National Health Accounts (NHA) is designed to give a comprehensive
description of resource flows in a health system, showing where resources come
from and how they are used. The Rwandan Ministry of Health has recognized the
importance of documenting the overall flow of health funds and those associated
with HIV/AIDS and reproductive health. Since its launch in 1998, the government
has shown a commitment to sustaining the NHA process with a view to generating
data that can assist the formulation of health policies that improve access to
care and efficiency of resource allocation. This NHA report aims to document the
magnitude, flows, and uses of public, private and donor funds in Rwanda for
overall health care and, specifically, for HIV/AIDS and reproductive health
services during the years 2002 and 2000. Key findings show that total per capita
health expenditures are $8.62, with 42 percent financed by private sources
(including households), 33 percent by the donor community, and 25 percent by
public sources. This pattern of financing shifts with respect to the financing
of HIV/AIDS and reproductive health services. The HIV/AIDS subanalysis shows
that donors finance 75 percent of all HIV-related expenditures. In reproductive
health, donors contribute 80 percent of financing. While households are not the
largest financiers of HIV/AIDS and reproductive health care, they do finance
over half of all curative expenditures in these key intervention areas and for
health care in general – raising concerns regarding the burden placed on
households to finance these services, particularly as 60 percent of the
population is below the poverty line. The public sector is responsible for
financing just 8 percent of expenditures for both HIV/AIDS and reproductive
health. Based on these and other findings, the NHA report suggests health policy
implications for the overall health system as well as for HIV/AIDS and
reproductive health services.