Background The popular use of traditional medicine in low-income settings has previously been attributed to poverty, lack of education, and insufficient accessibility to conventional health service. However, in many countries, including in Rwanda, the use of traditional medicine is still popular despite the good accessibility and availability of conventional health services. This study aims to explore why traditional medicine is popularly used in Rwanda where it has achieved universal health coverage. Methods The qualitative study, which included in-depth interviews and participant observations, investigated the experience of using traditional medicine as well as the perceived needs and reasons for its use in the Musanze district of northern Rwanda. We recruited 21 participants (15 community members and 6 traditional healers) for in-depth interviews. Thematic analysis was conducted to generate common themes and coding schemes. Results Our findings suggest that the characteristics of traditional medicine are responding to community members’ health, social and financial needs which are insufficiently met by the current conventional health services. Participants used traditional medicine particularly to deal with culture-specific illness – uburozi. To treat uburozi appropriately, referrals from hospitals to traditional healers took place spontaneously. Conclusions In Rwanda, conventional health services universally cover diseases that are diagnosed by the standard of conventional medicine. However, this universal health coverage may not sufficiently respond patients’ social and financial needs arising from the health needs. Given this, integrating traditional medicine into national health systems, with adequate regulatory framework for quality control, would be beneficial to meet patients’ needs.

Previous studies challenge the assumption that economic growth improves subjective well-being, and argue that economic growth is incompatible with not only nature conservation but also subjective well-being. To achieve SDGs, a mode of economy that sustains both subjective well-being and the natural environment needs to be investigated. This ethnographic study explored community-based economy systems in post-genocide Rwanda, and elaborated the process and mechanisms by which the contemporary gift economy facilitated subjective well-being in culture and natural landscape. Findings showed that subjective well-being can be achieved by applying alternative modes of economy (gift economy, sharing economy) and having access to direct sources of well-being (natural environment, social cohesion, cultural identity, and spirituality), when basic needs are satisfied by well-established infrastructure and

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