Bamwe mu bayobozi b’ibitaro byo mu Ntara y’Iburasirazuba baranenga cyane imvugo ikunze gukoreshwa na benshi ivuga ko ibitaro bifunga abarwayi babuze ubwishyu ngo kuko ibitaro bitajya bifunga abantu ahubwo bibavura.

Ibi bitaro bigaragaza ko mu gihe umurwayi abigannye arembye, bikora ibishoboka byose bikamuvura nubwo yaba adafite amafaranga.

Cyakora nyuma yo gukira, hakabaho uburyo bwo kumvikana inzira zo kwishyura amafaranga uwo murwayi aba yivujeho kuko iba ari serivise igomba kwishyurwa kugira ngo haboneke amafaranga yishyura imiti n’izindi serivise zikenerwa mu bitaro.

Igiteye agahinda, ngo ni uko iyo habayeho gukerererwa gutaha kuri abo barwayi baba batujuje ibisabwa mbere y’uko bavurwa, ngo usanga bavuga ko bafunzwe, bagasiga icyasha ibitaro n’abaganga baba babavuye, nyamara hari ibiba bigitunganywa kugira ngo batahe ariko bumvikanye n’ibitaro.

Muri iki cyegeranyo, turabagezaho uko iki kibazo giteye mu bitaro by’uturere 7 two mu Ntara y’Iburasirazuba:

Bugesera

Ubuyobozi bw’Ibitaro bya ADEPR Nyamata mu karere ka Bugesera buratangaza ko kugeza mu ntangiriro z’uyu mwaka wa 2015 byahombye amafaranga asaga miliyoni 20 kubera abarwayi batabyishyuye nyuma yo kubaha serivise zitandukanye muri ibyo bitaro.

Umuyobozi w’Ibitaro bya ADEPR Nyamata, Rutagengwa Alfred, aravuga ko icyo gihombo kije gikurikira icyo bagize mu mwaka wa 2012-2013, aho bahombye asaga miliyoni 9 ndetse n’uwawubanjirije wa 2011-2012 bari bahombye asaga gato miliyoni 7.

Abarwayi bambura ibitaro barimo ibyiciro bitandukanye. Hari abaza kwivuza badafite ubwisungane mu kwivuza.

Iyo bakize bakabura ayo kwishyura, bamwe baratoroka abandi bakandikishwa impapuro ko bagiye kuyashaka ariko ntibayatange. Hari abafite ubwisungane mu kwivuza ariko ntibabone 10% kuko Mutuelle yishyura 90%.

Harimo kandi abanyamahanga bahivuriza biganjemo Abarundi ndetse n’abimukira baba badafitiwe umwirondoro w’aho batuye hazwi.

Abandi ni abatoragurwa bakomeretse cyangwa se barwaye ndetse niyo bamwe bapfuye, ibitaro bigorwa bibashyingura, aho umurambo umwe utwara amafaranga ibihumbi 60 kugira ngo ubashe gushyingurwa, hatabariwemo ibyamutanzweho mu bitaro.

Barasaba akarere, Leta n’abafatanyabikorwa kugira icyo bakora kugira ngo ibitaro bidakomeza guhomba kuko bigira ingaruka ku mikorere yabyo.

Gatsibo

Kuva mu gihe cy’umwaka n’igice gishize, Ibitaro bya Kiziguro byo mu karere ka Gatsibo, birabarura umwenda ugera kuri miliyoni 20 z’amafaranga y’u Rwanda byambuwe n’abaturage babyivujemo ariko bakabura ubwishyu.

Kuba ibi bitaro byegereye umuhanda wa kaburimbo, bituma hari abahazanwa bakoze impanuka nta bwishingizi bw’ubuzima bafite hakiyongeraho n’abazwi nk’indaya.

Kuri aba, hiyongeraho abarwayi bazanwa barembye cyane kubera ko bativuje ku gihe, biterwa no kutagira ubwisungane mu buvuzi. Aba bose baravurwa, bakira bakagirana amasezerano n’ibitaro y’uko bazishyura ariko benshi ngo ntibayubahiriza.

