Towards Universal Health Coverage in Tanzania: A Call to Leave No One Behind
By Godfrey Philemon, Country Coordinator, People’s Health Movement Tanzania (PHM Tanzania)
Efforts led by the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) in Tanzania show increasing political will towards achieving Universal Health Coverage (UHC). The proposed Single National Health Insurance Fund (SNHIF) and the Health Financial Strategy are at the center of the UHC policy reforms.
People’s Health Movement (PHM) Tanzania is leading national level political activism for primary health care and UHC. In collaboration with other stakeholders, the organization is closely monitoring development, and implementation of the prospective policies. According to desk reviews conducted in Tanzania, barriers to achievement of UHC lie in the issues of coverage and equity.
Only 15% of the population is covered by one of the national health insurance programs. The National Health Insurance Fund (NHIF) covers 6.6%, and the Social Health Fund (CHF) / Tiba kwa Kadi (TIKA) covers 7.3%. Other health insurance plans constitute a social security fund, including private and community health insurance, covering — collectively — about 2% of the population. Approximately 85% of the population is left without health insurance coverage, leaving them vulnerable to the high costs of health care.
PHM Tanzania calls on the Tanzanian government to reduce out of pocket costs for health care services by speeding up expansion of the health insurance program beyond only 15% of the population. Most importantly, implementation of SNHIF should prioritize people living in poverty, the vulnerable, and marginalized. Financing of the new health insurance program should be tax-based and available to every member of the Tanzanian public. PHM calls for subsidized, quality health care for all — leaving no one behind.
Tanzania’s new, proposed health insurance plan defines the essential health services package, with emphasis on promotion of equity in access to health care. PHM Tanzania calls for a delivery model of health services that is based on primary health care, with strong emphasis on community health with the participation of communities, to address the crosscutting social determinants of health.
PHM Tanzania recognizes the new Human Resources for Health (HRH) strategy, and current efforts to incentivize Community Health Workers (CHW). PHM Tanzania notes, however, that the current health budget allocation for CHW is insufficient to promote comprehensive access to primary care at the community level. PHM Tanzania calls for increased, uniform investment in CHW, who are increasingly contributing to malaria testing, control and home based care activities.
PHM Tanzania commends the Tanzanian government on the steps taken towards Universal Health Coverage. The organization will continue to support government and other stakeholders to ensure that the right to health is met for all Tanzanians, so that no one is left behind as the country moves closer to UHC.
