There are two P4H-backed missions in 2011 in support of the implementation of Community-Based Health Insurance (CBHI) in Rwanda. The first, focusing on the CBHI Procedure Manual and CBHI strategic direction (May 2011), includes a review of the implications of the planned health system reforms for governance and issues including the introduction of a comfort package, wealth-based premiums, efficient fund collection, financing a national risk pool, equalization mechanism and funds flow, and a framework for revenue distribution between levels of care. The second, backed by WHO, analyzes the CBHI financial data and develops a financial model for equalization and redistribution of premium revenue across health care levels. These sequenced studies result in the revision of the CBHI Procedure Manual and are used as the basis for the issuance of an inter-ministerial order on premium redistribution and equalization.