Dr. Diocres Mukama Twagiramungu uyobora Ibitaro bya Kiziguro, avuga ko hari n’abo bajya kureba mu ngo zabo bagasanga nta bushobozi bifitiye bakarekera; ndetse n’abavuga imyirondoro itari iyabo nyakuri.

Igisubizo ku kibazo nk’iki, ngo ni uko abaturage bose baba bafite ubwisungane mu kwivuza.

Kayonza

Kuva mu mwaka wa 2012, abarwayi bamaze kwambura ibitaro bya Gahini byo mu Karere ka Kayonza, amafaranga asaga gato miliyoni 22 z’amanyarwanda nyuma yo kuvurwa ariko bakabura ubwishyu.

Abo barwayi bari mu byiciro bitandukanye nk’abajyanwa nyuma yo gukomerekera mu mpanuka n’urugomo rutandukanye, abimukira baba batagira aho babarizwa hazwi n’abajya kwivuza ari abakene ku buryo no kubona icyo kurya biba bitaboroheye, nk’uko umuyobozi ushinzwe ubutegetsi muri ibi bitaro, Bwana Rubulika, abivuga.

Bamwe mu bivuriza muri ibi bitaro bavuga ko hari ingero nyinshi z’abarwayi bavurwa ariko ntibahite babona amafaranga bishyura, bamwe babona uko batoroka bakagenda abandi ibitaro bikabasigarana iminsi mike kugira ngo harebwe niba bashobora kubyishyura.

Ubuyobozi bw’ibi bitaro buvuga ko iyo umurwayi avuwe akabura ayo yishyura, ibitaro bimugoragoza bigakomeza kumucumbikira iminsi igera kuri itatu kugira ngo barebe niba yakwishyura, ariko iminsi yacumbikiwe bategereje ko yishyura yo ngo ntabwo ibarirwa mu mafaranga agomba kwishyura.

Nubwo hari abagumishwa mu bitaro ngo harebwe niba bakwishyura, benshi ngo ntibishyura ku buryo ibitaro bibarekura, imyenda yabo igakorerwa raporo.

Kirehe

Umubare w’abaturage batishyura serivise z’ubuvuzi ni muke cyane ku buryo nta gihombo gifatika biteza Ibitaro bya Kirehe n’ibigo nderabuzima byo muri aka karere.

Ibi ahanini bishingira ku bufasha bwatanzwe muri aka karere n’Umuryango Partners In Health (Inshuti Mu Buzima) kuva mu mwaka wa 2007, aho wishyuriraga abaturage ubwisungane mu buvuzi uhereye ku batishoboye.

Uwingabiye Alice ukuriye Umuryango Inshuti mu Buzima mu Karere ka Kirehe, avuga ko kuva mu mwaka wa 2007 kugeza muri 2013, bishyuriye ubwisungane mu buvuzi abaturage basaga ibihumbi 90 ari nako babahaga imfashanyo umuntu ku wundi cyangwa se binyuze mu matsinda y’ubudehe.

Muri uyu mwaka wa 2014/2015, uyu muryango watanze umusanzu w’ubwisungane mu buvuzi ku baturage bagera ku bihumbi 14 muri aka karere ka Kirehe.

Inkunga ingana gutya ngo igabanura mu buryo budasubirwaho umubare w’abaturage ba Kirehe batagira ubwisungane mu kwivuza.

Niyonzima Vianney uhagarariye imivurire mu bitaro bya Kirehe avuga ko nta muntu urigera afungwa cyangwa ngo ahutazwe biturutse ku kubura amafaranga na “Mutuelle”.

Ngo iyo umuryayi ageze mu bitaro bamuvura batitaye ku bibazo afite kandi ngo nta gihombo gikabije bitera ibitaro. Cyakora ubu buryo babukoresha mu rwego rwo korohereza abarwayi, na bo ngo bakazayatanga nyuma bayabonye.

Mu baturage b’akarere ka Kirehe baganiye na Kigali Today, bose bavuga ko nubwo serivise itangwa itaragera ku rwego ruhagije, ngo nta muntu uhutazwa n’uko adafite “Mutuelle” kandi ngo na bo bamaze kumenya akamaro kayo bayitabira batabanje kubihatirwa.

