Social Protection for Individual And National Development NHIF, CHF/TIKA HEALTH FINANCING PROGRAMS

1. NATIONAL POVERTY POLICY WEEK25TH – 27TH NOVEMBER, 2013 Social Protection for Individual And National DevelopmentNHIF, CHF/TIKA HEALTH FINANCING PROGRAMS The Ag Director General National Health Insurance Fund (NHIF) Dar es Salaam

2. Summary of Presentation • From the Arusha Declaration (1967) to the Health Sector Reforms (1993/94); • Social Health Protection- Programs • Description of NHIF and CHF/TIKA Programs; • Anti-poverty and Development Programs at NHIF (Best Practices); • Challenges of extension of SHI to the poor; and • Recommended measures and the way forward.

3. 1: From the Arusha Declarations to the Health Sector Reforms • The Arusha declaration policy 1967 • Free health,& education (welfare system) • The government (main Provider and Financier) • Expansion of services & emphasis on PHC (disadvantaged groups assured access to health services) • The health sector reform policy 1993 • Measures to address economic recessions • Introduction of cost sharing 1993 (NHIF and CHF are the products of the reforms) • Changes of attitude (from free to contributions) • Sharing of health care responsibilities between the Government, private sector, communities and individuals • The Govt set a Secretariat at the MoHSW to coordinate the reforms • Health matters are looked and considered in a Sector wider approach perspective. • The Health delivery system operates in a decentralized system National Health Financing Workshop

4. 2.Social Health Protection Programs National Health Financing Workshop

5. 3. Description of NHIF AND CHF/TIKA (how the Program Works and how the Poor People are Involved

6. 4. Anti-Poverty and Development Programs at NHIF (Best Practices)

7. 4. Anti-Poverty …….

8. 5. On Going Activities at NHIF • Finalizing proposals for awarding best practices (LGAs) on extension of coverage including the pro-poor to CHF; • Documenting and promoting best practices on NHIF and CHF; • Technical assistance to a women group in Majohe –Ilala (so that they open ADDO) • Countrywide sensitization campaign on CHF in collaboration with LGAs (the use of Cinema Van and drama groups)

9. 5. Challenges • Increased dependence to the schemes even those who are able to work demanded to be included as dependants; • Absence of standardized tool for determining who is poor and on how to manage exemptions; • Most LGA’s does not make a provision in their annual plans and budget to cater for the pro-poor (most LGS’s depends on NGO’s to finance pro-poor; • Access to medicines for the pro-poor is still major challenge as they have not linked to alternative outlet such as ADDO; • NHIF members with families exceeding six have bear costs for additional members of their families as the Fund cover up to six beneficiaries

10. 6. Recommendations • All those who are able to contribute to NHIF/CHF should contribute to the programs so as to reduce dependences and create a strong pool to subsidize or finance the pro-poor; • The process of developing National tool for identification of the poor should be expedited and involve key stakeholders at all stages; • LGAs should make provisions for the pro-poor in their councils; and • NHIF and LGA have to work hand in hand in looking for solutions with regards to access to medicines for CHF members. • There is an imperative need to revive and re-practice all previous best practices that helped the Country to succeed in health and other related campaign (KULENI KUKU MAYAI MBOGA SAMAKI MAZIWA- Makongoro’s Song. MtuniAfya- Mbaraka, SKUVI- promoted by IPP media) • Promote the concept of social capital on health (especially at primary levels); • A need for coordinated efforts. • Fighting poverty in all its dimension including loosing hopes or giving up (a need of even using Religious Leaders in the anti-poverty fights)

11. Submission The paper is submitted for information, sharing of knowledge, experience and discussions. Thanking you all for listening and attention www.nhif.or.tz P.O.BOX 11360 Dar es Salaam