The Tanzanian Police Force, Prisons and PharmAccess have signed Memorandums of Understanding aiming to develop sustainable health insurance and health finance solutions for their health facilities.
PharmAccess has been implementing the PEPFAR/USAID funded TPPI HIV/AIDS workplace program of Police, Prisons and Immigration since 2008. 52 Police and Prison health facilities have been renovated and equipped, and staff has been trained in the past five years. A great outcome has been that health is now on the agenda of the Police Force and Prisons, leaving room to work towards a sustainable solution for inclusive healthcare. 60,000 police and prison officers and their families are now covered by health insurance through the National Health Insurance Fund (NHIF) and the 52 police and prison clinics are contracted as service providers by NHIF, allowing these clinics to generate income. This is an important step in the direction of donor-independency.
Over the past five years all renovations and trainings have been funded by PEPFAR/USAID. Ensuring sustainability has become pressing since PEPFAR/USAID funding for the TPPI HIV/AIDS Program was concluded in September this year.
Another urgent challenge as a result of the success of the program is that the health budget of the Ministry of Home Affairs only covers services for servicemen and their families, not for the majority of civilian patients. Police and Prison clinics provide services, not only to servicemen and their families, but also to civilians who live near these clinics. Before renovations these clinics were in a very dilapidated state and few patients would come there. Today, tens of thousands patients attend the clinics and 80% of the patients are civilians. Yet, police and prison clinics are administered and funded by the Ministry of Home Affairs (MOHA), not by the Ministry of Health and Social Welfare (MOHSW). Additional funding is needed to keep the services accessible for civilians.
Under this Memorandum of Understanding PharmAccess and the Ministry of Home Affairs will look for additional and alternative funding to answer to the most pressing financing needs of the Police and Prison clinics. Aim is that within one year sufficient funding by NHIF, MOHSW, and possibly USAID and other donors will be available to continue quality health services at Police and Prison clinics throughout Tanzania for the staff and civilians. In the short term, PharmAccess has requested bridge-funding from the Dutch Health Insurance Fund to cover the baseline healthcare costs at the facilities for this coming year.