Health Financing

Health Financing

At the time of the Tanzanian independence, health care was mandated as a free social service for all Tanzanians. It was financed by taxes and donor contributions until the poor economic conditions in the 1980's and 1990's created a funding gap in the health sector. In 1994, Health Sector Reforms (HSR) placed a portion of the financing responsibility on the community members with the objective of improving access to and quality of care through additional revenues. Health financing was therefore one of the key areas addressed by the HSR and included the creation of user fees (cost-sharing), social health insurance, Community Health Funds (CHFs), and private-public partnerships. Decentralization of health services was also promoted and there was an enhanced focus on District level management.
Today there are a number of approaches to health financing in Tanzania, including Government funding, donor contributions, social health insurance, community contributions and private health insurance.

HPSS health financing activities focus on strengthening the National Health Insurance fund flows, community health funds, and public financial management of cost-sharing funds. The project after a four year first phase in Dodoma region is now in its second phase (2015-2019) and expanded to including also Morogoro and Shinyanga region. Specifically, HPSS health financing activities in addition to consolidation in Dodoma region are geared toward meeting these outcome targets:

  • Increase available locally generated funding for health services in all regions (to 500 Million TZS in Morogoro and 205 Million TZS in Shinyanga) by 2019.
  • Introduce new or amended health financing structures and financial management procedures at all district and health facility levels by 2019.
  • Increase CHF enrolment rates to 25% coverage in all regions by 2019.