Annex_6_PATIENTCLIENT_QUESTIONNAIRE_-_all_versions_-_English_eng_-_2023-09-18-18-11-10.xlsx

This study explores how Rwanda is working to sustainably finance healthcare services for two neglected tropical diseases—soil-transmitted helminths (STH) and schistosomiasis (SCH)—as international aid for such diseases declines. The research surveyed 235 patients across 24 health centers in districts most affected by these conditions, focusing on how accessible, affordable, and well-utilized these services are under Rwanda’s domestic health financing mechanisms.Key findings show that while basic medications like mebendazole are widely available, others like praziquantel face frequent stockouts due to delayed reimbursements from the CBHI to clinics. Women experience longer travel and waiting times, resulting in higher opportunity costs than men. Yet, out-of-pocket expenses remain low—under USD 1 per visit—suggesting minimal financial risk to patients across income brackets.Patients rated the quality and acceptability of services highly, though most facilities lacked NTD treatment protocols. The study underscores how domestic efforts—such as budget allocations and health insurance coverage—have helped improve access. However, it stresses the need to streamline reimbursement processes and strengthen supply chains to avoid disruptions in drug availability. The findings provide valuable insight for policymakers aiming to reduce dependency on external funding while enhancing equitable access to NTD care.

本研究聚焦针对被忽视热带病的国际援助持续下滑的背景，探讨卢旺达如何为两种被忽视热带病（neglected tropical diseases, NTD）——土源性蠕虫病（soil-transmitted helminths, STH）与血吸虫病（schistosomiasis, SCH）——的医疗服务构建可持续筹资模式。研究在两类疾病流行最严重的地区的24家卫生中心调研了235名患者，重点考察卢旺达国内卫生筹资机制下，相关诊疗服务的可及性、可负担性与利用充分性。调研结果显示，尽管甲苯咪唑（mebendazole）等基础药物供应充足，但吡喹酮（praziquantel）等其他药物却因社区健康保险（Community-Based Health Insurance, CBHI）向诊所拨付报销款延迟，时常出现断供情况。女性患者的通勤与候诊时间更长，因此相较于男性患者，其就医的机会成本更高。不过患者自付费用仍处于较低水平——单次就诊费用不足1美元——这表明不同收入阶层的患者面临的财务风险均极低。尽管多数医疗机构尚未制定被忽视热带病的诊疗规范，但患者对医疗服务的质量与可接受度评价颇高。本研究凸显了国内筹资举措——如预算拨款与健康保险覆盖——在改善服务可及性方面的积极作用，但同时强调需优化报销流程、强化药品供应链管理，以避免药物供应中断。本研究结果可为政策制定者提供有益参考，助力其在降低对外援依赖的同时，提升被忽视热带病诊疗服务的公平可及性。