Ngoma

Kuva mu myaka 3 ishize, Ibitaro bya Kibungo birabara igihombo cy’amafaranga y’u Rwanda akabakaba miliyoni 26 (25,853 664) kubera abantu baza kwivuza bakabura ayo kwishyura.

Umuyobozi w’Ibitaro bya Kibungo, Dr Namanya Wiliam, avuga ko abambura ibitaro baba biganjemo abasore n’inkumi bagana ibi bitaro bakoze impanuka cyangwa batunguwe n’uburwayi, bamara kuvurwa bakabura ubwishyu bitewe n’uko nta bwisungane bwo kwivuza baba bafite ngo bishyure make.

Dr. Namanya avuga ko iki gihombo nta gikuba cyateye cyane kuko nta service yahagaze ariko akavuga ko bikomeje bishobora kugira ingaruka kuko aba bantu baba batakajweho imiti myinshi kandi ikeneye kwishyurwa ngo hagurwe indi.

Umurwayi ubuze ubwishyu kuri ibi bitaro bya Kibungo ngo baramureka agataha kuko nta kundi bamugira kandi biba ari inshingano zabo zo gufasha ubagana wese, nk’uko byakomeje bisobanurwa n’ubuyobozi bw’ibi bitaro. Cyakora ngo babanza kugirana amasezerano y’uko azajya yishyura, nubwo nta musaruro ufatika bitanga.

Mu kugerageza gushaka umuti w’iki kibazo abakozi b’ibitaro bashyizeho isanduku y’ingoboka izajya ifasha mu kwishyurira abayabuze maze iyi sanduku ikaba yanashakirwa abayifasha harimo n’akarere n’abandi bantu.

Ikindi kirimo gukorwa ni ugukomeza ubukangurambaga mu gutanga ubwisungane bu buvuzi kugiran go abantu bose bitabire iyi gahunda neza kuko ari yo yabashoboza kwivuza nta nkomyi.

Nyagatare

Nubwo muri rusange nta barwayi benshi bakibura amikoro yo kwishyura ibitaro kubera ubwisungane mu kwivuza ( Mutuelle de santé), mu bitaro bya Nyagatare, haracyari bamwe mu barwayi bambura ibitaro nyuma yo kuvurwa.

Dr. Ruhirwa Rudoviko, Umuyobozi w’Ibitaro bya Nyagatare, avuga ko iyo umurwayi avuriwe mu bitaro ariko akabura amafaranga yo kwishyura nyuma yo gukira, agirana amasezerano yanditse n’ibitaro agaragaza igihe azabonera amafaranga akagaruka kwishyura.

Ngo abenshi b’inyangamugayo baragaruka bakishyura uretse ko ngo hari n’abatagaruka, nk’abimukira. Aba bimukira ngo akenshi ni bo baba badafite ubwisungane mu buvuzi kandi banakennye ku buryo hari n’abo ibitaro bisonera ayo mafaranga kubera ko bibona ko badafite ubushobozi bwo kwishyura.

Uretse abambura ibitaro baragiranye na byo amasezerano, hari n’abamara kumva ko bakize bagatoroka ibitaro bataranasezererwa na muganga kuko babona ko nta bushobozi bwo kwishyura. Ibi babishobozwa ahanini n’uko Ibitaro bya Nyagatare bitagira uruzitiro.

Nubwo kwambura ibitaro bikigaragara i Nyagatare, ngo imibare igenda igabanuka kandi ubuyobozi bw’Ibitaro bya Nyagatare bugashishikariza abaturage kutarembera mu ngo ahubwo ko bagana amavuriro, bakavurwa maze bakazishyura abakize.
Akarere ka Nyagatare karimo ibitaro bimwe gusa, ibigo nderabuzima 20 n’amavuriro (Poste de Santé) 18.

Rwamagana

Umuyobozi w’Ibitaro bya Rwamagana, Dr. John Baptist Nkuranga, avuga ko hari abarwayi bagana ibi bitaro bakavurwa ariko bamara gukira ntibashobore kwishyura serivise baba bahawe ku buryo mu gihe cy’imyaka 2 ishize, abaturage nk’abo barimo ibi bitaro umwenda w’amafaranga agera kuri miliyoni 15 z’amafaranga y’u Rwanda.

