‘Capitation’ ni uburyo amavuriro cyangwa ibigo bitanga serivisi z’ubuvuzi, byishyurwa umubare runaka w’amafaranga yagenwe, akishyurwa mbere, kandi akishyurwa kuri buri muntu ukoresha ubwo bwisungane mu kwivuza.

Ubwo buryo butandukanye n’ubwari busanzweho buzwi nka ‘Fee-for-service payment’, aho amavuriro/ibigo bitanga serivisi z’ubuvuzi byishyurwaga nyuma yo gutanga serivisi, bigategura impapuro zo kwishyuza, zikohererezwa ikigo cy’ubwiteganyirize mu Rwanda (RSSB) kugira ngo cyishyure.

Inkuru dukesha Ikinyamakuru ‘The New Times’, ivuga ko Minisiteri y’Ubuzima ifatanyije na RSSB, bazatangira gushyira mu bikorwa ubwo buryo bwo kwishyura mbere, bitarenze uyu mwaka wa 2022, ariko ku ntanguriro ubwo bukazahera mu bigo nderabuzima bya Leta.

Mbere yo gutangira gushyira mu bikorwa iyo gahunda, hazabanza gukorwa ubushakashatsi, buzakorerwa ku bigo nderabuzima no ku mavuriro mato azwi nka ‘poste de Sante’, mu bizarebwa muri ubwo bushakashatsi harimo umubare w’abantu ibyo bigo byakira, impuzandengo y’ababyisuzumishaho, ibiciro by’ubuvuzi batanga n’ibindi.

Amakuru azava muri ubwo bushakashatsi azafasha Minisiteri y’Ubuzima na RSSB, mu gushyiraho umubare w’amafaranga agomba kwishyurwa ivuriro runaka muri iyo gahunda yo kwishyira mbere.

Abatanga serivisi z’ubuvuzi muri ibyo bigo bitanga serivisi z’ubuvuzi, bazasinya amasezerano yo kuzajya bishyurwa mbere, ayo masezerano akazaba agaragaramo urutonde rwa serivisi zigomba guhabwa abakiriya babo.

Ibyiza n’impungenge kuri ubwo buryo bwo kwishyura mbere

Dr. Jean Nepo Utumatwishima, Umuyobozi mukuru w’Ibitaro bya Rwamagana, yavuze ko ubwo buryo bushya bwo kwishyura ari intambwe ishimishije ku gihugu cy’u Rwanda, kuko n’ubundi Isi iragana mu gihe cyo kujya ikoresha ubwo buryo bwa capitation.

Yavuze ko ubwo buryo buje gufasha amavuriro kubona amafaranga, ayafasha mu gukemura ikibazo kiyakeneye icyo ari cyo cyose.

Yagize ati “Kuri twe, iyi ni gahunda nziza, kubera ko amavuriro azajya abona amafaranga yo kugura ibikoresho bikenerwa muri za Laboratwari no kugura imiti. Ayo mafaranga ashobora no gufasha amavuriro guhemba bamwe mu bakozi (contractual staff) igihe babafite”.

Ati “Mbere byasabaga ko dutegereza amezi menshi, RSSB ikabanza gusuzuma neza impapuro zishyuza (invoices) kugira ngo ibone kutwishyura”.

Gusa, yavuze ko hazakenerwa ubugenzuzi bukomeye, kugira ngo ishyirwa mu bikorwa ry’ubwo buryo bushya bwo kwishyura, ritazakoreshwa nabi, bikagabanya ubwiza n’ubwinshi bwa serivisi z’ubuzima.

Yagize ati “Niba Ikigo nderabuzima runaka kizi ko kizahabwa Miliyoni esheshatu (6M) ku kwezi, cyaba cyakiriye abarwayi cyangwa se kitabakiriye, bishobora kurangira icyo kigo nderabuzima gikoze ibishoboka byose, kugira ngo cyakire abarwayi bakeya, bityo cyirinde gukoresha amafaranga cyahawe. Urugero niba umuntu yari gukorerwa ibizamini bine byo muri Laboratwari, bishobora kurangira yandikiwe ibizamini bibiri gusa, kugira ngo amafaranga icyo kigo cyahawe muri gahunda yo kwishyurwa mbere”.

Kugira ngo ibyo bitazabaho, uwo muyobozi yavuze ko bizasaba amagenzura (audits) yo kureba niba amabwiriza agenga ayo mavuriro yubahirizwa, niba ubuvuzi butangwa bufite ireme rikwiye, kureba niba abarwayi badasiragizwa bava mu ivuriro rimwe boherezwa mu rindi.

Yagize ati “Ariko mu Rwanda, nk’uko mubizi, dufite ubuyobozi bwiza butuma abantu bagomba gusobanura ibyo bakora, dushishikariza abaturage kujya bavuga kuri serivisi bahabwa, aho bitagenze neza ntibabyihererane”.

Alypio Nyandwi, ukora ubushakashatsi ku bijyanye n’ubuzima rusange (Public Health), yavuze ko ubu buryo bushya bwo kwishyura mbere buzagabanya imwe mu mikorere mibi, mu bijyanye no kugaragaza neza uko umutungo ukoreshwa ku ruhande rw’abatanga serivisi z’ubuzima.

Nk’uko Dr Utumatwishima yabisobanuye, Nyandwi nawe ati “Ubwo buryo bwo kwishyura mbere, busaba ubugenzuzi buhoraho, kugira ngo iyo gahunda izashobore gutanga umusaruro.”