Under the Twubakane Decentralisation and Health Project, responsibility for primary healthcare has moved from the national level to district level. Healthcare centres in the city are run as a mixture of public sector, government-assisted and private sector, with some traditional healers also operating. Not all residents have easy access to these facilities, however, with some having to walk more than 30 minutes to reach the nearest centre. The government has devolved the financing and management of healthcare to local communities, through a system of health insurance providers called ''mutuelles de santé''. The ''mutuelles'' were piloted in 1999, and were made available nationwide by the mid-2000s, with the assistance of international development partners.