After two years due to the pandemic period, UGHE’s Center for Executive Education hosted twenty-four participants from the Nigeria National Health Insurance Scheme for a one-week in-person program in Kigali to help them understand the Rwanda National Health Insurance system as well as develop their leadership skills. The participants explored different topics on leadership and management and learned how Rwanda achieves universal health coverage. 

This program was structured using a knowledge exchange approach. “The goal of the program is not to “teach” our Nigerian delegates, but to share our experience, provoke thoughts, and stimulate ideas on how to acquire universal health coverage through health insurance,” said Dr. Rex Wong, Director of Bill and Joyce Cummings Institute of Global Health.  The program compared and analyzed the two National Health Insurance Systems between Rwanda and Nigeria and facilitated the conversations among leading experts in both countries, compared and analyzed the successes and the challenges in each country.

UGHE’s Vice Chancellor, Prof. Agnes Binagwaho delivered a lecture on the history and journey of the community-based health insurance (Mutuelle de Sante) in Rwanda and how to implement and effectively run it through collaboration to achieve quality health care for all. “Building community-based health insurance requires a spirit of solidarity and belief that health is a human right in your communities. A collaboration between the ministry of health and the government is what will help push it forward.”   

Following the lecture, an MOU was signed between UGHE and the Nigeria National Health Insurance Scheme for collaboration in attaining universal health coverage in Nigeria. 

Prof Abebe Bekele, Deputy Vice Chancellor of Academic and Research Affairs, and Dean of the School of Medicine joined the participants to discuss the importance of academic institutions like UGHE in building an equitable health system. He said,” UGHE’s health education system is preparing students to become health professionals to fill the large gap of health workers not only in Africa but also globally, to address the world’s most pressing needs through equity lenses” 

The program also involved visiting health centers in Kigali to witness how the community-based health insurance is implemented, how it benefits the patients, what health care services it covers and how the health centers are managed and operated to promote equitable health care delivery.  

Dr. Rex Wong, Director of Bill and Joyce Cummings Institute of Global Health discusses why Rwanda was selected as the case study for the program. “In less than 30 years, Rwanda did not only recover from the devastating Genocide against the Tutsi but also surpassed the millennium development goals. It is nothing less than a miracle for a country to move from desperately poor, demoralizingly divided to achieving gender equality, reduced child and maternal mortality, and most importantly providing universal health coverage for its citizens. The success story of Rwanda should serve as an example of the importance of strong political commitment, evidence-based policies, good governance, and effective institutions in health and economic development.”  

During the program, participants proposed some next steps and action items to work on after the program. Dr. Adeniyi Oginni and Prof Uzoma Maryrose Agwu are some of the participants we discussed, and they shared their experiences and lessons gained from the program.  

“Through this program, I learned that we should never give up on our health system, but instead always study the situation and find solutions through the collaboration for effective implementation. Rwanda faced similar challenges our health system is facing, but instead learned from them and never gave up until they arrived at their current position. Besides, I liked how interactive and practical the program was, allowing us to reflect and visit health facilities to witness what we were learning in class. I’m returning home to put what I’ve learned here into action, especially involving everyone to achieve equitable community-based health insurance in our country.” Prof Uzoma Maryrose Agwu, Professor of Obstetrics and Gynaecology and Executive Secretary of Ebonyi State Health Insurance Agent 

“We learned the steps of implementing community-based health insurance and the collaborations between the Ministry of Finance, Ministry of Health, local governments, and various communities that resulted in its high coverage. The speakers were very engaging, honest, and friendly, and they led us through practical interactions that deepened our reflections on the types of solutions we would take home with us. Two key takeaways are that we need a strong punishment or reward system that encourages people to put what they’ve learned into practice while adhering to regulations and engaging in cross-sector collaboration for sustainability.” Public Health Physician and Environmentalist, Executive Secretary, Osun Health Insurance Agency & Chairman, Forum of CEOs of State Social Health Insurance Agencies in Nigeria.  

The program was concluded with light-hearted moments with participants and issuing certificates of completion. Prof Anil Kumar Indira Krishna, Director of the Center for Executive Education reflects on the one-week program. “The participants understood the concept, process, and implementation modalities of Rwanda’s Community Based Health Insurance. They have also learned the fundamentals of leadership to effectively lead their team in achieving universal health coverage in Nigeria. In the future, we need to develop a couple of leadership programs on policy analysis and development, implementation science, and other topics that will further strengthen the health system to address global health insurance systems.”