Makinda: Let us push for universal health coverage

A HEALTH worker appears pleased with the working environment due to accessibility of all necessary tools.


TANZANIA urgently needs to reaffirm its commitment and push forward the Universal Health Coverage (UHC) agenda to facilitate provision of equitable health services for all.

“As a country, there is a need to come up with practical and feasible ways of extending health service coverage to the majority of the population who are currently not covered by any form of health insurance,’ retired Speaker of the National Assembly, Anne Makinda said.

Ms Makinda who is a National Health Insurance Fund (NHIF) Board Chairperson, echoed this call while speaking at the First Health Insurance and Social Protection Conference held recently.

“We all agree that with healthier people who participate effectively in social economic endeavours, it is possible to reach the target of becoming a middle income country before even the year 2025 as scheduled,” said Ms Makinda.

Ms Makinda noted that over 70 per cent of Tanzanians are currently not covered by any form of health insurance be it public or private.

The World Health Organisation (WHO) describes UHC as a process of progressive realisation in which all people receive the quality, essential health services they need, without being exposed to financial hardship.

The United Nations (UN) Sustainable Development Goal number three targets to achieving universal health coverage, including financial risk protection; access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all by the year 2030. UHC in Tanzania, prospects and challenges is the agenda of the day for the Government, the ministry responsible for health matters and all citizens at large. It is equally a NHIF agenda. Ms Makinda cited some examples of countries like South Korea which took 12 years to attain universal health coverage.

Other countries took more than 100 years to get to the same level. Access to good health services which is covered by insurance is still a problem to the community both in the rural and urban areas in Tanzania.

Despite government’s efforts to solve a number of challenges facing the health sector, there is still a lack of enough skilled health workers, health facilities, drugs and medical supplies.

Yet Tanzania boasts of long history in providing quality health care to the community through health insurance thanks to NHIF and other insurance cover by private insurance agencies.

The introduction of Community Health Fund (CHF), NHIF and other private health insurances have helped Tanzania acquire a vast experience on best practices to share at international level.

Despite the successes recorded, the country has done very little to document, publish and promote the achievement to the external world.

“Stories of improved CHF in Kilimanjaro and Manyara for which NHIF and PharmAccess are partnering to improve access to quality health care services to the local community, should be recorded, documented and promoted,” notes Ms Makinda. In improving the quality of health care at the national level, the Government has undertaken some initiatives to develop health infrastructure.

According to Ms Makinda, the initiatives include enhancing human capacity for health, improving health technology, provision and supply of medicine and medical equipments. With regards to UHC, the former Speaker said the country is anticipating achieving it through health insurance, whereas NHIF has begun with the improved CHF, which will be implemented in 50 local government authorities in collaboration with the Ministry responsible, LGRA with the development partners (DPs). “Experience that shall be learnt will be used to feedback the processes towards universal health coverage envisaged for community,” she noted.

Ms Makinda appealed for best digitalisation ways which can facilitate identification of the special groups on health and development issues to enable them access some of the services in relations to their ability to pay or social status.

It was recommended that researchers and academic institutions should undertake more operational research work in the field of universal health coverage as a standing agenda.

However, the World Health Report of 2013 describes research for UHC as not a luxury, but rather, something fundamental to the discovery, development and delivery of interventions that a community need to maintain its good health.

It is from that perspective that community engagement and dialogue should be encouraged to facilitate understanding among the targeted groups who are the end users of such services.

Due to the increased demand by the society to quality, reliable and affordable health services for all, PharmAccess International in partnership with Tanzania Insurance Regulatory Authority (TIRA) decided to convene the First Health Insurance and Social Protection Conference with a special focus on Tanzania road to UHC.

Programme Director of PharmAccess International, Mr Heri Marwa, said the objective of convening such a meeting was to devise ways to help the government to fast track UHC in the country.

“Experts, the academia, policy makers, DPs, the International Community, Social Protection Security Funds and other key health stakeholders met and discussed practical solutions which will assist the government in devising means of attaining UHC,” Marwa said.

On his part, the Commissioner of Insurance at the Tanzania Insurance Regulatory Authority (TIRA), Dr Baghayo Saqware, said the conference was meant to promote public, private partnership in the provision of health services with a focus on the local community.

“The role of the private sector in the provision of quality and reliable health services in the country should not be ignored, for they are an important factor for UHC success,” said Mr Saqware.

Elaborating on the issues of coverage, the Director of Legal Services at the Social Security Regulatory Authority (SSRA), Mr Onorius Njole pointed out that most of the insurance schemes are confined to the formal sector, hence does not give more room for extended coverage.

“Issues of coverage could be addressed through a legal framework to allow for the social protection sector to cover both the formal and informal sector,” noted Mr Njole in his remarks.

Since Tanzania like other countries has people with different social status and needs, multiple initiatives are required to meet basic conditions if provision of health insurance were to succeed.

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