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Rwanda shows that it is possible to design and implement low cost health insurances for low income and cover all the population (universal health insurance coverage).

Since 1962, Rwanda experienced many attempts in developing microhealth insurances for low income. Almost all of them failed per lack of possibilities of having large numbers as those community health insurances schemes were limited to small groups. From 2000, with the support of USAID, the government of Rwanda developed three pilots schemes. Five years later, the coverage reached 80%. The successes came from the capacity of government and partners to design realistic schemes as well as the high level of implementation capacity (practical interventions).