Dar es Salaam, July 31 2014 – On Thursday July 25, The Tanzanian National Health Insurance Fund (NHIF) signed a memorandum of understanding (MoU) with PharmAccess towards supporting the implementation of the Community Health Fund (CHF) in three regions in Tanzania. PharmAccess will provide technical assistance and support in strengthening the Tanzanian health system at regional and local government level.
The NHIF is a compulsory health insurance scheme for civil servants which is also open to other groups on a voluntary basis. The CHF is a voluntary, district-run health scheme for the informal sector. In 2009, the government mandated the NHIF to supervise the implementation of the CHF. However, while health insurance coverage throughout the country is slowly increasing, enrollment in the CHF, which generally covers more rural and low-income groups, continues to lag behind government targets.
PharmAccess has been successfully supporting a community-based health insurance scheme in four districts of the Kilimanjaro region for over two years. This health plan is open to coffee farmers who are members of the Kilimanjaro Native Cooperation Union (KNCU). On average, coffee farmers pay 40% of the insurance premium, with the Health Insurance Fund, funded by the Dutch Ministry of Foreign Affairs, covering the remainder. At the end of 2013, the KNCU Health Plan had more than 13,000 enrollees, representing over 40% enrollment in some target groups called ‘KNCU primary societies’. In comparison, enrollment for the CHF in Kilimanjaro, Arusha and Manyara averaged 4.6% as of June 2013, scoring below the 6.5% national average and way below the national target of 30% by December 2015.
In light of the expertise gained by PharmAccess with the establishment and roll out of the KNCU health plan, PharmAccess and NHIF had been discussing a possible partnership for some time. By improving the quality of the healthcare providers, NHIF and PharmAccess strive to increase total coverage of the improved CHF (‘iCHF’) to 30% of the urban and rural population of these three regions by the end of 2016. In order to improve the quality of healthcare services, the public and private healthcare facilities in iCHF will be introduced into the SafeCare program. SafeCare is an internationally recognized quality improvement program that was launched by PharmAccess three years ago and currently has over 1000 facilities enrolled all over Africa.
NHIF and PharmAccess will roll out their joint activities district by district, starting in Siha district. PharmAccess will provide technical assistance for administration, quality improvement and marketing for the iCHF. Compared to the current CHF, the premium will be at a higher actuarial level to ensure sustainability of quality healthcare delivery. The government will provide 50% premium subsidy and this subsidy is provided through NHIF. Enrollees contribute the remaining half of the premium themselves. This element of local ownership, combined with the capacity building that PharmAccess will provide, ensures long-term sustainability of the scheme.
Current members of the KNCU Health Plan will be given the opportunity to join the iCHF. As such, they will benefit from access to more healthcare facilities, as well as a more extensive benefits package.