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By J. E. Sendoro CHF Coordinator MOH&SW, Tanzania

COMMUNITY HEALTH FUND AS A COMPLEMENTARY FINANCING OPTION IN TANZANIA Presented at CHF Best Practice Workshop: 31 st Jan – 2 nd Feb. 2007 Golden Tulip Hotel –Dar Es Salaam. By J. E. Sendoro CHF Coordinator MOH&SW, Tanzania . Existing Health Financing Option In Tanzania.

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By J. E. Sendoro CHF Coordinator MOH&SW, Tanzania

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  1. COMMUNITY HEALTH FUND AS A COMPLEMENTARY FINANCING OPTION IN TANZANIAPresented at CHF Best Practice Workshop: 31st Jan – 2nd Feb. 2007Golden Tulip Hotel –Dar Es Salaam By J. E. SendoroCHF Coordinator MOH&SW, Tanzania

  2. Existing Health Financing Option In Tanzania • Government Funding • Donor Contributions • Social Health Insurance (NSSF,NHIF) • Private Health Insurance • Donations From Individuals, Companies, NGOs • Out Of Pocket Payments (User Fees) • Community Contributions

  3. Definition • Community Health Fund (CHF) in Tanzania is a voluntary pre-payment scheme, which offers a client (household) the opportunity to acquire a “health card” after paying contribution. • A household can be an individual or a family • A card is renewed after every 12 months.

  4. Background • CHF in Tanzania started as a pilot scheme in 1996 in Igunga district. • The scheme was a result of studies conducted in 1990-92 on willingness and ability to pay. • Implementation experience of Igunga was evaluated in 1998 then used to roll out the scheme to nine more districts. • In2001, the policy decision was reached to cover all districts through an Act of Parliament.

  5. CHF Concept & Design in Tanzania • It is a voluntary scheme. • It is district based. • CHF entails pre-payment for health care and risk sharing. • Provision of user fee for non-members • Exemption mechanism for poor and vulnerable groups.

  6. Concept & Design Cont…. • The scheme operates in partnership between communities and the Government. • The Government provide “Matching Grant” to CHF scheme at district level. • Communities can pay contributions during harvest time and enjoy services throughout the year. • CHSB and Community Health Committees manage the Fund. • CHF scheme is not intended to replace the government funding.

  7. Objectives of CHF according to Act No.1 of 2001 • Mobilize financial resources from the community for provision of health care services to its members. • Provide quality and affordable health care services through sustainable financial mechanism. • Improve health care management in the communities through decentralization.

  8. Expected Results • A sustainable financial mechanism. • Adequate medical supplies and equipment at health facilities. • Improved quality of health care services • Adequate, skilled and motivated health providers • Improved community participation.

  9. Implementation Status of CHF Achievements • Operational guideline for introduction and management of the scheme is in place. • 92 DC’s have been sensitized and adopted CHF Legal Instrument. • 69 DC’s have launched the scheme and are in various stages of implementation.

  10. Achievements Cont….. • Between July 2004- June 2006 the total of Tshs 800,000,000/= was requested and paid as matching grant. • Capacity building have been done to districts • Improved infrastructure of health facilities • Supportive supervision have been performed accordingly.

  11. Achievements Cont….. • The mobilized financial resources are used for health care improvement e.g. rehabilitation. • The introduction of new CHF management tools and software (CHF TRACK). • Contract between MOH&SW and individual councils on expenditure framework of the matching grant.

  12. Concerns and Challenges • Low enrollment of members • Membership ranges from 4%-20% (b) Inadequate Management skills • CHF is expanding faster (to more districts) than management skills. • Improper record keeping in some councils.

  13. Concerns and Challenges Cont…. ( c) Supervision conducted to councils revealed the following: • Inadequate community awareness on CHF • Inadequate community involvement and ownership • Poor quality of care and lack of accountability to the community • Leakages or loss of fees collected • Misuse of membership cards.

  14. The Way Forward • Extend the use of New CHF management tools and software to all councils in phases • Enhance monitoring and evaluation at all levels • Harmonize premium country wide • Continue to improve advocacy program at all levels • Strengthen planning and management skills through on the job training and other training opportunities

  15. The Way Forward Cont… • Strengthen coordination by use and maintaining Zonal and Regional Coordination Centres • Provision of required materials and equipment to councils • Ensuring the involvement of all key stakeholders in CHF promotion and implementation process

  16. The Way Forward Cont… • Assist councils in reviewing and improving the benefit package overtime • In built incentive package in CHF promotion program.

  17. ASANTENI KWA KUNISIKILIZA THANK YOU FOR LISTENING

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