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Working Paper 120 - Community Based Health Insurance Schemes in Africa: The Case of Rwanda
According to WHO (2005) 100 million people every year are driven into poverty due to catastrophic health expenditure. It is imaginable that most reside in resource poor settings such as Sub Saharan Africa (SSA) with very weak modern health care systems and in most cases without any functioning health insurance schemes (e.g WHO, 2003; Carrin et al, 2005) . The result is high disease burden that has a risk of propagating a sickly, unproductive labor force. In Sub-Saharan Africa, formal and well functioning health insurance schemes generally exist for the very few who are employed in the formal sector. For the majority, health care is accessed through out-of-pocket expenditure, which in many instances may lead to suboptimal use of health care services. As a result, expenditure on heath related needs in some countries could be substantially high (see Figure 1 & Figure 2) with visible divergence across the income divide.