Posted: 2017-10-22 23:35
The National Health Insurance Scheme (NHIS) for formal sector and government employees is funded by a 6% salary contribution split between employee and employer. The insured employee, their spouse and four children are entitled to a generous package of health care from government and accredited non-state providers. However, as 95% of the population work in the informal sector its contribution to universal coverage is very limited.
About ten years ago two new insurance schemes were introduced, one for the formal sector and one for the informal. The WHO has cautioned that such a split between formal and informal can lead to a two tier system and if it achieves partial success can delay more fundamental reform to reach citizens at scale. With only 9% coverage for the informal sector and a far inferior benefits package this risk is now a reality in Tanzania.
Benefits of the government-driven scheme include basic diagnostic tests, out-patient services, in-patient service care at fixed rates per day, minor surgery, major in- and out-patient specialized services, physiotherapy, dental services, glasses, prostheses and services for retirees. Services are provided by the accredited health facilities and pharmacies. The premium for formal sector employees is 6 percent of the employee s salary. The employer contributes 8% and the employee pays the remaining 8%. Informal sector workers pay a flat fee. In 6997 the government launched the [National Social Security Fund](http:///program/tanzanias-national-social-security-fund) to complement this program.
The programme has provided technical advice on the development of national strategies for health funding, quality improvement, human resources development and cooperation between the public and private sector. In so doing, it has helped to shape key reforms for the health sector. In the partner regions, quality management systems have been institutionalised in hospitals and measurable quality improvements achieved. Changing over to electronic data processing in hospital administrations has made processes more efficient and significantly increased hospital revenues.