Decentralisation of Health Systems and the Fate of Community Health Fund in Tanzania: Critical Review of High and Low Performing Districts

Mpambije, Chakupewa Joseph

doi:10.11648/j.sjph.20170502.21

Cited by 13 publications

(7 citation statements)

References 19 publications

(28 reference statements)

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“…8 of 1999 established the today used NHIF and started is operations in June 2001 [ 1 , 10 , 11 ]. Through the NHIF, public formal sector employees are paying a are required to contribute 3 percent of a monthly’s salaries while government also contribute same share to make a total of 6% with not more than 5 other members of the family as a dependent [ 8 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Equity in the public social healthcare protection in Tanzania: does it matter on household healthcare financing?

Kitole

Lihawa

Mkuna

2023

Int J Equity Health

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Efforts to promote equity in healthcare involve implementing policies and programs that address the root causes of healthcare disparities and promote equal access to care. One such program is the public social healthcare protection schemes. However, like many other developing countries, Tanzania has low health insurance coverage, hindering its efforts to achieve universal health coverage. This study examines the role of equity in public social healthcare protection and its effects on household healthcare financing in Tanzania. The study used secondary data collected from the National Bureau of Statistics' National Panel Survey 2020/21 and stratified households based on their place of residence (rural vs. urban). Moreover, the logit regression model, ordered logit, and the endogenous switching regression model were used to provide counterfactual estimates without selection bias and endogeneity problems. The results showed greater variations in social health protection across rural and urban households, increasing disparities in health outcomes between these areas. Rural residents are the most vulnerable groups. Furthermore, education, income, and direct healthcare costs significantly influence equity in healthcare financing and the ability of households to benefit from public social healthcare protection schemes. To achieve equity in healthcare in rural and urban areas, developing countries need to increase investment in health sector by reducing the cost of healthcare, which will significantly reduce household healthcare financing. Furthermore, the study recommends that social health protection is an essential strategy for improving fair access to quality healthcare by removing differences across households and promoting equality in utilizing healthcare services.

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Section: Introductionmentioning

confidence: 99%

Equity in the public social healthcare protection in Tanzania: does it matter on household healthcare financing?

Kitole

Lihawa

Mkuna

2023

Int J Equity Health

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“…It has been frequently reported that households are unable to join the scheme due to poor community engagement and high premium rates. 6,[8][9][10][11]13 Engagement of the community through communication and awareness about CHF reforms was not done well at the community level between the community members and CHF implementing partners. Speci cally, community engagement assumed a top down approach, whereby community members were mainly involved during the implementation process.…”

Section: Discussionmentioning

confidence: 99%

An Assessment of the Implementation of the Re-structured Community Health Fund in Gairo District in Tanzania

Asantemungu¹,

Maluka²

2020

Preprint

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While the government of Tanzania has been implementing community health fund (CHF) for more than two decades, the uptake of the scheme has been persistently low due to management and performance problems. As a response, from 2011 a new initiative was adopted that changed the overall structure, management and benefit packages of the CHF. This paper assesses the implementation of the newly re-structured CHF in Gairo District in Morogoro Region. This study employed a descriptive qualitative case study design using three types of data collection techniques, namely individual interviews (n=14), focus group discussions (n=4) and document review. A thematic approach was used to analyse the data. Findings show that the re-structured CHF has improved the pooling and provider payment mechanism compared to the old CHF. Benefit packages have been expanded to include referral services up to regional level. However, stakeholders, including community members, had negative perceptions of the restructured CHF owing to high annual premium rates, low incentive to enrolment officers, weak registration network and poor quality of health care services. In order to improve CHF performance and achieve universal health coverage, the central Government needs to invest more in the improvement of the quality of health care services, particularly availability of drugs and medical supplies. Additionally, the government should make CHF scheme compulsory to all members of the community who do not have alternative health insurance.

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“…In a Tanzanian decentralized health care system, HFGCs were introduced in 1999 during the health sector reforms [21]. The HFGCs are composed of elected community members and health facilities in charge [22].…”

Section: Introductionmentioning

confidence: 99%

The Governance of Pandemics in Primary Health Care: The Governance Strategies Adopted by Health Facility Governing Committees in Times of COVID Pandemic in Tanzania

Kesale

Mahonge

Muhanga

2022

Preprint

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The governance of COVID 19 in Lower and Middle-Income Countries (LMICs) is very critical for curbing its effects. However, it is unknown what governance strategies are adopted by Health Facility Governing Committees (HFGCs) s as a response to the pandemic. We employed an exploratory qualitative design to study the governance strategies adopted by HFGCs during the COVID19. Since COVID 19 is new, an inductive approach was used as it involves analyzing collected data with little or no predetermined theory for the study. A purposive sampling technique was employed in which multistage clustered sampling was used to select regions, councils, health facilities and respondents. In-depth interviews with HFGCs chairpersons and Focus Group Discussions with members of HFGCs were used to collect data. The data were analyzed based on the themes which emerged during data collection. We found five governance strategies that were found to be commonly adopted by many HFGCs which are financial allocation, re-planing, mobilization of resources, community sensitization and mobilization of stakeholders. however, these governance structures were not all adopted by all HFGCs. The HFGCs slowly adopted governance strategies in the times of COVID 19 pandemics because were unprepared. Despite being empowered by the Direct Health Facility Financing, still, the newest of the COVID 19 has been a challenge to many HFGCs. This calls for urgent capacity building for governance institutions on how to deal will pandemics in primary health facilities.

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Decentralisation of Health Systems and the Fate of Community Health Fund in Tanzania: Critical Review of High and Low Performing Districts

Cited by 13 publications

References 19 publications

Equity in the public social healthcare protection in Tanzania: does it matter on household healthcare financing?

Equity in the public social healthcare protection in Tanzania: does it matter on household healthcare financing?

An Assessment of the Implementation of the Re-structured Community Health Fund in Gairo District in Tanzania

The Governance of Pandemics in Primary Health Care: The Governance Strategies Adopted by Health Facility Governing Committees in Times of COVID Pandemic in Tanzania

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