Nubwo atabyita “kwambura”, Dr. Nkuranga, avuga ko iki kibazo gikomereye Ibitaro bya Rwamagana kuko iyo bagereranyije basanga ibi bitaro bitakaza amafaranga abarirwa hagati ya miliyoni 1 n’ibihumbi 300 na miliyoni 1 n’ibihumbi 500 by’amanyarwanda buri kwezi, yashoboraga gukoreshwa mu kugura imiti ivura abandi barwayi.

Abenshi mu badashobora kwishyura serivise bahabwa ni abatagira ubwisungane mu kwivuza kandi nta n’amafaranga bafite (abo ni bo batwara menshi), igice cya kabiri ni icy’abatishoboye bishyurirwa “mutuelle” na Leta ndetse n’abandi bayiyishyurira ariko baba basabwa 10% (Ticket moderateur) bakayabura.

Harimo kandi n’abakorera impanuka mu muhanda ndetse n’abazikorera mu birombe bicukurwamo amabuye y’agaciro mu Karere ka Rwamagana, bagahita babaterura baberekeza ku bitaro. Muri aba, ngo usanga bamwe baba batagira ubwisungane mu kwivuza cyangwa se ugasanga muri icyo gihe ntabwo bafite kandi badafite n’ubitaho.

Dr. Nkuranga avanaho “urujijo” ruvuga ko ababuze amafaranga yo kwishyura ibitaro bafungwa, akavuga ko ibitaro bidafunga abaturage ahubwo ko ikijya kibaho ari uko bamwe mu barwayi bavurwa bagakira ariko ntibahite babona amafaranga yo kwishyura ibitaro, hari igihe bakerererwa gutaha kugira ngo babanze bagirane amasezerano yo kwishyura.

Muri ubwo buryo, ngo birashoboka ko umurwayi ukize ashobora gukerererwa gutaha kuko hari n’igihe ibitaro biba bigishakisha amakuru mu nzego z’ibanze kugira ngo bimenye niba koko imyirondoro itangwa n’uwo murwayi (wavuwe) ari ukuri.

Ibitaro bifatanya n’inzego z’ibanze gukurikirana abavuwe ntibishyure

Iyo ibitaro bimaze kuvura abarwayi bakabura ubwishyu, habaho gukorana n’ubuyobozi bw’inzego z’ibanze kugira ngo hamenyekane neza imyirondoro ifatika y’aho abo baturage batuye, bityo bigafasha no mu kubakurikirana babishyuza. Muri ubu buryo, na bwo hishyura mbarwa ku buryo uyu mwenda uba ugaragara mu nyandiko gusa ariko kwishyurwa bisa n’ibidashoboka.

Nk’umuti urambye w’iki kibazo, ngo inzego zose zikwiriye gushishikariza abaturage gutunga ubwisungane mu buvuzi kuko ikiguzi cyabwo gihenda cyane bikaba bigoye ko umuntu yacyigondera mu gihe yiyishyurira 100%.

Mu gihe afite ubwisungane, umuturage yivuza nta nkomyi n’ipfunwe yishyurirwa 90% by’ibyo yakoresheje.

Muri ubu buryo, ngo nubwo yabura 10% aba asabwa, ntabwo ibitaro byahungabana cyane nk’uko bihangana n’igihombo cyo kwamburwa 100% by’amafaranga aba yagiye ku barwayi nk’abo.

Muri iki cyegeranyo, ntitwabashije kubona amakuru y’Ibitaro bya Rwinkwavu mu Karere ka Kayonza ndetse n’Ibitaro bya Ngarama mu Karere ka Gatsibo.

Nubwo uyu mwenda utarahungabanya ibitaro mu buryo bukomeye, ngo hadafashwe ingamba zihamye, byazageza igihe ibitaro bikabura imiti ndetse n’amafaranga yo kubifasha mu zindi serivise na gahunda ziba zikorerwa mu bitaro kandi mu gihe byakomeza gutya, bishobora gutuma abaturage benshi batiyumvisha inshingano bafite ku buvuzi bubagomba, urwego rw’ubuvuzi rukaba rwahungabana.

Icyegeranyo cyakozwe n’abanyamakuru ba Kigali Today bakorera mu Ntara y’Iburasirazuba