Optimizing health care benefits by health insurance schemes
Health policy and providing sustainable access to affordable and quality health care are some of the most important issues on current social policy agendas. For this reason, the Government of Tanzania initiated a prepayment health insurance scheme, the National Health Insurance Fund (NHIF), which started its operations in 2001.
At the time of its inception, the scheme had accredited all government facilities. Later on, in 2004, the NHIF started to accredit faith based, NGO and private health facilities to bridge the gap on the supply side at the public health facilities that were initially accredited. Due to members’ complaints about the inadequacy of medical services obtained from accredited medical facilities, the NHIF considered what improvements could be made to its medical services package. Before expanding the benefits package, the main challenge was how to ensure the long-term sustainability of the scheme whilst meeting the members’ expectations concerning services.
However, the Fund made four major strategic improvements in its medical benefits package with the aim of increasing the availability of medical services, enhancing the utilization rate, increasing reimbursement to accredited service providers and reducing complaints from members.
2Tanzania NHIF 2011-1.pdf 407.39 kB
ISSA Good Practice Award Winner
Publication year: 2011
Implementation year: 2002
主题: Adequacy and quality of social security benefits and services, Health, Social security financing
Organization: National Health Insurance Fund
国家/地区: Tanzania, United Republic of