TANZANIA: AS 2024 comes to an end, it will remain in the memories of all Tanzanians due to a significant milestone recorded in the provision of health services in the country.
It is the year when Tanzanians witnessed a record improvement of access to health services by all people following the initial operation of the Universal Health Insurance (UHI) in August this year.
It is expected that in the first year of operation, the scheme will cover 15 million people, which represents 25 per cent of the population.
The fund also launched new membership registration system, claims processing system and three new health insurance packages.
National Health Insurance Fund (NHIF) Director General Dr Irene Isaka, said recently that the new initiative is designed to cover everyone, regardless of their socioeconomic status.
It seeks to provide access to essential healthcare services, reduce the financial burden on families and strengthen the healthcare system all of which are crucial for the country’s sustainable development and well-being.
“The government has taken steps to expand health coverage to more citizens, including rolling out a National Health Insurance Fund that covers public and other formal sectors. As part of its reforms, the government aims to ensure that even those in the informal sector and rural areas benefit from healthcare services,” she said.
Dr Isaka said that currently, health insurance coverage in Tanzania stands at just about 15 per cent of the population. Of this, 8 per cent is covered by NHIF, 6 per cent through the improved Community Health Fund (iCHF) and only 1 per cent by private insurance.
She said that this coverage is insufficient compared to the actual needs of the population, making the UHI initiative essential for reaching all segments of society.
She stressed that universal health coverage is vital for providing financial protection, ensuring access to quality healthcare services and guaranteeing affordable essential medicines and vaccines for all.
Dr Isaka further said that the launched registration system enables members to register and self-serve without visiting the fund’s offices.
The system has made it easier for members to sign up. She said the claims processing system also developed locally has increased efficiency by processing claims quickly using Artificial Intelligence (AI), thus reducing the time taken to make payments to service providers.
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The launched new packages are Serengeti Afya, Ngorongoro Afya and Toto Afya Kadi (TAK) where the first two packages offer varying levels of healthcare services, from general check-ups to specialised treatments. The main difference is in the number of services and the annual cost.
The Toto Afya package is specifically designed for children and offers two enrolment options: individual and group (through schools).
The group enrolment option offers a lower cost and immediate benefits. She said the newly launched packages are supplementary to the basic package, aimed at enabling members to access additional services when needed and giving them the freedom to choose services based on their preferences.
NHIF Director of Medical Services (DMS), David Mwenesano, said the Fund is well-prepared for a significant increase in its membership base, with the first year of implementation expected to cover 25 per cent of all citizens—around 15 million people, up from the current 4.9 million.
Mwenesano said that the proposed payment system for the UHI will be capitation, where service centres are allocated funds based on the size of the area and the types of diseases prevalent in the area, with verification occurring after claims are submitted. A referral system will also be used in the provision of services during the implementation of UHC.
He also said that the Fund’s benefit packages will consider factors such as disease burden (the prevalence and severity of diseases in specific areas) and will include services designed to protect citizens from paying for care that could push them into poverty.
The packages will also ensure equitable access to healthcare, especially for vulnerable groups like pregnant women, children under five and the elderly.
He also said that the government’s policy priorities, such as reducing maternal and child mortality, will be factored into the packages.
Mwenesano said that the Fund has come up with new system requirements for connecting to service providers’ Health Management Information Systems (HMIS), including biometric verification (fingerprinting and facial recognition) at all service points.
President Samia Suluhu Hassan signed the Universal Health Insurance Bill into law in December last year a move that marked a historic moment in the country’s health sector after the tabling of the bill in Parliament was rescheduled several times and moved to the Standing Committee for Social Services and Community Development for further consultations.
The bill was presented in Parliament for the first reading in September 2022 but following concerns raised by lawmakers and stakeholders, its second and third readings were rescheduled to allow further improvement of the document.
However, in November last year the National Assembly unanimously endorsed government bill to attain Universal Health Coverage (UHC) which was assented to law by Dr Samia early December last year.
Tabling the UHC Bill in the National Assembly in November last year the then Minister for Health Ms Ummy Mwalimu noted that due to the magnitude of the matter, all considerations and recommendations that had earlier on hampered the process of endorsement of the Bill has been keenly dealt with attracting the many amendments.
She said the government had proposed six main measures to finance over 15.8 million poor Tanzanians (around 26 per cent of the population) so as to attain UHC.
The sources include service levies on carbonated drinks, liquor, cosmetic products, betting, motor vehicle insurance fee and through electronic transaction levies.
Financing health expenses for the poor was among the key issues which were raised when the Universal Health Coverage Bill was tabled for the first reading in Parliament. Ms Mwalimu indicated that the government had suggested establishment of a special fund which would settle the cost of health insurances for vulnerable groups in the country.
According to her, a special mechanism will be employed in the identification and registration of people who do not have the ability to pay for the insurance.
The group will be included under the public health insurance scheme as stipulated in the guidelines.
“In accordance with the Bill, every Tanzanian will be required to enroll into a health insurance scheme to ensure people obtain medical services without any challenges even at challenging times.
“The government will employ statistics from the Household Budget Survey of 2017/2018 which shows that 26.4 per cent of all Tanzanians are poor. In accordance to the statistics, the Population and Housing Census of 2022 indicate over 15.8 million comprise of vulnerable groups which is equivalent to over 3.6 households and those living in abject poverty stand at over 4 million people (8 per cent) accumulating 1.1 households,” said Ms Mwalimu.
She noted that the government will also effectively supervise the matter in ensuring poor people have access to quality health care.
Besides, the minister revealed that the special fund will be used to facilitate medical services for people suffering from chronic and lifetime diseases like kidney complications, cancer as well as emergency services resulting from accidents.
In line with this, she said, the scheme has given directives for insurance schemes to offer a Standard Benefit Package to its beneficiaries.
The package equally gives room for beneficiaries to obtain additional benefits which cannot be accessed in the primary package. The goal is to ensure every citizen accesses basic services obtained in the Standard Benefit Package.
