Determinants of Demand for Outpatient Health Care in Rwanda

Abstract

In the 2000s, the Government of Rwanda initiated health sector reforms aimed at increasing access to health care. Despite these reforms, there has not been a corresponding increase in demand for health services, as only about 30% of the sick use modern care (NISR in Preliminary results of interim demographic and health survey 2010. NISR, Kigali, 2011). The objective of this paper was to examine the factors influencing the demand for outpatient care in Rwanda and suggesting appropriate measures to improve utilization of health services. The data are from the Integrated Household Living Conditions Survey (EICV2) conducted in 2005 by the National Institute of Statistics Rwanda (NISR). A structural model of demand for health care is estimated to measure the demand effects of covariates. The findings indicate that health insurance is a significant determinant of outpatient medical care. In addition, the price of health care and household income are among the main drivers of utilization of health care. Women are more likely to seek outpatient health care as compared to men. Two main policy recommendations emerge from these findings. First, the government should reduce out-of-pocket healthcare expenditures (OOPE) through subsidies for public health facilities. Second, the government should reduce the premiums for community-based health insurance schemes (CBHIs) to increase coverage rates.