premiums to make it more financially progressive and sustainable. Many governments in sub-Saharan Africa and south Asia have studied Rwanda’s approach, particularly mechanisms to achieve high coverage, which exceeded 90% by 2010. We assessed the effect of different community-based initiatives on Rwanda’s progress towards universal health-care coverage and increased use of health services.