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Country Report Out

Country Report Out. Tanzania. October 23, 2009. Tanzania Country Team. Eugen Chikuvasi Mikongoti – Zonal Director, National Health Insurance Fund (NHIF) Mary Kitambi – PPP Desk Officer, MOHSW Sr. Rita Toutant – CEO, Tanzania Network of Community Health Funds (TNCHF)

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Country Report Out

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  1. Country Report Out Tanzania October 23, 2009

  2. Tanzania Country Team • EugenChikuvasiMikongoti – Zonal Director, National Health Insurance Fund (NHIF) • Mary Kitambi – PPP Desk Officer, MOHSW • Sr. Rita Toutant– CEO, Tanzania Network of Community Health Funds (TNCHF) • Gaston GaudenceKikuwi – Chairman, VIBINDO Society (Micro Health insurance Schemes)

  3. Current Health Financing Situation: Existing Schemes • National Health Insurance Fund (est. 2001). • Mandatory • Covers all public servants and any other citizen of TZ may sign up (covers ~ 5% of total population) • Community Health Funds (CHF) (est. 1996) • Voluntary • Covers rural informal sector and is managed by LGAs (5-6% of population) • National Social Security Fund (NSSF) • Mandatory • Covers formal private sector (3-4% of population) • Micro Health Insurance • Voluntary • Covers urban and rural formal (inc. FBOs, NGOs, etc) and informal sector workers ( >1% of population)

  4. Existing Schemes Continued • Private insurance • Voluntary • Covers private formal sector (>1% of total population) • National Health Service (NHS) • Accessible to everyone with user fee based on facility level of care • Covers ~90% of the population Key Takeaways Most health services are financed and provided by NHS ~ 10% of population has some form of health insurance Out-of-pocket spending is ~ 83% of private health expenditure(40% of total health expenditure is private)

  5. Opportunities to expand / improve health insurance • There is strong political will in TZ for reform • July 2009: legal decision to merge CHF and micro insurance with NHIF, with goals of: • Expanding health insurance coverage to all Tanzanians • Improving capacity of CHF & microinsurance through support from NHIF • January 2009: NHIF was opened up for enrollment to all Tanzanians (with premium payment) • NHIF has specialized financial, technical and human resource capacity to spearhead the insurance reforms.

  6. Potential challenges or obstacles • Low capacity of CHF and microinsurance • Low quality and quantity of available services, especially human resources, drugs, and diagnostics • Inflexibility in the legal framework guiding reform so adjustments are cumbersome • Lack of experienced staff at CHF and microinsurance schemes • Lack of adequate resources • Lack of knowledge about health insurance PLUS negative perceptions about insurance in general

  7. Actions and next steps that we can take • Report back to our agencies • Document the current state of play with health insurance • NHIF will organize a stocktaking of CHF (are they working, # of members, data management, etc.) • MOH will call stakeholders’ meeting to discuss to sensitize members, mobilize resources, define roles, and share the Action Plan for Coordinating NHIF, CHF and microinsurance • NHIF will review operational systems of CHF and microinsurance • Continued advocacy for CHF coordinators at the district level

  8. Thank you! Asante!

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