Scoping Report on UNIVERSAL HEALTH COVERAGE: RwandaIntroductionAccording to WHO, universal health coverage ensures the provision of affordable, good quality, easily accessible health services to those in need. Two key aspects of UHC include health service coverage and financial risk coverage. The latter is crucial, according to the WHO, because it provides assurance that patients will not suffer serious financial hardship as a result of seeking medical treatment. Indicators that clearly illustrate the state of universal health coverage have been selected based on the above requirements and those used to measure progress against the relevant Millennium Development Goals. Rwanda is a low-income country as defined by the World Bank ($1,035 or less). , which suffered a massive civil war in 1994. The government claims this has caused lasting socioeconomic damage in addition to the destruction of its health infrastructure. Health care is financed by the state as well as by individual contributions through health insurance and out-of-pocket fees for services. According to a WHO health report, communicable diseases account for 77% of all deaths. Geographically, many inhabitants live in rural areas, reducing the scope of health coverage. Under the Vision 2020 health initiative, healthcare in Rwanda has improved significantly by building many hospitals where the poor are treated free of charge. Analysis of indicators Under-five mortality rate (U5MR) This is the probability of dying between birth and exactly five years of age expressed per 1000 live births (UNICEF). In 2011 the U5MR was 54 for both sexes, significantly below the average of 107 for sub-Saharan Africa. Data shows significant improvement in reducing U5MR s...... middle of paper ...... healthcare. Evans and colleagues “defined spending as catastrophic if a family's financial contributions to the health care system exceed 40% of income remaining after subsistence needs have been met.” On this basis, Rwanda's spending has taken a turn for the worse and has become catastrophic. The data is calculated from a combination of reports and household surveys which may suffer from sampling error. It is suitable for Rwanda, which has a relatively small elderly population that would otherwise contaminate the data as older adults require extensive medical care, which could provide a misleading picture. The data could once again prove more informative if calculated separately for rural and urban areas. Prevalence of tuberculosis