Health Sector – How Next Year's Rwf278 Billion Budget Will Be Spent

Rwanda's health sector has been allocated over Rwf278.1 billion for the 2022-2023 fiscal year under the proposed national budget currently before parliament. The funds will be used to finance projects intended to improve healthcare, according to officials.

The disclosure was made on Tuesday, May 31, during the budget hearing where the Ministry of Health and six affiliated agencies were defending their budget priorities for the next financial year before the Parliamentary Committee on National Budget and Patrimony.

Compared to the over Rwf371.8 billion for the current fiscal year, which will end on June 30, the health sector budget for the next year was reduced by 25 percent or over Rwf93 billion.

According to the Ministry of Finance and Economic Planning, the drop in the sector allocation is partly due to the fact that the severity of the Covid-19 pandemic has reduced, meaning that fewer resources will be deployed to tackle the pandemic than last year.

Here are some of the activities and projects planned for in the 2022/2023 budget in the health sector.

Subsidising Mutuelle de Sante

The Government will spend over Rwf5.5 billion on transfer of annual Community-Based Health Insurance (CBHI) premiums to the Rwanda Social Security Board (RSSB) for vulnerable people (both men and women).

This action is meant to subsidise healthcare for the poorest citizens, who subscribe to CBHI commonly known as Mutuelles de Sante.

Zachee Iyakaremye, the Permanent Secretary at the Ministry of Health said that the Government pays a contribution to Mutuelles de Sante for the neediest people in the first Ubudehe Category as they cannot afford it.

"The Government will continue supporting this action by paying Rwf2,000 for each eligible vulnerable person," he said.

Funding IRCAD Rwanda project

The project to build a Research and Training Institute Against Digestive Cancer (IRCAD) in Rwanda was allocated over 4.1 billion in the next financial year.

Its construction started on September 17, 2019 and the deadline was July 3, 2022, at a cost of more than Rwf21 billion.

As of now, Rwf16.9 billion has been spent on the project.

Meanwhile, the completion and operationalisation of IRCAD needed Rwf7 billion, but received Rwf4.1 billion for the next year, implying a gap of Rwf2.8 billion.

"If this gap is addressed, it can help our country to position itself well in terms of the healthcare we very much need," said MP Odette Uwamariya.

Outpatient facility at King Faisal Hospital

The construction works of a new outpatient department buildings and other refurbishments works for King Faisal Hospital was allocated Rwf2.7 billion.

This activity started on January 3, 2020 and it is projected that it will be completed on June 3, 2026 at a cost of Rwf13.5 billion. So far, Rwf4.7 billion has been used to finance it.

Maternity and neonatology equipment

Iyakaremye said that the procurement of equipment for maternity and neonatal units in health facilities and ultrasound machines were allocated over Rwf2.1 billion.

"You realise that in various health facilities, when mothers give birth to premature babies, yet neonatology does not perform well, this contributes to infant deaths," Iyakaremye said.

"That is why we planned for the purchase of maternity equipment including the ultrasound machine used to monitor the foetus growth and identify the problems they might have so that they are dealt with earlier," he said.

Indoor residual spraying

Indoor Residue Spraying (IRS), an activity meant to tackle malaria, needed Rwf4.7 billion for next year, but was allocated Rwf2.9 billion. Therefore, it suffers a funding gap of more than Rwf1.8 billion.

MP Odette Uwamariya said that indoor residual spraying is important to the fight against malaria, indicating that the identified budget gap for this initiative should be addressed.

MRI machine at CHUB

Under the financial plan, a Magnetic resonance imaging (MRI) machine will be bought for CHUB. This is a piece of medical equipment with a technology that produces detailed images of the organs and tissues in the body, to help disease diagnosis. It is expected to cost around Rwf1.4 billion.

CHUB Director General, Sabin Nsanzimana said MRI is important for this health facility located in Huye District of Southern Province, and even serves people from the Western Province.

"We are grateful that the MRI, a major piece of equipment that was lacking, has been included in the plan," he said, indicating that CHUB is the largest hospital which serves more people outside Kigali- about four million.

Major issues that need urgent attention

CHUB Director General, Sabin Nsanzimana said that the hospital has a salary gap of about Rwf492 million [as the funding for its staff pay got over Rwf6.9 billion against the required over Rwf7.4 billion for the next year.]

"If we do not get this required money, we will not be able to offer medical services adequately, and there are medical workers we will not be able to employ, yet those services they would be providing cannot be stopped," he said.

Rwanda FDA Chief Finance Officer, George Ntaganda said that the authority as a relatively new entity that has been recruiting more workers to fulfil its responsibilities, it has a gap in the salary budget amounting to Rwf335 million.

"We want you to advocate for us on this issue," he appealed to MPs.