The Implementation Experience of Social Health Insurance Scheme in Tanzania

Presenter: Emmanuel Humba, National Health Insurance Fund

Abstract

The NHIF in Tanzania, a form of Social health insurance (SHI) scheme, was first introduced in July 2001 in Tanzania. The Fund was enacted by the Act of parliament No 8 of 1999 with the coverage of civil servants only and in 2002 the Act was amended by the miscellaneous amendments no 25 of 2002, whereby coverage was extended to all public sector employees. The establishment of the Fund is an outcome of studies conducted between 1990 and 1992 on the long term options for financing health care services in Tanzania.

The need to design and implement a national health insurance scheme in Tanzania reflected a number of concerns that were raised regarding the financial sustainability of the health sector. The concerns were based on observed decline in the amount of resources flowing into the health sector, which resulted in decrease in the availability and quality of health services provided. Moreover, the NHIF was established so as to strengthen the cost sharing in government health facilities, provision of health insurance to the employees in the formal sector especially after the introduction of user-fees, enhancing health equity among employees in the health sector and providing an environment for the growth and participation of the private sector.

This paper will analyze the implementation experience of social Health Insurance in Tanzania in regards to the real country’s situation as compared to the international standards on implementing the SHI. The way the SHI has been implemented in this country basing on the environment and the demands of beneficiaries without violating the principles of SHI, has attracted so many countries whereby people from about ten countries (Vietnam, Nepal, Lesotho, Sierra Leone, Zambia, Uganda, Kenya, Swaziland, Zimbabwe) have already visited the Fund to learn how the Fund has succeeded in implementing SHI and to get hands on experience. For Instance Zambia is now utilizing the Tanzania NHIF’s Actuary to help them start their SHI scheme.

The paper will also show how the National health insurance fund has brought an impact to the health sector in Tanzania and as well to see if it has fulfilled the policy objectives of its establishment. In addition, more importantly to see if it has created increased and assured revenue flow for financing health services.

Lastly, the paper will highlight how the fund is organized, how it works, the benefit package offered to its beneficiaries and the coverage so far and what it intends to do in future.