Rwanda’s health insurance ecosystem struggles with inefficiencies, fraud, and delays in claims management. Manual processes and weak integration between electronic medical records (EMRs) and insurance systems lead to inconsistent eligibility checks, pricing discrepancies, and long processing times. Fraudulent claims account for an estimated 10–15% of costs, undermining the financial sustainability of national insurance schemes. These problems are not unique to Rwanda—they affect many African health systems where fragmented data systems and limited oversight weaken health financing.

RHIP is middleware connecting EMRs with insurance systems, enabling real-time eligibility checks, faster approvals, and standardized pricing (using ICD-11, LOINC, etc.). The platform is already deployed in Rwanda, integrated with RSSB and national EMRs (eBuzima, eFiche, OpenMRS, MediSoft). The next phase includes AI-powered fraud detection and predictive cost forecasting, creating a model that can be extended to other African countries seeking to strengthen health insurance sustainability.