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HPSS: Health Promotion & System Strengthening Project
HPSS: Health Promotion & System Strengthening Project
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HPSS: Health Insurance for the Poor
HPSS: Health Insurance for the Poor
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HPSS: Pharmaceutical Management
HPSS: Pharmaceutical Management
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HPSS: Health Promotion
HPSS: Health Promotion
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News and Announcements

Tanzania, Swiss for inclusive health insurance

Recently, implementers of the Health Promotion and System Strengthening (HPSS) Project, which is funded by Swiss Agency for Development and Cooperation (SDC), in collaboration with the government of Tanzania, organised a symposium on health insurance scheme to the informal sector, which gathered together local and foreign participants to discuss how best the goal could be attained (75-85 per cent). The HPSS project has been facilitating CHF activities to ensure the majority of Tanzanians, especially those from vulnerable families, have access to sufficient and affordable health services.

 

CHF members are categorised in two groups. The first group is a six-member family in all regions with the exception of Dar es Salaam, whose residents have to pay only 30,000/- (per family) for one year’s health services at any health centre (public and private) in and outside of their home regions. If a certain family is composed of a single member (an individual), he/she is also to pay the same amount, which in Dar es Salaam is 40,000/- for a 12-month health service. A six-member family is to pay 150,000/- per year, but patients are strictly to have services at only public health centres.

In her presentation during the symposium, Swiss Ambassador to Tanzania Florence Mattli said the informal sector is very fragile when it comes to accessing health services. Informal workers are indeed vulnerable to financial risks, in particular when they fall sick. In response to their health needs, many low and middle-income countries have recently introduced social health insurance schemes targeting the poor. The goal is to improve their health and provide them a protection against health financial consequences.

 According to her, last month at the World Economic Forum in Davos, Switzerland, the international community was discussing different health financing issues, with discussants calling for financial innovations and domestic resource mobilisation for health financing with the principle of Agenda 2030 for Sustainable Development Goals (SDGs) to leave no one behind and reach the furthest behind first.

“With the scheme of this symposium focusing on health insurance for the informal sector, it is evident that the government of Tanzania does not want to leave anyone behind. I would like to assure you of continued support of the Swiss government towards strengthening Tanzania’s health system,” she said.

According to her, SDC plans to go for the third and exit phase of HPSS. It is a four-year phase that focuses on working with the government to consolidate achievements that have been made so far. She urged participants to put in mind that adhesion to insurance schemes and out of pocket purchase card required demonstration to the population that CHF represented real value for money over time. For a successful exit phase, SDC will expect the government to gradually take over the financial responsibility of the costs currently being paid by the HPSS project.

“We are confident that in 2030 when the exit phase comes to an end, there will be a sustainable and functioning health insurance scheme in place for the poor and the informal sector,” said the ambassador.

In response, Minister for Health, Community Development, Gender, Elderly and Children Ummy Mwalimu, who graced the event, said in efforts to ensure all Tanzanians were covered, a Bill on Single National Health Insurance (SNHI) had been finalised and would be tabled in the coming National Assembly’s session (April) for approval. Once enacted, the new law would direct every Tanzanian to have health insurance coverage.

The minister said having the SNHI law was possible since the government of Tanzania, in collaboration with other actors, including World Health Organisation (WHO) and International Labour Organisation (ILO), had conducted research and observed that Tanzanians could pay for the insurance cover, given the fact that most of them were able to buy a 500/- air time daily.

 Figure 1Minister for Health, Community Development, Gender, Elderly and Children, Hon. Ummy Mwalimu exchanging idears with Swiss Ambassador to Tanzania Hon. Florence Mattli during the Symposium on Health Financing for Informal Sector in Dar es Salaam 

She added it was possible due to remarkable improvements in the National Health Insurance Fund (NHIF), which for the financial year 2017/18 had collected up to 480bn/- per year, compared to 4.7bn/- collected in 2005/06. The collected money has been allocated for, among others, setting and improving infrastructure in hospitals, availability of equipment and drugs as well as training health service providers to make them more competent in their work.

“Up to June 2018, NHIF had registered 856,446 members with 3,918,999 beneficiaries - which covers about seven per cent of all Tanzanians. NHIF started with providing all civil servants with health insurance and then expanded to include other employees. The government took another initiative in 2000 of establishing Community Health Fund (CHF) to cover the informal sector,” said the minister, adding: “The majority of Tanzanians, who have been left out belong to the informal sector, which is also a very important sector of the national economy, including farmers in the agricultural sector, livestock keepers, craftspeople and all others, who are self-employed.”

According to her, the government understands the importance of prepayment scheme modalities to cover health and economic components of individuals and families. In so doing and while wait for the SNHI law, the ministry is set to launch different health insurance packages through NHIF next month, which are affordable for every Tanzanian.

NHIF Board Chairperson, former Speaker of National Assembly Anne Makinda said covering every Tanzanian was possible and what was needed was only political will on top of regular public awareness campaigns to let people understand the importance of having health insurance cover. She at the same time called up on good management of health insurance funds to ensure all collected funds were properly allocated to targeted areas to improve infrastructure and availability of all qualified medical staff.

“For instance, some NHIF clients complain about lack of services despite pre-payments. We have to create a strong system for proper management of all insurance funds. The step will encourage many Tanzanians to have insurance covers and everybody here knows what all this means once everybody is covered,” said Ms Makinda.

For his part, Mikumi MP Joseph Haule said there was a need to focus on the availability of all medical equipment and drugs.
“In my constituency, CHF clients are usually directed to buy drugs from their pockets. Worse still, there is only one nearby health centre, Saint Kizito. It is a private hospital, which does not accept CHF cards and I do not know why. Our public health centre is being constructed. Patients are forced to travel about 80km in search of health services in Kilosa District,” he said, stressing that: “I do agree that public education on health insurance is very important, but must be backed up by availability of sufficient and timely services at all health facilities.