Historic step toward universal health

A new era of healthcare is set to begin for millions of Tanzanians this month as the government launches the pilot phase of the Universal Health Insurance (UHI) programme.

Designed to dismantle financial barriers, the initiative promises that no citizen, from rural farmers to urban petty traders, will be turned away from any hospital due to the size of their wallets.

The UHI rollout stands as a flagship pillar of President Samia Suluhu Hassan’s 100- day implementation agenda for her second term, signalling a bold start to her administration’s renewed social contract with the people.

Under the pilot phase, the government is putting its money where its mouth is by fully covering health insurance premiums for the country’s most vulnerable families.

Eligible households, identified through the Tanzania Social Action Fund (TASAF) and the Prime Minister’s Office (PMO-RALG), will have their costs entirely footed by the state.

“In this pilot phase, the government will contribute 150,000/- per year for each household of up to six members,” National Health Insurance Fund (NHIF) Communications Manager Mr James Mlowe told the ‘Daily News’ in an exclusive interview.

He added, “Through this, they will have access to a Basic Essential Services Package covering more than 372 health services at facilities ranging from local dispensaries to national referral hospitals.”

The pilot phase is designed as a strategic roadmap, allowing the government to assess implementation costs and service coverage before a full-scale national rollout.

Beyond the immediate relief for the vulnerable, Mr Mlowe said that the pilot phase is a strategic learning tool.

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It will provide the government with critical data on implementation costs and service demand, allowing for adjustments before the programme goes nationwide.

“This phase is our litmus test,” he said.

“It allows us to review whether our current estimates are sufficient and whether the services adequately meet the needs of Tanzanians, or if we need to expand the package further.”

In a significant move toward modernising the sector, NHIF has confirmed that the days of cumbersome paperwork are over, citizens will now be able to use their National Identification (NIDA) cards to access life-saving treatment.

“Tanzanians can now join NHIF online, pay contributions using control numbers and use their National Identification cards to access healthcare services,” Mr Mlowe added.

He said that the system has been fully digitised to enable seamless enrolment and electronic payments.

The UHI initiative is not just for those in poverty, it is designed to bring the missing middle into the fold.

Under the new Health Insurance Act, NHIF is expanding its reach to include private sector employees, small-scale miners, livestock keepers and traders.

To cater to these different financial capacities, the Fund has introduced five distinct insurance packages named after Tanzania’s iconic landmarks of Tarangire, Ngorongoro, Mikumi, Serengeti and Tanzanite.

Each package offers varying levels of benefits, giving citizens the freedom to choose coverage that fits their specific budget and healthcare needs.

Speaking on the broader reform agenda, Minister for Health Mohamed Mchengerwa said the Universal Health Insurance marks a structural shift in how Tanzania’s health system will operate, with NHIF positioned at the centre of the reform.

He said NHIF will no longer operate merely as a player, but as the stabiliser and guarantor of the national health system, with responsibility for managing financial, operational and technological risks.

The minister said UHI is neither a political statement nor a ceremonial event, but a national system that begins operating from the first day of its launch, adding that preparedness across hospitals, the health workforce, digital systems and governance structures will determine its long-term success.

He added that the programme’s success will not be measured by the launch itself, but by how effectively the system performs the day after, and for generations to come.

The legislation also brings changes for international residents. In a move aimed at safeguarding public health and ensuring all residents contribute to the healthcare ecosystem, any foreigner staying in Tanzania for more than 30 days is now required to register for health insurance.