Leaving no one behind in informal urban settlements: A qualitative study of access to healthcare services among the urban poor in Kigali, Rwanda

Abstract

Failure to access healthcare services is both a cause and effect of poverty and defies the universal health access principles. Residents of informal urban settlements live with numerous health threats amidst limited resources. This study analysed the barriers to healthcare access in Kigali’s informal urban settlements. We used a descriptive qualitative design, with mixed approaches of data collection including desk review, focus group discussions and key informant interviews with administrative cell leaders, heads of health centres, community health workers and selected household heads in the study area. Results indicate that subscription to health insurance was popular and health facilities were located in close proximity. However, an interplay of structural and financial barriers limited healthcare access. The influx of patients at some evening hours, a dearth of medical supplies and healthcare personnel affect access and quality of healthcare services which compromises universal access to healthcare among the urban poor.