DODOMA: TANZANIA is making progress in implementing Universal Health Insurance (UHI), widely recognised as essential for building a healthy, equitable and prosperous nation.
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. Its initial operations started in August this year.
Speaking to Editors in Dodoma on Thursday, the Director General of the National Health Insurance Fund (NHIF), Dr Irene Isaka, said this new initiative is designed to cover everyone, regardless of their socioeconomic status.
It seeks to provide access to essential healthcare services, reduces the financial burden on families and strengthens 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 (pictured above) 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.
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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.
The NHIF Director General also pointed out that the UHI will significantly address the challenges faced by vulnerable populations, including approximately four million people with disabilities, who make up about 8 per cent of the population and face higher rates of poverty and unemployment.
Dr Isaka further noted that 26.4 per cent of Tanzanians currently live below the poverty line, with around 70 per cent of this poverty concentrated in rural areas. Outof-pocket health payments account for more than 25 per cent of health expenditure in low-income households.
“The elderly population in Tanzania, those aged 60 and above, is growing rapidly, now comprising about 6 per cent of the population. This group faces serious health challenges due to non-communicable diseases (NCDs) and age-related conditions. All these challenges will be addressed through the effective operation of UHI,” she added.
“As you are aware, the UHI Act, Section 13, 2023, mandates the government to cover premiums for the poor, ensuring their enrollment in health insurance,” she said.
In providing an overview of NHIF’s role and performance, Dr Isaka acknowledged the challenges but noted that the Fund continues to provide healthcare access through affordable health insurance mechanisms.
She said that the NHIF benefit package has expanded progressively to cover a wide range of citizens across their life cycle, including specific packages for vulnerable groups like children, students, and retired members since 2019.
On the payment of claims to service providers, she said that by the end of June 2024, the Fund had paid a total of 650 bn/-. Of this amount, 37 per cent was paid to government centres, 35 per cent to private centres and 28 per cent to religious organisations.
Regarding retirees’ medical usage, Dr Isaka noted a gradual increase in the number of beneficiaries, rising to 151,500 in 2021/22, stabilising at around 152,000 in 2023/24, and continuing into the first quarter of 2024/25.
The number of patients has also steadily increased, from 36,936 in 2016/17 to 125,582 in 2021/22, before slightly declining to 120,551 in 2023/24. The average number of visits per patient has risen from three in 2016/17 to seven since 2020/21, reflecting increased service utilisation.
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The amount paid for claims has risen significantly over the years, with major spikes of 58 per cent in 2017/18 and 43 per cent in 2018/19. Growth has continued, with 22 per cent in 2022/23 and 5 per cent in 2023/24, reaching a peak payment of 91.9bn/-.
Dr Isaka outlined efforts to rescue the Fund from potential collapse, including implementing actuarial valuation recommendations, addressing fraud at health facilities, verifying members and services, curbing adverse selection, and automating processes to prevent issues like adverse selection.
