NHIF requests a revision of the health insurance service guidelines

ARUSHA: STAFF of the National Health Insurance Fund (NHIF), have requested the Board of Directors of the Fund to speak to the Ministry of Health on the revision of various guidelines for medical services provided so that they can be implemented equally by all service providers, to eliminate the confusion that causes some members to miss out on services at service delivery centers.

The request was made by NHIF Arusha Regional Staff while speaking to the Fund Board that was on a visit to review the implementation of the Fund’s activities at the Regional level.

Presenting the request, the Head of the Quality Control Department, Dr Elika Issowe said that there have been ongoing challenges in the implementation of service delivery guidelines, especially the Basic Standards for Health Services (BSHS) issued last year, which specifies the distribution of services in health facilities based on the level and expertise of service providers.

According to the guidelines, facilities recognized as specialized polyclinics should have only specialist doctors providing specialist services, while general polyclinics are required to have general practitioners (GPs) providing basic services.

He said that due to this guideline, some health facilities have started to make changes to their infrastructure and status to comply with the requirements of the guideline, which has raised new challenges for NHIF members.

In light of this situation, Dr Issowe asked the board to consider the possibility of advising the ministry to review and improve these guidelines with the aim of eliminating inconvenience to members who are denied services in some facilities.

“In some centers, NHIF members have been denied services or delayed in receiving treatment, while customers who pay cash have been receiving services more easily without restrictions.

He added, “This situation has raised complaints from members, complaining about the lack of equality in the provision of services despite them contributing to insurance with the aim of receiving treatment without inconvenience, so we request that this issue be looked into,” said Dr Issowe.

The NHIF Arusha Regional Manager, Hipoliti Lello, presenting an implementation report to the board, said that the quality of services to members has continued to be monitored to ensure that they receive services with dignity and at the right time.

“Our Quality Control Team has continued to conduct various inspections of centers to ensure that the services provided to members are good but the Office has also continued with educational strategies to reach and register more citizens,” said Lello.

The Board, led by it’s Chairman Eliud Sanga, accompanied by Prof George Luhago and the Director General Dr Irene Isaka, together commended the staff and urged them to continue working diligently and with great creativity so that the Government’s goal of every citizen having health insurance is achieved.

Sanga urged employees to strengthen relationships between them at work and outside of work hours to build cooperation and love throughout their time at work.