UHC4T1D in Rwanda

Type 1 diabetes is a manageable chronic condition requiring daily insulin intake/injections. In developing countries like Rwanda, children/youth die before or after diagnosis. There are about 3500 known cases of type 1 diabetes. Only youth/children living in the capital city (Kigali) receive free support from an international nongovernment organization called Life for A Child (LFAC). At the same time, everybody else relies on the local health system. 

Rwanda has an innovative community-based health insurance (CHBI) known as mutuelle de sante (MUSA), under which everybody pays $3/year (the entire family has to be covered). Once covered, the copays are only 10%, i.e., instead of $20 a month, only $2 is needed for two vials of insulin. Without MUSA, the majority cannot afford insulin; without insulin, the patient cannot survive.

It has become a big issue recently because of a prolonged drought from May 2022 to February 2023, preventing agricultural activity and leading to famine.

Our program uses two-fold solutions: first, raising funds to pay MUSA for those who cannot afford it ( and we pay for both the patient and family members). The payment is made through a centralized website called Irembo:https://irembo.gov.rw/user/cit...

After that, we work with the beneficiaries to provide small livestock such as chickens or pigs. This is to ensure the sustainability of the program.

This solution saves the lives of youth and children living with T1D and their family members and injects cash into the health system.

Without health insurance, people cannot afford insulin, therefore, may die. The livestock also helps prevent poverty and leads to the program's sustainability.

The founder of the program (Laurien) used to work as a researcher on T1D, and he noticed the issues faced by this population.

I work with the nurses in charge of T1D from all 21 district hospitals involved in the program. We also work with peer leaders to ensure we understand this population's issues. We have a WhatsApp group to share information daily.

Laurien travels to Rwanda thrice yearly and meets each nurse/ hospital administrator, patients, parents, and sometimes with the community health workers to exchange ideas and make decisions together.

We serve around 2100 (300 with T1D and 1800 as family members).

Our main barrier is financial, and we would like to have your support.