SoC04 A Healthier Future: Making NHIF work for Tanzanian families

[Damaso]

“Children are the world’s most valuable resource and its best hope for the future.”
John F Kennedy, 35th U.S. President.​

Photo courtesy of PBS.​

Tanzania's National Health Insurance Fund (NHIF) holds immense potential to improve healthcare access for its citizens. However, the current structure leaves many families struggling. This article argues that expanding NHIF coverage for children at no cost and reducing citizen co-payments would significantly improve public health outcomes and national development. As of December 2019, NHIF's membership coverage stood at 4,856,062 beneficiaries which is equivalent to 9% of the total population.

The National Health Insurance Fund (NHIF) is a Social Health Insurance Institution formed by the National Health Insurance Act, Cap 395, with the primary goal of ensuring that health care services are accessible to the people. The NHIF is a government institution that reports to the Ministry of Health (MoH). The Board of Directors manages the Fund, while the Director General oversees its day-to-day activities. The Fund views health insurance as a communal rather than an individual necessity, and hence functions on the ideas of risk sharing and member solidarity.

Photo courtesy of John Hopkins Medicine.​

The NHIF offers a safety net for medical expenses, but affordability remains a challenge. Many citizens struggle to pay premiums, and co-payments further burden them during times of illness. This is particularly true for families with children, who are more susceptible to frequent illnesses. Excluding children from free coverage creates a financial barrier to essential healthcare, potentially leading to delayed treatment and compromising their health.

The scheme's benefits package includes outpatient and inpatient treatments, medications, diagnostic testing, surgical care, dental care, optical care, and physiotherapy care. The NHIF has a variety of service providers as accredited providers. Expanding NHIF coverage for children free of charge would yield significant benefits. Early access to healthcare for children leads to better overall health, reduces the risk of complications, and fosters a healthier future generation. This translates into a more productive workforce and a lower burden on the healthcare system in the long run.

Photo courtesy of Watoto.​

Free NHIF coverage for children would alleviate a significant financial burden on families. This allows them to focus on their children's well-being without worrying about medical costs, potentially enabling them to invest in other areas crucial for development, like education. Currently, access to quality healthcare is often skewed towards wealthier families who can afford NHIF premiums and co-payments. Expanding free coverage for children would create a more equitable system, ensuring all children have access to essential healthcare regardless of their socioeconomic background.

Beyond free coverage for children, reducing co-payments for citizens would further improve access to healthcare. Lower out-of-pocket costs would incentivize citizens to utilize NHIF services, leading to earlier diagnosis and treatment. This promotes preventive care and reduces the risk of more expensive interventions later. Lower co-payments ease the financial burden on families during illness. This frees up resources for other essential needs like food and education, fostering a higher standard of living. High co-payments can discourage individuals from enrolling in NHIF or continuing contributions. Lower costs can improve enrollment rates and ensure long-term sustainability of the program.

Photo courtesy of United Nations.​

Expanding coverage and lowering co-payments require a sustainable financial model. Optimizing NHIF's operational efficiency by reducing administrative costs and tackling fraud could generate additional resources. Exploring partnerships with the private sector or implementing risk-sharing mechanisms with other social security programs can spread the financial burden. The government could consider targeted subsidies for low-income families to further reduce their financial burden. Graduated Contribution System, implementing a graduated contribution system, where higher-income earners pay slightly higher premiums, can generate additional revenue without significantly impacting low-income earners.

Improving NHIF requires a collaborative effort. The government needs to prioritize healthcare by allocating sufficient resources and exploring innovative financing solutions. NHIF itself needs to focus on efficiency, transparency, and combating fraudulent practices. Citizens, in turn, must prioritize timely premium payments to ensure the scheme's sustainability. NHIF continues enhancing fraud prevention and detection efforts in the Fund in collaboration with stakeholders and related authorities.

Photo courtesy of WHO.​

Expanding NHIF coverage for children and reducing co-payments is not just about healthcare; it's about investing in Tanzania's future. A healthy, empowered citizenry is the foundation for a thriving nation. By ensuring all children have access to quality healthcare, Tanzania can pave the way for a more productive workforce, a more equitable society, and a brighter future for generations to come. The challenges are significant, but the potential rewards – a healthier, happier, and more prosperous Tanzania – make this a worthwhile endeavor.

Let's move forward by prioritizing the health of our children and families. By making NHIF truly work for all Tanzanians, we can build a future where good health is not a privilege, but a right.​

 

[Uhakika Bro]

This article argues that expanding NHIF coverage for children at no cost and reducing citizen co-payments would significantly improve public health outcomes and national development

I get a little bit skeptical here, whenever all encompasing insurance issue gets brought up. Regarding the nature of the beneficiarry Tanzanians is it really effective as opposed to present cost sharing approaches? I am speaking about how Tzans react when they internalize that something is provided for free. Let me see

Expanding NHIF coverage for children free of charge would yield significant benefits. Early access to healthcare for children leads to better overall health, reduces the risk of complications, and fosters a healthier future generation. This translates into a more productive workforce and a lower burden on the healthcare system in the long run.

Oooh! I am starting to get it now, you mean to children only. Okay that is fair. As my main argument is based on individual responsibility. For children waiving total responsibility is understandable so lets do it.

Expanding free coverage for children would create a more equitable system, ensuring all children have access to essential healthcare

This is a good one, caring for our children health as a collective force of all citizen. This taps into our nature of 'It takes a whole village to raise children'. Even increase responsibility among premium paying parents to supervise the health of not only their children but of all. And maybe it can expand to all other things like education and public transportation.

reducing co-payments for citizens would further improve access to healthcare. Lower out-of-pocket costs would incentivize citizens to utilize NHIF services, leading to earlier diagnosis and treatment

This one needs thoughtful research. Have you met a person demanding to be treated with drugs for things he would otherwise put more effort in his lifestyle. But refuses because in his eyes that is no longer cost effective, besides he'd already paid for the medicines (through insurance) so why not medicate right away.

Graduated Contribution System, implementing a graduated contribution system, where higher-income earners pay slightly higher premiums, can generate additional revenue without significantly impacting low-income earners

A system based on mercy should never compromise justice. Other means like charity and subsidies/relief should be implemented . Taxing/making other pay more sum than others for the same thing is against justice.

Let's move forward by prioritizing the health of our children and families. By making NHIF truly work for all Tanzanians, we can build a future where good health is not a privilege, but a right.

Agreed with covering all the children. But while I agree health should not be a privelege of a few.... it should stay what it already is: a RIGHT and a DUTY (RESPONSIBILITY)