TANZANIA: AS Tanzania moves towards Universal Health Coverage (UHC), stakeholders—including development partners—have identified gaps in digital health transformation and proposed solutions to expedite this ambitious initiative.
The country has already enacted the Universal Health Insurance Act, which aims to ensure every citizen is enrolled to health insurance schemes to guarantee access to health care for all Tanzanians, particularly those from lower-income brackets.
In the USAID Public Sector Systems Strengthening Plus (USAID PS3+) Health Forum, held recently in Zanzibar during the 11th Tanzania Health Summit, panelists emphasized the importance of collaboration between the public and private sectors.
They noted that effectively using strengthened systems is crucial for expanding healthcare coverage.
The USAID PS3+ forum, themed “Towards Universal Health Coverage: A Digital Approach to Strengthen Public Sector Systems for Improved Service Delivery,” focused on sharing insights from the impact of the USAID PS3+ strengthened systems on the health sector.
Dr Gemini Mtei, Deputy Chief of Party (DCOP) for the Abt-led USAID PS3+, highlighted the need to strengthen digital platforms by investing in technology to facilitate the enrolment of individuals in health insurance schemes.
He said that as the government expands health insurance coverage, it is essential to develop systems capable of managing populations from the formal and informal sector down to the community level.
Dr Mtei also stressed the importance of investing in digital transformation to create simple enrolment processes, potentially through mobile technology, to make it easier for people to join health insurance schemes. He noted that one of the main challenges that may discourage the willingness of people to enroll is the bureaucratic process of enrolment. “If the enrolment process is cumbersome, people are unlikely to register,” he explained.
Regarding service delivery for insured individuals, Dr Mtei said that integrating electronic medical records with health insurance claims management systems is critical. This integration would allow for a two-way management approach for services provided to insured members.
He added that a robust claims management system should include an audit trail to track member management across healthcare facilities.
Following the development of Electronic Medical Records (EMR) in the public sector, Dr Mtei stressed the need for coordination with private providers to enhance the efficiency of the health insurance system and guaranteeing continuum of care.
He noted a current gap due to the absence of a national data set that can track a patient’s journey from public to private facilities. This data is crucial for designing health service benefit packages that address community needs as the country strives for UHC.
Speaking about the role of digital systems in UHC, the Director of Information & Communication Technologies at the Ministry of Health (MOH), Silvanus Ilomo, said that through USAID support and strong collaboration with key stakeholders, the MOH has been able to harmonize systems across the community.
“In deploying digital systems like the Unified Community System (UCS), the ministry collaborates closely with stakeholders, including the private sector” said Ilomo.
Ali Idrissa Abeid from the Zanzibar Health Services Fund (ZHSF) stressed the importance of integrating the fund’s systems with those of service providers as part of digitalization efforts.
“ZHSF has initiated this process by integrating our identification and authorization system with the Zanzibar Residence Identity Cards (ZanIDs), allowing our members to access health services using their ZanIDs. We plan to extend this integration to other platforms, such as the National Identification Authority (NIDA),” he said.
Mr Idrissa also emphasized the use of mobile applications to engage the community, raise awareness about available services, and facilitate member enrolment and information updates.
Additionally, he proposed using Artificial Intelligence to process claims from service providers, thereby reducing payment times and controlling fraud.
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“Currently, service providers may submit claims and receive payments after two to three months due to the mismatch between available human resources and workload. By integrating AI into our systems, we can automate this process, significantly reducing the time it takes to pay service providers,” he explained
