PRESENTATION In Rwanda the private practice is very young compared to Kenya, Uganda, Tanzania and Burundi. The 1st clinic was established in 1992 after many years of efforts and after a private doctor decided to be a MP’s to push on the parliament the advocacy for private practice. But private practice started in real, just after genocide with the arrival of doctors from outside the country and leader with new approach concerning medicine.
We started with small clinic with one doctor, generally a GP and one nurse for usual cares and a lab technician without forgetting that many small clinics were ran by nurses. There were no medical insurances but some enterprises (banks, factories, etc..) were able to pay for their employees.
In 1995, started polyclinics and at this level,two specialists were necessary in order to get status of polyclinic.We were just dealing with out patients, in patients, deliveries, but no surgical operations . At the same period, we were few polyclinics (Plateau and Croix du Sud/southern cross) In 1997, started Polyclinic du Carrefour. In 1998, after shifting the location, polyclinic la Croix du sud started surgical operations and was performing with +/- 1000 deliveries.
Starting of Medical insurances In 2000,Suremed,a South African Health insurance was the first to be used in Rwanda. In 2004, RAMA/RSSB which is a heath insurance devoted to civil servant only started , then after MMI which is military health insurances, and then private insurances like SORAS ,CORAR,AAR.
There is also a public insurance for all Rwandan called Mutuelle de Santé but applicable in public sector only. An other step were reached with the opening of the 1st private hospital :Hospital la Croix du Sud/Southern Cross Hospital in 2009.
Our achievement and challenge: There are many improvement in the way private doctors are perceived by the population and more important by all the authorities because we are receiving a large portion of the population and the impact of our presence is very well known in all fields (curative medicine, preventive medicine, family planning, laboratories, pharmacy etc..).
•I think that we are appreciated from thecommunity because the number and the capacityof diversified clinics are increasing. (now we haveophthalmology clinic, dentistry, ENT clinic,diabetic clinics, gyneco and obstetric clinics.)• We are buying more and expensive equipmentsbut only after individual big sacrifice fromclinical’s owners due to our challenges which are:
Lack of qualified human resources(hospital managers, technicians for maintenance, nurses, Specialists,etc) Most of our patients are ordinary citizens with limited means, a portions of patients who are affiliated to various medical insurance schemes of low tariffs that do not reflect market realities. This regrettable challenge creates inadequate profit margins, thus compromising our capacity to invest in capable human resources and top-notch hospital equipment. A lack of incentives for investors as in education and agriculture sectors.In all, we believe that, these are the main reasons why there are few investors looking with interest towards our country’s private health sector
But ,to be honest, I can’ t end my presentation without appreciating particularly the Minister of health for the positive policy towards private practice and in general put emphasis on the vision of our country in all fields to strengthen the public-private Partnership. We can not end also without expressing gratitude to organizers of this big forum, in which we learn from each other experiences, and therefore allows us to avoid several problems, and most important encourages private health practitioners.