INTRODUCTION: Universal Health Coverage (UHC) aims to ensure equitable access to essential health services without financial hardship. Rwanda has made substantial progress toward UHC through its Community-Based Health Insurance (CBHI) scheme. This study assesses trends in healthcare utilization and equity in access using national-level secondary data.
METHODS: A secondary data analysis was conducted using Rwanda Demographic and Health Survey (2015, 2020), Ministry of Health annual reports (2015–2023), and World Health Organization UHC service coverage indicators. Descriptive and comparative analyses were applied to evaluate trends in outpatient visits, skilled birth attendance, and immunization coverage across socioeconomic and geographic groups. Evidence from peer-reviewed literature was integrated to contextualize findings.
RESULTS: Outpatient visits per capita increased from 1.5 in 2015 to 2.3 in 2023 (53% increase). Skilled birth attendance rose from 91% to 94% between 2015 and 2020, while immunization coverage remained above 90%. Despite these gains, disparities persisted across wealth quintiles and rural–urban populations. Key barriers included medicine stock-outs, co-payment requirements, transport challenges, and long waiting times, disproportionately affecting low-income groups.
CONCLUSION: Rwanda’s UHC strategy has significantly improved healthcare utilization and service coverage. However, persistent inequities highlight gaps in financial protection and access. Strengthening supply chains, reducing indirect costs, and improving health literacy are essential to achieving equitable and sustainable UHC outcomes.
