CHF in Tanzania

CHF in Tanzania

 

The Community Health Funds (CHFs) was established by the Government of Tanzania with the support of the World Bank under their health and nutritional activities. CHFs are a “voluntary community-based financing scheme in which households pay contributions to finance part of their basic health care services to compliment the government health financing efforts.”
The main objectives of the CHFs are:

  1. To provide a sustainable financial mechanism which enables communities to contribute to their health care costs
  2. To improve access to health care for rural communities and those in the informal economy
  3. To improve the quality of health care through equipment, supplies, and human resources
  4. To promote decentralization and community empowerment with the aim of improving health care management

The CHF pilot project was launched in Igunga District in 1996 and a national implementation was planned. Ten regions were outlined for the first implementation under the CHF Act in 2001, and CHFs is now mandatory in all of the remaining regions.
CHF membership was based on household enrolment with a predefined household size. One membership card was issued per household and was valid for a period of 12 months. The annual contribution from each household in 2011 was between 5,000 – 15,000 Tanzanian Shillings, as defined by the districts. The Government subsidizes the CHF schemes with matching fund contributions.
CHF membership allows the household to access medical services without further co-payments at the primary level. The benefit package is at the discretion of the district. In most cases, benefits are limited to primary level care, and in rare cases include secondary care. Poor households that are unable to pay the premium may be issued CHF membership cards or an exemption letter upon recommendation by the Village Council. Other households without a CHF membership must pay user fees to access care.
CHFs are intended to be a risk-sharing health financing mechanism, but unfortunately they haven’t been as effective as hoped in reducing risk for members. It was time to rethink CHFs.