A Vision for Health: Performance-Based Financing in Rwanda

A Vision for Health: Performance-Based Financing in Rwanda

Final Report of the Rwanda HIV/Performance-Based financing Project

Rwanda has caught the world’s attention. It is healing from civil war and the horrors of the 1994 genocide and forging a new identity as a peaceful, democratic, and unified nation. Ambitious social and economic initiatives in one of the poorest countries in the world are yielding results, including double-digit growth of the gross domestic product (GDP) for the past nine years, the global economic crisis notwithstanding.

But the vitality of a nation is measured by more than the GDP. The overall health and well-being of the population is a critical indicator, and a robust health care system is a prerequisite. In 2000, the World Health Report described Rwanda’s health care system as one of the weakest in the world. The Government of Rwanda responded with an ambitious health sector reform initiative, and in the last several years has been moving purposefully toward its goal of quality health care for all. Reforms begun in 2005 have brought health insurance to 85 percent of the population, and the availability, delivery, and quality of health services have steadily improved, in some areas dramatically.

From 2005 through 2009, the US Agency for International development (USAID) provided funding and technical assistance to help Rwanda implement a performance-based financing (PBF) program that has proven to be a key factor in strengthening the health system. The Government of Rwanda has demonstrated the commitment and political will to build on the successes of the reforms and move toward a robust and internally sustainable health care system utilized by all Rwandan citizens.

Governments of other developing countries are taking note.