Toward mandatory health insurance in low‐income countries? An analysis of claims data in Tanzania

Durizzo, Kathrin; Harttgen, Kenneth; Tediosi, Fabrizio; Sahu, Maitreyi; Kuwawenaruwa, August; Salari, Paola; Günther, Isabel

doi:10.1002/hec.4568

Cited by 17 publications

(15 citation statements)

References 89 publications

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“…The current Health Sector Strategic Plan (HSSP V, 2021-2026) aims to increase health insurance coverage to 56% of the population (from 32% in 2018; Durizzo et al, 2022) and raise government health spending to 5% of the gross domestic product (GDP) by 2026 (from 3.8% in 2019; WHO, 2022) to achieve Universal Health Coverage. However, despite plans for unified financial protection under the forthcoming Single National Health Insurance (SNHI) (planned for launch in July 2023), the current arrangements remain highly fragmented with separate mechanisms and funds for formal and informal sector workers.…”

Section: Resultsmentioning

confidence: 99%

Tanzanian social policy in the new millennium – a cross-sectoral analysis from a gender perspective

Lambin,

Nyyssölä

2024

IJSSP

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PurposeMainland Tanzania has seen two decades of significant social policy reforms and transformations in its social and economic structures, whilst the country continues to grapple with persisting gender inequalities. This article examines Tanzania's social policy developments from a gender perspective. The authors analyse the level, reach and quality of social policy delivery to working-age women across the areas of health policy, social protection and employment policy during 2000–2021.Design/methodology/approachThe article draws on qualitative research deploying the scoping review method. The data consist of diverse secondary materials, including academic publications, government policy documents, relevant statistics and other types of “grey” literature.FindingsTanzania has made significant advancements in the legal frameworks around welfare provision and has instituted increasingly gender-responsive government policy plans. The health and social protection sectors, in particular, have witnessed the introduction of large-scale measures expanding social policy implementation. However, social policy delivery remains two-tiered, with differences in provisions for women in the formal and informal sectors.Originality/valueSocial policy delivery and implementation have increased and diversified in Sub-Saharan Africa (SSA) during the new millennium, with a growing integration of gender-specific policy objectives. However, limited social policy scholarship has focused on the gendered effects of broader social policy models in SSA. The article remedies the concomitant knowledge gaps by examining various social policies and their impacts on working-age women in Mainland Tanzania. The authors also engage with the theoretical welfare regime literature and present an analytical framework for gender-sensitive assessment of emerging social policy models in the Global South.

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Section: Resultsmentioning

confidence: 99%

Tanzanian social policy in the new millennium – a cross-sectoral analysis from a gender perspective

Lambin,

Nyyssölä

2024

IJSSP

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“…In Tanzania, only 32% of the population had health insurance as of 2018 14. The NHIF is the most comprehensive health insurance programme in Tanzania and covers 7% of the population based on the number of beneficiaries reported in the NHIF Annual Report from 2020/2021 15.…”

Section: Methodsmentioning

confidence: 99%

Investigating sustainability challenges for the National Health Insurance Fund in Tanzania: a modelling approach

Osetinsky,

Fink,

Kuwawenaruwa

et al. 2023

BMJ Open

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ObjectiveThis study aimed to model the long-term cost associated with expanding public health insurance coverage in Tanzania.Design, setting and participantsWe analysed the 2016 claims of 2 923 524 beneficiaries of the National Health Insurance Fund in Tanzania. The analysis focused on determining the average cost per beneficiary across 5-year age groups separated by gender, and grouped by broad health condition categories. We then modelled three different insurance coverage scenarios from 2020 to 2050 and we estimated the associated costs.Outcome measuresAverage cost per beneficiary and the projected financing requirements, projected from 2020 to 2050.ResultsThe analysis revealed that the average per beneficiary cost for insurance claims was $38.58. Among males over 75 years, the average insurance claims costs were highest, amounting to $125. The total estimated annual cost of claims in 2020 was $151 million. Under the status quo coverage scenario, total claims were projected to increase to $415 million by 2050. Increasing coverage from 7% to 50% would result in an additional financing requirement of $2.27 billion. If coverage would increase by 10% annually, reaching 56% of the population by 2050, the additional financing need would amount to $2.84 billion.ConclusionThis study highlights the critical importance of assessing the long-term financial viability of health insurance schemes aimed to cover large segments of the population in low-income countries. The findings demonstrate that even without expansion of coverage, financing requirements for insurance will more than triple by 2050. Furthermore, increasing coverage is likely to substantially escalate the cost of claims, potentially requiring significant government or external contributions to finance these additional costs. Policymakers and stakeholders should carefully evaluate the sustainability of insurance schemes to ensure adequate financial support for expanding coverage and improving healthcare access in low-income settings.

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“…An interesting study [ 33 ] based on data from Tanzania revealed patterns and consequences of expanding the network of mandatory health insurance coverage for low-income countries. According to the results of the analysis, it was established that expanding the coverage network could negatively affect the financial stability of institutions that serve such applicants.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Impact of Coronavirus Disease COVID-19 on the Relationship between Healthcare Expenditures and Sustainable Economic Growth

Vysochyna

Vasylieva

Dluhopolskyi

et al. 2023

IJERPH

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The coronavirus disease (COVID-19) pandemic led to a catastrophic burden on the healthcare system and increased expenditures for the supporting medical infrastructure. It also had dramatic socioeconomic consequences. The purpose of this study is to identify the empirical patterns of healthcare expenditures’ influence on sustainable economic growth in the pandemic and pre-pandemic periods. Fulfilment of the research task involves the implementation of two empirical blocks: (1) development of a Sustainable Economic Growth Index based on public health, environmental, social, and economic indicators using principal component analysis, ranking, Fishburne approach, and additive convolution; (2) modelling the impact of different kinds of healthcare expenditures (current, capital, general government, private, out-of-pocket) on the index using panel data regression modelling (random-effects GLS regression). Regression results in the pre-pandemic period show that the growth of capital, government, and private healthcare expenditures positively influence sustainable economic growth. In 2020–2021, healthcare expenditures did not statistically significantly influence sustainable economic growth. Consequently, more stable conditions allowed capital healthcare expenditures to boost economic growth, while an excessive healthcare expenditure burden damaged economic stability during the COVID-19 pandemic. In the pre-pandemic period, public and private healthcare expenditures ensured sustainable economic growth; out-of-pocket healthcare expenditures dominantly contributed to the pandemic period.

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Toward mandatory health insurance in low‐income countries? An analysis of claims data in Tanzania

Cited by 17 publications

References 89 publications

Tanzanian social policy in the new millennium – a cross-sectoral analysis from a gender perspective

Tanzanian social policy in the new millennium – a cross-sectoral analysis from a gender perspective

Investigating sustainability challenges for the National Health Insurance Fund in Tanzania: a modelling approach

Impact of Coronavirus Disease COVID-19 on the Relationship between Healthcare Expenditures and Sustainable Economic Growth

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